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At least 1,603 records · Page 89Linked to original sources
PubMed1990

[Ambulatory management of idiopathic scoliosis using the Lyon orthopedic treatment. 70 cases reviewed].

This work tries to clarify the place which is due to the modified Lyons orthopaedic treatment of scolioses. Actually, nowadays, because of progress in surgery, some people abandon all orthopaedic treatment which caught severe progressive scolioses at the end of the growth period. The study covers 70 patients from a minimum distance of 3 years after the end of orthopaedic treatment. The treatment, in comparison with the classical Lyons treatment has two principle modifications: sequence protocol plaster then corset, purely external, not necessitizing hospitalisation or a stay in a specialised centre; and the use of resine which lightens the plaster. The results are given in angular loss as regards to the end of treatment, according to 3 factors; chronological form of the scoliosis, localization of the scoliosis, degree of the initial curvature. It emerges that in spite of the absence of hospitalisation at the beginning of the treatment, the results are comparable to those in literature (8, 19). We obtained 39 stabilizations of progression, 8 moderate aggravations without ulterior surgery, that is 67% good results. Our study confirms the high failure rate of orthopedic treatment of initial scolioses of 50 degrees and more (50%); compared to initial scolioses of 49 degrees to 20 degrees (29%); of dorsal scolioses (42%) compared to lumbar scolioses (18%); of child scolioses (40%) compared to adolescent scolioses (17%). It leads us to keep the Lyons treatment for progressive scolioses of 25 degrees to 40 degrees, from the start of puberty, or as preparation for surgical treatment.

Adolescent↗
PubMed1990

Tc-99m HM-PAO labelled leucocyte scanning for detection of infection in orthopedic surgery.

The use of labelled granulocyte scintigraphy is recognized as a reliable method for detecting osteomyelitis and other skeletal sepsis. Tc-99m hexamethyl propyleneamine oxime (Tc-99m HM-PAO), a lipophilic chelate offers the advantages of availability, lower radiation dose and higher image resolution, compared to other labelling agents. We have scanned 36 orthopedic patients with suspected infection, using autologous granulocytes labelled with Tc-99m HM-PAO. In all cases, scans were compared with clinical, microbiological and/or surgical findings. Sensitivity was 94% and specificity was 80%. We therefore believe that Tc-99m HM-PAO leucocyte scanning provides a useful method for detecting osteomyelitis and other skeletal infections.

Adolescent↗
PubMed1990

[Intraoperative autologous blood transfusion. Value in major orthopedic surgery].

Intra-operative autologous blood transfusion (IAT) employing a cell separator has proved an effective and safe means of reducing the amount of homologous blood needed for major orthopedic operations. Homologous blood was required in only 15 or 26% of patients, who underwent cemented or uncemented total hip replacement. This is significantly less than in a control group without IAT, in which homologous blood was required in 65 and 71% respectively. In 33% of patients, who had an operation of the spine and in 35% of cases of revision total hip surgery homologous blood was necessary in addition to IAT. We feel, that preoperative blood donation is indicated in addition to IAT, in total hip revisions, major surgery of the spine, as well as in special situations when a total hip replacement is planned.

Blood Transfusion, Autologous↗
PubMed1988

Fibrin sealant in orthopedic surgery.

The use of clotting substances from blood for hemostasis dates back to 1909. In 1972, modern fibrin sealing (FS) was developed in Vienna. For application, the two components, i.e., a sealer protein solution (mainly fibrinogen) and a thrombin solution, are mixed to produce the fibrin clot. The sealant may be applied with a needle, as a spray, or by premixing (e.g., with antibiotics, bone chips) for subsequent sealant application in cavities. While the positive effect of FS in normal wound healing has been conclusively demonstrated, its influence on bone healing remains controversial. The positive experimental results mostly refer to the early phase of bone healing in rabbits (cortical drill hole, autologous and heterologous (Kiel) cancellous transplants, osteotomies, osteochondral fractures) and dogs (cortical bone and spongiosa defects). Some authors observed no effects (in dogs, osteotomy) or delayed healing in artificial bone growth chambers with the use of heterologous sealant. FS was also applied in combination with implantation material (tricalcium phosphate and bone gelatin) to facilitate application. Clinical results are especially convincing as to osteochondral fractures, repair of the Achilles tendon, and in hemophiliacs. Fibrin sealant facilitates hemostasis, permits tissue fixation, enhances plasticity of granular implant material, and stimulates fibroblast growth. Although its direct osteogenic effect remains questionable, fibrin sealant is known to be an excellent tool in orthopedic and trauma surgery.

Animals↗
PubMedDate not supplied

[Terminological problems of orthopedic stomatology].

