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PubMedDate not supplied

[Hemodynamic effects of flunitrazepam in coronary patients. Postoperative study immediately after digestive tract and orthopedic surgery].

The present study was designed to evaluate the haemodynamic effects of flunitrazepam used for sedation in the post operative period after abdominal or orthopedic surgery. Patients with coronary artery disease (C.A.D.) were divided in two groups; in group II stable cardiac failure was present. Results did not show any significant haemodynamic changes after flunitrazepam in both groups. Flunitrazepam is a haemodynamic secure and valuable agent for sedation during recovery for patients with C.A.D. even in stable cardiac failure.

Blood Gas Analysis↗
PubMed1985

Trends in hip dysplasia control: analysis of radiographs submitted to the Orthopedic Foundation for Animals, 1974 to 1984.

From 1974 through 1984, the Orthopedic Foundation for Animals evaluated 143,218 radiographic submissions representing 151 breeds of dogs. All breeds from which there were 35 or more evaluations had some frequency of dysplasia. Seventy breeds, each with over 100 submissions, were tabulated and ranked according to frequency of hip dysplasia. Frequency of dysplasia varied from 0.6% in the Borzoi to 46.9% in the Saint Bernard. These data were compared with data obtained earlier (1966 to 1973) on evaluations in 38 breeds for changes in frequency. There was significant (P less than 0.05) reduction in frequency of dysplasia in 27 breeds, a significant (P less than 0.05) increase in frequency in only 1 breed (German Shorthaired Pointer), and no significant change in frequency in 10 breeds. The median significant decrease was 22.4%, and the range was from 3.1% in the Chesapeake Bay Retriever to 48.7% in the Keeshond. The reduction in frequency of hip dysplasia demonstrated the value of a control program. There were 5 breeds with a significant (P less than 0.05) decrease in frequency of dysplasia that had over 5,000 evaluations from 1974 to 1984. The decreases in frequency were independent of changes in American Kennel Club registrations for these breeds (a dramatic decline in registrations for the German Shepherd Dog and Old English Sheepdog, and a dramatic increase for the Rottweiler, Golden Retriever, and Labrador Retriever). Frequency regressed linearly in the German Shepherd Dog and Old English Sheepdog, but regressed nonlinearly in the other 3 breeds. The percentage reduction in frequency from the base frequency (1966 to 1973) for these breeds was 17.5% for the German Shepherd Dog, 23.1% for the Old English Sheepdog, 9.1% for the Rottweiler, 10.1% for the Golden Retriever, and 6.8% for the Labrador Retriever.

Age Factors↗
PubMedDate not supplied

Orthopedic problems in hemophilia.

Orthopedic management of the various complications resulting from musculo-skeletal bleeds in the hemophiliac, has now become standard and routine. However, the orthopedist should never minimize the threat of iatrogenic disease resulting from his surgery, or from the hemostatic control necessary for all operations. Operations should be properly indicated with standard and established techniques always being used. The development of antibodies, the risk of wound breakdown and secondary infection, and the need for further operative intervention, all create serious hazards to the hemophiliac patient. The orthopedist must be fully supported by a hematologist and laboratory back-up. Finally he should understand coagulation control and the necessity for its monitoring.

Adult↗
PubMedDate not supplied

Computerized tomography in orthopedic surgery.

Computerized tomography has been demonstrated to be highly effective and accurate in delineating soft tissue and bony cross-sectional anatomy. The technique is very helpful in: (A) delineating the 3-dimensional extents of destructive lesions; (B) defining the nature of lesions by revealing their tissue densities and invasive characteristics; and (C) delineating the cross-sectional anatomy of complex geometric lesions; for example, fractures of the pelvis and spine. These features enable the orthopedic surgeon to better diagnose pathological lesions, plan surgical procedures, screen patients for metastases, and facilitate percutaneous biopsy or aspiration of difficult anatomic sites. While these applications are becoming well established, additional uses are under investigation in the areas of trauma, and in clinical research of metabolic bone disease.

Adenocarcinoma↗
PubMedDate not supplied

Coagulolysis assay in the detection of deep vein thrombosis in the orthopedic patient. A preliminary report.

