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PubMedDate not supplied

CDH diagnosed at 2 to 12 months of age--treatment and results.

A treatment program for late-diagnosed CDH included skin traction, arthrography, tenotomy of adductor and psoas tendons, and immobilization of the hips in the "frog leg" position with a plaster cast for 8-12 weeks, followed by an abduction frame until the acetabular dysplasia normalized. Follow-up of 40 children with nonteratological CDH performed 2-12 years after diagnosis revealed 38 normal hips and 2 patients with coxa magna, one of whom had intermittent hip pain.

Casts, Surgical↗
PubMed1988

[Conservative treatment of elbow dislocations].

Ligamentous injuries following dislocations of the elbow joint are a primary indication for nonsurgical treatment. The principles of closed reduction are longitudinal traction of the forearm, followed by flexion. The period of immobilization in a plaster cast should be decided on an individual basis. For elbows that show no tendency to redislocate, immobilization for no more than 1 week should suffice. For elbows with a tendency to redislocate 2-3 weeks' immobilization is recommended. Radiological follow-up shows a high percentage of degenerative changes, i.e. subchondral sclerosis, osteophytosis, periarticular calcification, irregularities in the epicondyles. In addition to slight degenerative changes, there are few subjective complaints and functional impairments. Now evidence has been found to recommend primary surgical treatment of ligamentous injuries associated with dislocation of the elbow.

Casts, Surgical↗
PubMed1988

The effect of ipriflavone treatment on osteoporosis induced by immobilization.

The purpose of these experiments was to study the effect of Ipriflavone (7 isopropoxy-isoflavone) on the osteoporosis induced by immobilization. The immobilization was produced by plaster cast of the right hind limb in young and old rats. Ipriflavone was administered via a gastric tube in a daily dose of 40 mg/kg body weight for 8 weeks. On the basis of histological and histomorphometric examinations of the tibia, results of Ipriflavone treatment are the following: 1) The decrease in the density and volume of spongy trabecules was less apparent in both meta- and diaphysis; 2) The amount of persisting cartilage core and structural rarefication of trabecules were diminished; 3) In the metaphysis osteoblastic activity was considerably enhanced; 4) Bone resorption and cortical thinning were decreased; 5) Bone remodeling was increased subperiosteally and to small extent also endosteally; 6) The treatment did not prevent the development of osteoporosis but significantly diminished it.

Aging↗
PubMed1985

Physically corrected orthogonal electrocardiographic lead systems in macaques and baboons.

The adequacy of various physically corrected electrocardiographic lead systems for lower primates was compared with the aid of physical models of the cardiac electrical field. Electrolytic tanks fashioned from plaster casts of the thorax of young adult male and female macaques and baboons were used. A dipole source situated at different points in the heart region simulated the electrical activity of the heart. Statistical evaluation and reciprocal comparison of the resultant parameters showed that the proposed modification of the McFee-Parungao lead system for macaques and baboons was most satisfactory, followed by the human variant of the same lead system and then by the variant for dogs. The greatest variability was displayed by parameters determined from measurements made with Frank's lead system, which was ranked last in the evaluation.

Animals↗
PubMed1988

Treatment in fractures of the odontoid process.

Fifty-eight cases of odontoid fractures treated at Keio University Hospital and affiliate hospitals from 1965 through 1985 were reviewed. Six patients under age 7 years (group A), were characterized as having epiphysiolysis. Among 52 patients over 8 years of age (group B), there were two Type I, 31 Type II and 19 Type III fractures. All cases in group A were treated conservatively by a plaster cast or a neck brace, and achieved bony union in 6 to 27 weeks. Five of 24 fractures in group B, treated conservatively, failed to unite. Nineteen cases of Type II and six cases of Type III were treated surgically. Transoral fusion was performed in six cases, internal fixation using a compression screw in ten, bone peg fixation in one, posterior fusion in eight, and posterior decompression in one. Two cases treated with transoral fusion and two with screw fixation failed to unite. We recommend conservative treatment of group A patients, Type I, and acute cases of Type III with minimal displacement in group B. Surgery should be performed in acute cases of Type II, Type III with significant displacement, and nonunion cases in Type II and Type III.