The author discusses the term orthopedic stomatology used only in the Soviet and Bulgarian literature implying prosthetic treatment in the maxillofacial region and oral cavity, proposing its substitution for a more appropriate and officially accepted, on a world-wide scale, named prosthetic stomatology. In this way, the aim is the elimination of the incorrect terms out of the scientific stomatological language in addition to the achievement of terminological standardization with the other countries throughout the world.

Bulgaria↗
PubMed1989

[Practice-relevant, functional analysis for the maxillary-orthopedic consultation].

The author presents a mirror of maxillary-orthopedic, functional analyses for assessment of motions and positions of the lower jaw bone, for examinations of the jaw joint and for registration of the so-called attendant function. The pertinent paper of documentation enables an ergonomically favourable utilization for basic, progress and final examinations, also in an extensive number of patients.

Humans↗
PubMed1989

[Study of internal reaction on the maxilla by orthopedic force].

For the purpose of analyzing deformations and movements in the maxilla loaded by orthopedic force to the maxillary first molar, a three dimensional finite element model of the maxilla was constructed. For modelling of the maxilla, the right side of an adult Indian skull was used. Constructed model was composed of 1,108 solid elements and 1,195 nodes. Materials of this model was composed of compact bone, cancellous bone, teeth and sutures. Constraint condition was fixed adjacent bone side surrounded by sutures. Load was directed from upward to downward 30 degree, changing every 30 degree reference to occlusal plane. Volume of load were weighed at 1 kg for each directions. Results 1. At upward load, stress was transmitted through the lateral wall of the maxillary sinus. The posterior portion of the maxilla was displaced more upward than anterior. Each process of the maxilla and the maxillary sinus was deformed, however, there was no stress on the orbitary surface. 2. At upward 60 degree load, the maxilla was compressed simply to the direction of load. At the upward 30 degree load, it was compressed backward-downward and rotated clockwise together with bending. 3. At backward load, the maxilla was moved backward and rotated clockwise. At downward 30 degree load, the maxilla was moved backward-downward and rotated clockwise. Both loads bended anterior portion of the maxilla and compressed posterior portion. The center of rotation or bending fell on the line joining the frontal process and the zygomatic process. 4. Of all five directions, backward load showed the maximum value of displacement and upward showed the minimum. Concerning with the absolute value of principal stress, backward load showed the maximum and upward 60 degree load showed the minimum. 5. Concerning with the principal stress value of sutures, compressive stress were distributed equally at upward load. However, as the load went to downward direction, it caused stress concentration. Especially, compressive stress in the pterygopalatine suture and transverse palatine suture, extensive stress in the midpalatal suture were especially great.

Adult↗
PubMed1989

[Cranial and facial sutures: embryological aspects, anatomy and effects on orthopedic treatment].

In this work, the AA. have related the principal suture of the skull and the face, analysing the embryonal, functional and anatomic aspects, with particular reference to the times of end of growth and ossification. Furthermore, the AA. had explained the orthopedic appliances which influence, with their action, the activity of specific suture, emphasizing the growth period in which they are more efficient in the correction of the various dentofacial disharmonies.

Adolescent↗
PubMed1987

Orthopedic aspects of competitive swimming.

Orthopedic problems related to competitive swimming are rarely disabling, but can be problematic in preventing training and competition. Most problems are related to the shoulder and knee. Treatment is primarily nonsurgical and directed at relieving symptoms and allowing the athlete to continue with swimming practice. Treatment aids such as ice packing, anti-inflammatory medications, muscle stimulation and electrogalvanic stimulation, strengthening exercises, and static stretching are encouraged; upper arm bands and patellar-stabilizing supports can be adapted to training routines.

Athletic Injuries↗
PubMed1988

[Orthopedic problems in children caused by neuromuscular diseases].

In the child, neuromuscular diseases have an affect not only on the soft tissues but also on the skeleton, with consequences regarding statics and locomotion. Problems essentially involve the joints of the lower limb. Certain are due to muscular imbalance, eg. an unstable hip, coxa valga, hyperanteversion or miscellaneous abnormalities of the knee. Others are due to sensory denervation, resulting in "neurological joints". Vertebro-pelvic abnormalities also occur with manifestations, according to the individual case, including tilting of the pelvis, paralytic scoliosis or vertebral dysmorphism. It is easy to understand the importance of awareness of such abnormalities, which can be detected early radiologically, and then subjected to expert evaluation in order to be able to select in good time the most appropriate orthopedic management.

Bone Diseases↗
PubMed1988

Vascular complications in orthopedic surgery.