The recently developed coagulolysis assay was utilized in conjuction with fibrinogen uptake scanning to monitor 91 of 111 consecutive orthopedic patients scheduled for hip surgery or total knee replacement. Sixteen patients had abnormal coagulolysis assays and positive scans. Venography was performed in 15 of these patients, and deep vein thrombosis was documented in 12. Five patients developed pulmonary emboli, including one with negative venogram. Thus, over 80% of the patients in which both the coagulolysis assay and the fibrinogen scan were abnormal had additional documentation of deep vein thrombosis. In 41 patients, the coagulolysis assay was negative. Venograms were not routinely performed in this group. However, 3 patients developed pulmonary emboli indicating that deep vein thrombosis developed in this group. Only one patient had a normal coagulolysis with a positive fibrinogen scan. Venography documented a deep vein thrombosis. Thirty-three patients who had normal coagulolysis assays and negative fibrinogen scans also had no evidence of deep vein thrombosis or pulmonary embolism. The coagulolysis assay appears to be a safe, noninvasive study for the detection of deep vein thrombosis. There was only a one per cent false-negative incidence.

Blood Coagulation Tests↗
PubMed1980

[Results of orthopedic and radiological investigations on the knee joint of old age patients (author's transl)].

Orthopedic and radiological investigations were performed on the knee joint of 200 old age patients. The majority of them had no or minute signs, and were free of symptoms. The X-ray characteristics of the degenerative changes of the old age patient's knee joints, and their relationship with the clinical findings are discussed too. The authors point to the relevance of prearthritic conditions in the pathogenesis of those serious osteo-arthritic changes, which become evident in advanced ages.

Aged↗
PubMed1980

[Orthopedic and trauma aspects of congenital myopathies (author's transl)].

A review on the orthopedic and trauma aspects of the muscular dystrophies and the non-progressive myopathies is given on the basis of personal experience and the relevant literature. Pathomechanism, incidence, treatment modalities of spinal deformities, joint malformations, contractures and systemic bone abnormalities are reviewed too. Spontaneous tendon ruptures are thought to be the complications of non-progressive myopathies.

Humans↗
PubMedDate not supplied

Orthopedic aspects of congenital insensitivity to pain.

In an 11-year-old girl with congenital insensitivity to pain, diagnosis depended on three diagnostic features: pain sensation absent from birth; entire body affected; all other sensory modalities and deep tendon reflexes present. The cause of this disease is unknown. Other diseases to be considered when insensitivity to pain is present are diabetes, lues, and syringomyelia. Less common neurologic diseases are congenital sensory neuropathy with or without anhidrosis, familial dysautonomia (Riley-Day syndrome), and sensory radicular neuropathy. The three orthopedic manifestations of congenital insensitivity to pain are recurrent fractures, neuropathic (Charcot's) joints, and osteomyelitis. Management is based on proper appreciation of the disease. Prevention of complications is important. Treatment of fractures and osteomyelitis is straightforward. However, the treatment of neuropathic joints demands caution and is done best nonsurgically.

Arthropathy, Neurogenic↗
PubMedDate not supplied

Computed tomography of orthopedic tumors of the pelvis and lower extremities.

An analysis of 6 representative cases of tumors of the pelvis and lower extremities demonstrates the clinical usefulness of computerized tomography (CT) in preoperative evaluation. CT provides information regarding precise size of the mass, its location and relationship to muscle bundles and fascial planes, definition of the margins of the mass, relation to neural, vascular and bony structures not previously available by plain film and angiography. This information is of particular value to the orthopedic surgeon in evaluating the feasibility of en bloc resections of tumors and in planning reconstructive procedures.

Adolescent↗
PubMed1981

[Backache in women from a gynecologic and orthopedic viewpoint].

In differential diagnosis of low back pain in women defects of the skeletal system as well as affections of the female genital organs must be considered. In these diseases low back pain may be caused directly by mechanic or indirectly by nervous factors. It is referred to the possibility of differentiation of low back pain by clinical symptoms. Based on new findings particularly osteoporosis makes close cooperation of the two medical specialties-orthopedics and gynecology-necessary, because the question of oestrogen application for prophylaxis and therapy of osteoporosis arises.

Back Pain↗
PubMed1984

Hypobaric spinal anesthesia in the operative management of orthopedic emergencies in geriatric patients.