Adolescent↗
PubMedDate not supplied

A scintimetric study of Colles' fracture. Comparison between cementation and closed treatment.

In order to study whether bone cement (methylmethacrylate) inserted in the medullary cavity of redisplaced Colles' fractures to fill the dorsal defect arising after repeat reduction is an obstacle to bony union, the course of healing was monitored by scintimetry in fractures thus treated (n = 10), in fractures treated by external fixation (n = 10), and in undisplaced fractures immobilized in a plaster cast. No differences emerged between the three groups. It is therefore assumed that the insertion of bone cement does not disturb the healing process.

Aged↗
PubMed1988

[Evaluation of the results of conservative treatment in cases of chronic lateral epicondylitis of the humerus in workers in the metal industry].

The causes of occurrence of tennis elbow (epicondylitis humeri lateralis) in metal workers were analyzed. It has been found that the disease occurred most often in locksmiths and turners with over 20 years of service. After treatment of 35 patients which consisted in transfer to light work, paying respect to plaster cast immobilization, injections in the region of the muscular insertions and physical therapy, good results were achieved enabling 21 patients to resume their jobs.

Adult↗
PubMed1988

[Acute management of spinal injuries. The cervical spine, conservative therapy].

Stable injuries of the cervical spine can be treated with a cervical collar. Unstable injuries that do not require repositioning can be immobilized with a Minerva plaster cast. Crutchfield's extension is used for extension of short duration during repositioning before setting a cast or performing surgery and for long-term extension in cases of transverse lesions of the spinal cord. The Halo apparatus is especially suitable for treatment requiring extension of long duration when there are no symptoms of transverse lesions of the spinal cord.

Atlanto-Axial Joint↗
PubMed1988

Cleft lip and palate in Denmark, 1976-1981: epidemiology, variability, and early somatic development.

The present investigation describes the incidence and variability of the primary cleft condition in all Danish infants born with cleft lip, cleft palate, or both, from 1976 to 1981 and analyzes general somatic growth from birth to age 22 months. Because of excellent sampling conditions in Denmark, the study material is nearly complete. Six hundred and seventy-eight infants with facial clefts were born during the period, corresponding to 1.89 per 1,000 of all newborns. Six hundred and two patients were examined--most of them twice: at 2 months and at 22 months. Material uptake included plaster casts of the upper jaw, cephalometric films in three projections, anthropometric registrations, and information from hospital charts. A detailed grading of the clefts according to severity was carried out. Sex distribution was 61% males and 39% females, of whom 34% had isolated cleft lip, 39% combined cleft lip and palate, and 27% an isolated cleft palate. Left-sided clefts were most frequent. In the combined cleft lip and palate group, 90% exhibited subtotal or total clefts, whereas the clefts were less severe in the isolated cleft lip and isolated cleft palate patients. Birth weight and length showed values close to the average for Danish newborns, but a lag was seen in infants in whom severe palatal cleft was included. The extended method of classification was suggested to select subgroups for special care.

Body Height↗
PubMed1988

[Distal radius fracture].

The treatment of fractures of the distal radius is in a state of flux, because the results of conservative treatment have so far been unsatisfactory in 20%-30% of cases. Instability resulting from dorsal compression, damaged ligaments (60%) and the presence of débris in the area of the metaphysis means that, while reduction is easy, retention is frequently difficult to achieve. Such fractures are reduced by using the ball of the little finger for extension while the ball of the thumb is positioned under the proximal fragment to provide support. A plaster cast based on the principle of three-point fixation is applied to immobilize the fractured part. The simplest surgical technique for unstable fractures of the distal radius is internal fixation with crossed Kirschner wires. For Smith's fractures [41], and especially those of type II (Thomas [44]), internal fixation with plates fixed to the volar bone surface is the procedure of choice. Comminuted fractures of the metaphysis and a tendency to shortening should be immobilized by external fixation. Early filling of the defect with cancellous bone leads to more rapid consolidation. In our own clinic we treated 409 cases of fracture of the distal radius in 2 years. The procedures applied were: conservative treatment in 39.6% of cases; internal fixation with wires in 55%; internal fixation with plates in 3.7%; and stabilization by means of external fixation in 1.7%.