Vascular complications may be seen secondary to trauma or in the perioperative period following elective surgery. Prompt recognition and correction of these problems are of utmost importance to assure functional viability of the affected extremity. Evaluation may be complicated by the presence of preexisting atherosclerotic occlusive disease in the elderly patient. Relevant points in the history and physical examination include mechanism of injury, preexisting disease, evaluation of motor and sensory function, and presence and character of pulses. Noninvasive vascular studies should be obtained in all patients. Absolute indications for angiography include absent pulses, signs and symptoms of ischemia, a bruit, and a posterior knee dislocation; decreased pulses, a significant hematoma, and proximity of the fracture fragment are relative indications. Controversial issues in the management of combined orthopedic and vascular injuries include the use of internal versus external fixation, the use of prosthetic versus autogenous material, and the need for venous reconstruction. Popliteal artery trauma is still associated with a high limb loss rate, and careful evaluation of knee injuries is necessary. Vascular compromise may also complicate joint replacement surgery. These complications are preventable, and management is greatly simplified by a detailed preoperative evaluation.

Adult↗
PubMed1987

Allografts in orthopedic surgery: a case report and literature review.

Recent advances in orthopedic surgery have reawakened interest in the use of osteochondral allografts. A case is presented of a 32-year-old man who was spared a hemipelvectomy for a huge chondrosarcoma of the pelvis by receiving a massive pelvic allograft. This is apparently the first report of such a procedure being performed in Canada. A history of allografting as well as the fate and immunologic aspects of bone grafts are presented. Bone-banking procedures and the clinical application of allografts in 1986 are discussed.

Adult↗
PubMed1987

Namaqualand hip dysplasia. Orthopedic implications.

Namaqualand hip dysplasia (NHD) is an inherited skeletal disorder that has been identified in 45 persons in five generations of a large family in South Africa. Involvement of the femoral capital epiphyses, which was present in all cases, led to significant orthopedic complications. Hip pain developed between three and 20 years of age and heralded the onset and gradual progression of premature degenerative arthropathy. The patients who were examined were all over 35 years of age; four had been treated by total hip arthroplasty. For appropriate and effective management of this uncommon but well-defined syndromic entity, an early and specific diagnosis is essential.

Adolescent↗
PubMed1986

Prophylaxis with cefamandole nafate in elective orthopedic surgery.

A prospective, randomized, double-blind study was conducted to determine the efficacy of cefamandole nafate in reducing infections in general orthopedic procedures. Of 743 patients initially entered into the study, 715 (362 on cefamandole, 353 on placebo) fulfilled the requirements of the protocol. The infection rate was 1.6% for the cefamandole-treated group and 4.2% for the placebo group. In operations lasting longer than two hours, there were two infections in the cefamandole group and seven infections in the placebo group (p less than 0.05). Staphylococcus aureus and gram-negative bacilli were the common pathogens. Adverse side effects were limited to transient elevations in liver enzymes.

Adult↗
PubMed1985

Computed tomography of orthopedic neoplasms.

CT facilitates diagnosis of orthopedic neoplasms by recognition of both the internal contents of the lesion and its borders with surrounding soft tissues. Involvement of adjacent vital organs and spread within the medullary canal are important for planning resection or amputation. Changes in the size of the lesion may be seen on CT scans following radiation therapy, and metastatic lesions to bone and lungs may be detected with high sensitivity. Biopsy performed with CT guidance is both safe and effective.

Biopsy↗
PubMed1985

Althesin in high risk patients with heart disease in orthopedic surgery.

Althesin was used in 65 patients with heart diseases undergoing orthopedic surgery, alone or in association with neuroleptanalgesic drugs. Patients were classified according to four types of heart diseases: atrial fibrillation in older patients (41.53%), disorders of cardiac rhythm (23.07%), valvular diseases (9.23%), ischemic heart disease (26.15%) and according to the degree of risk (ASA 3 and 4). All patients were carefully studied before the operation, and adequately treated with cardiac drugs in order to reduce heart rate, to reduce blood pressure and to reduce heart failure, whenever necessary. Anesthesia was induced with Althesin in all patients, and maintained with Althesin/N2O/O2 in 24.61% of the cases, and Althesin/N2O/O2/NLA in 75.39% of the cases. No significant changes in heart rate or in blood pressure were observed either during surgery or in the first 24 hours after the operation. There were five deaths in the days after the operation, one of which was due to surgery. One patient was discharged while still in a coma. All the other patients were discharged from the hospital within approximately four weeks from the day of the operation in good general condition. It was concluded that Althesin is a very reliable anesthetic agent for patients with heart diseases.

Adult↗
PubMed1985

Cost of orthopedic injuries sustained in motorcycle accidents.

Fifty-one serial admissions to the orthopedic services at the University of California, Davis, Medical Center, Sacramento, for motorcycle accident trauma with open fractures were reviewed. Fifty-five percent of those tested were alcohol intoxicated at the time of admission. Seventy-five percent carried no insurance of any kind, and for the total group, 72% of the cost of acute hospitalization (+17,704 per patient) was paid by the state of California, with an additional 10% paid by other tax-based sources. Care of motorcycle trauma consumes a substantial portion of public health care funds in California. This could be reduced by legislative action concerning helmet use, licensing, and rigid enforcement of compulsory insurance.

Accidents, Traffic↗