Hypobaric spinal anesthesia was administered to 40 patients undergoing lower limb surgery. Twenty-nine of the patients were debilitated geriatric patients who presented with orthopedic emergencies, in most cases a fractured hip. Hypobaric spinal anesthesia was found to be a simple and safe procedure that provided adequate analgesia. Due to its inherent nature, hypobaric spinal anesthesia does not necessitate positioning of the patient on the injured, painful side (unlike hyperbaric spinal or epidural anesthesia) and, therefore, facilitates a smooth and painless transfer of the patient to the operating table. Complications encountered were similar to those following hyperbaric anesthesia.

Adult↗
PubMedDate not supplied

Nutritional status of orthopedic patients with surgical complications.

The incidence and effects of malnutrition in orthopedic surgery and nutritional status were investigated at the time of surgery in 106 patients. Arm muscle circumference was used to measure the nutritional status. The incidence of complications was correlated with poor protein nutrition. Patients with evidence, of protein malnutrition had a higher incidence of wound infection. Patients with multiple previous operations had a greater number of complications of any type. The combination of poor nutritional status and multiple previous operations was associated with a 42% incidence of postsurgical complications.

Arm↗
PubMed1982

The white blood cell scan in orthopedics.

A new nuclear scanning technique was found more specific for bone, joint, and soft tissue infections than any previously described scanning technique. The leukocyte scan, whereby a patient's own cells are labeled with a radioactive tagging agent (111In oxine), can distinguish an active infectious process from other pain-inducing conditions. Ninety-seven 111In labeled autologous leukocyte scans were performed in 88 patients. The findings in 17 of 40 patients scanned for possible acute osteomyelitis, six of nine for suspected septic arthritis, and six for possible soft tissue infections, were positive. Subsequent clinical courses verified the infectious nature of these processes in all patients. Patients who had chronic osteomyelitis (14), bony metastases (four patients), heterotopic ossification (three), and degenerative arthritis (two) demonstrated negative findings. Of the seven patients scanned for acute long-bone fractures, one demonstrated positive findings. Nine scans demonstrated positive findings without determined causes. The leukocyte scan is a useful addition to the diagnostic tools of the orthopedic surgeon.

Adult↗
PubMed1983

[Proglumetacin for fast and safe control of joint pain of orthopedic importance].

Thirty patients with articular pain had been treated with proglumetacin during average 12 days. Twenty-three (77%) responded well to very well to the treatment. Total symptom score decreased by 49%, and each tested symptom (painful, inflammatory and functional) significantly improved, in spite of the short observation period. Tolerance was defined good to excellent in 26 patients (87%). Overall, 10 patients complained of mild to moderate accessory symptoms, mainly heartburn and epigastric pain. No C.N.S. symptoms were observed, nor variations of the laboratory tests, carried out in 16 patients. Proglumetacin, therefore, showed to be a suitable drug for the fast and safe management of articular pain of orthopedic interest.

Adult↗
PubMed1981

[Statistical study of alveolar process inclination. Analysis of results of teleradiographic examinations of the head, in sagittal and vertical projection, in 1 600 children referred for consultation in a specialised dentofacial orthopedic unit (author's transl)].

For 1 600 children sent to a dental facial orthopedics consultation, the vestibulo lingual inclination of the incisors and molars was measured on two cephalograms of the head, the first one in profile, the second in vertical incidence, the X-Rays being perpendicular to the plane of the biting surfaces of the molar teeth. A statistical analysis was realized on the dental inclination previously observed in order to precise the frequency and amplitude of each anomaly, test their associations and evoke their muscular causes.

Adolescent↗
PubMed1982

Effects of presurgical oral orthopedics on bilateral complete clefts of the lip and palate.

The effects of presurgical oral orthopedics on children with bilateral complete clefts of the primary and secondary palates were later studied in the deciduous and mixed dentitions. The treated and non-treated groups were identical as regards surgical technique, timing of surgery and surgeon. In the deciduous dentition 4% of the 23 treated cases had incisor crossbite, while 46% of the 13 untreated cases had incisor crossbite. In the mixed dentition the frequency was 21% of the 14 treated cases and 73% of the 15 non-treated cases. At both stages these differences were highly significant. A cephalometric skeletal analysis demonstrated no significant difference between the two groups at either the deciduous or mixed dentition stages.

Cleft Lip↗