Fracture Fixation, Internal↗
PubMed1988

Volume changes occurring in postoperative below-knee residual limbs.

Comparative maturation rates of 36 below-knee postoperative, healed amputation residual limbs were observed. Measured were the limb volumes and circumferences. Three methods of residual limb stabilization were employed: 1) elastic wrap; 2) plaster cast and pylon; and, 3) plastic laminate socket and pylon. The limbs receiving the plastic laminate showed the most rapid stabilization, while the elastic wrap did not stabilize. Considerable variance existed in relations between variables. Correlation between limb circumference and volume was poor. However, in general, the rates of change, i.e., the relations between volume and time, and circumference and time, were statistically significant (p less than .05).

Amputation Stumps↗
PubMed1988

Anterior and posterior marginal fracture-dislocations of the distal radius. An analysis of the results of treatment.

Anterior and posterior marginal fractures of the distal end of the radius associated with dislocation of the carpus are rare injuries. The results of 20 patients with 12 anterior and eight posterior marginal fracture-dislocations of the distal radius were reviewed. Eleven patients had closed reduction and plaster cast immobilization, including three with external fixation, while nine patients required surgery and internal fixation. At a mean of 3.2 years, 40% were rated as excellent, 45% as good, 5% as fair, and 10% as poor. There was roentgenographic evidence of posttraumatic arthritis in 13 patients (65%). Major factors affecting the clinical results were accurate articular realignment and the presence of ipsilateral carpal injuries. There were no significant differences in results between anterior and posterior marginal fractures or between closed or operative methods of treatment when the radiocarpal articular surface was restored to less than 1 mm residual displacement. Restoration of articular congruency is the primary goal of management of these fractures.

Adult↗
PubMed1977

[Growth, orthodontics and orthopedics, by Pierre Fauchard (1928), Hendrik Van Deventer (1739) and Nicolas Andry (1740)].

In the eightteenth century (by Fauchard) and orthopaedics (by H. Van Deventer, a Dutch surgeon) have been founded independently as practcal sciences without the faculties of medicine. The famous book of Andry, "L'orthopédie", also translated in English (1743), has not been written for the medical profession. It deals only with "such means as may easily be put in practice by Parents themselves, and all such as are employed in Educating children". Nevertheless it states precisely the name of the speciality and defines some ethical, aesthetical and physiological principles also applicable to orthodontics. This is also the case for H. Van Deventer, who was the first to take plaster casts before, during and after treatment.

Belgium↗
PubMed1988

[Lengthening of the triceps surae muscle in children with motor disorders of cerebral origin performed before the age of 6. Results at the end of growth].

Thirty-seven patients with cerebral palsy aged between two and six years had a lengthening of the triceps by various methods: gastrocnemius recession alone or combined with soleus lengthening (Green), lengthening of the tendon Achilles by the Green method, or by Z-lengthening. All were reviewed at the end of growth. Recurrence was more frequent, in two cases out of four, in those operated on before the age of three years. There were four recurrences out of 10 in those operated on between three and four years and four out of 23 among those between four and six years. There were three cases of talus, only one of which was severe in a child who had not yet walked. There was no other deterioration of function. In six cases operated on before they had begun to walk, two did not achieve walking because of the severity of their motor state. Recurrence was more frequent in hemiplegic than in diplegic children. Operative technique must be precise. Lengthening of the tendon Achilles is preferable to gastrocnemius recession. Plaster casts are kept on for three weeks. Whilst splintage is ultimately unnecessary, it is necessary to re-educate the triceps muscle.

Cerebral Palsy↗
PubMed1988

Treatment of open tibial-shaft fractures. External fixation and secondary intramedullary nailing.

Between 1979 and 1986, sixteen of 369 open fractures of the tibial shaft were treated by external fixation followed by intramedullary nailing. These fractures comprised one Type-I, two Type-II, and thirteen Type-III injuries. This method of treatment was the original treatment plan in nine patients (56 per cent), for delayed union while the external fixator was still in place in four patients (25 per cent), for loss of reduction in a plaster cast in two patients (13 per cent), and for osteomyelitis and a segmental defect in one patient (6 per cent). The average duration of external fixation was 8.5 weeks; the average time between removal of the external fixator and intramedullary nailing, three weeks; and the average time between injury and nailing, twelve weeks. All sixteen patients were followed until either the fracture had united (eleven patients) or there was an established non-union (five patients). At that time, seventeen additional procedures were performed, including bone-grafting, fibulectomy, and re-nailing. Only five of the sixteen fractures healed without additional surgical procedures or major complications. The five fractures that progressed to a non-union were all Type III, and all were complicated by a deep infection. Over-all, the complications included seven deep infections (an intramedullary infection in four patients, osteomyelitis in two, and a chronic draining sinus associated with a ring sequestrum in one); five minor infections during external fixation, which developed into five of the seven deep infections that occurred after the secondary intramedullary nailing; and eight non-unions, three of which progressed to union after multiple procedures. The over-all incidence of non-union was 50 per cent and that of deep infection, 44 per cent. On the basis of the high incidence of complications in both the present series and the few reports in the literature, we concluded that alternative treatment options should be carefully considered before electing this sequential method of fixation.

Adolescent↗
PubMed1987

[Transfixation method--treatment of tibial fracture with external ring fixation--II].

The transfixation method first introduced by Böhler has been modified by means of a self-devised annular fixator and has thus been re-introduced by the authors of this paper, with the view to reducing the drawbacks of conservative and surgical treatment of closed lower leg fractures. Reposition of the fracture is achieved by means of this paper, with the view to reducing the drawbacks of conservative and surgical low. Retention is followed by application of a plaster cast up to the knee, with the Steinmann pins covered. Technique, indication, and results are described. Successful fracture consolidation was achieved in good position and with good functional results in all cases.

Bone Nails↗
PubMed1978

Non-routine extractions in orthodontic treatment.

A four-unit symmetrical premolar extraction case demands meticulous levelling, overjet reduction, space closure, rotating, paralleling and torqueing to justify the gambit of having extracted the teeth at the commencement of treatment. This involves the patient in complex therapy which may, for any of several reasons, be contra-indicated for that particular patient, though a decision based on the plaster casts alone may have upheld such an approach. The purpose of this article is to discourage automatic decisions to extract first premolars in orthodontic extraction cases. The clinician is offered a classification of special cases in which an alternative should be sought, based on careful consideration of the general dental, facial, physical, psychological and economic state of the patient.

Acute Disease↗
PubMed1987

[Evaluation of the mid-term results of trident osteotomy using orthodontic goniometry].

The authors study a series of twenty patients who underwent a "trident" maxillary osteotomy for transversal deficiency. They try to have a good evaluation of the exact value of the inter-molar distance after one year, in comparison with the expected value on the plaster casts before operation. Furthermore, they measure the axial modifications of the first molar, which consists in vestibulo or linguo version. For this study, they use a simple method which is called "orthodontic goniometry" and give a great precision. The transversal augmentation seems to be quite stable, with only fifteen per cent lost in the measured intermolar distance. But there are dental axial changes in eighty per cent of the patients. The most common modification consist in vestibular inclination, without damage for the result. But in thirty per cent of the cases, a palatal inclination is observed, with deterioration of the results. This is a good reason for maintaining a palatal contention during at least six months after surgery.

Adolescent↗