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At least 1,657 records · Page 92Linked to original sources
PubMed1995

[Neuro-orthopedic and muscle tonus disorders in patients with spinal cord injuries].

Heterotropic ossifications and contractures are frequent during evolution of spinal cord injury. Heterotopic ossifications occur in the first months following the acute state. Hip is the most common localisation. No preventive or curative treatment is available. At an early stage, clinical or instrumental (sonographic) diagnosis may prevent functional consequences. Muscular disbalance, incomplete physiotherapy, tonus disorders lead to contractures of limbs or trunk. They may have severe consequences on activities of dairy living. Surgical procedures may be necessary. Tonus disorders may resist to usual drugs. In this cases, intrathecal infusion of baclofen, injection of botulinus toxin, neurosurgery of orthopedic surgery may be useful.

Contracture↗
PubMed1996

[Orthopedic foot abnormalities as a important sign of lumbosacral spinal lipoma in an 11-year-old boy].

A case of an 11-year-old boy with giant lumbosacral spinal lipoma is presented. Hobbling on the left foot and its dropping was observed at the age of 9 after which left equinovarus foot and excavated foot deformities developed. Diurnal and nocturnal enuresis, infection of the urinary tract, and bilateral vesico-ureteral reflux were found. At birth, the patient had cleft palate and cleft upper lip, and bending of the interbuttocks groove, which is suggestive of occult spina bifida. It seems that in the case of orthopedic foot abnormalities developing in a previously healthy child, MRI investigation of the lumbosacral spine should be considered.

Child↗
PubMed1995

Rapid orthopedic lengthening of the mandible in primates by sagittal split osteotomy and distraction osteogenesis: a pilot study.

This study proposes the development of an intraoral surgical approach to distraction osteogenesis to treat maxillofacial defects. Bilateral sagittal split osteotomies were made in the ascending ramus and body of the mandible of two adult cynomologus primates, and the dento-osseous segment was completely mobilized. A distraction device was fabricated from a Glen-Ross screw soldered between two mini bone plates. The bone plates were fixed by self-tapping screws to both right and left proximal and distal mandibular segments. Beginning 1 week postoperatively, both distraction plates were opened 1 mm every day until the mandible was advanced a total of 10 mm. Comparison of cephalometric radiographs and study casts prepared preoperatively, at the completion of the mandibular orthopedic advancement, and up to 12 weeks postdistraction, showed that mandibular advancement was successful and stable. There was radiographic evidence of bone filling the osteotomy sites, and there was no scar tissue formation or evidence of relapse.

Animals↗
PubMed1995

Surgically assisted-rapid orthopedic lengthening of the maxilla in primates--relapse following distraction osteogenesis.

A recent study has shown that the maxilla in primates can be successfully lengthened (0.5 mm every other day up to 6.0 mm) by means of surgically assisted-rapid orthopedic movement, using the principles of distraction osteogenesis. The present study was designed to determine if the maxilla can be advanced at a faster rate and if relapse would occur after removal of the orthodontic appliance. Metallic markers were placed in the cranial base and maxilla of two Cynomolgus primates, and cephalometric radiographs were taken. Bilateral horizontal and interdental osteotomies were created between in the first premolars and the canines, and the anterior segment was completely mobilized. An orthodontic appliance was bonded to the teeth and the screw was closed, compressing the osteotomy site. One week postoperatively the appliance was opened four quarter turns every day until the anterior segment was advanced by 10 mm. Cephalometric radiographs were taken at 6, 8, and 12 weeks postadvancement. At 12 weeks, the orthodontic appliance was removed, and at that time and 2, 4, and 6 weeks later, cephalometric radiographs were taken and study models fabricated. At the end of the postretention period, the animals were sacrificed, and the maxillae were evaluated by light microscopy. Results showed that the maxilla can be successfully advanced at a faster rate and for longer distances, and that the advanced maxilla does not relapse during the 6-week postretention period.

Animals↗
PubMed1997

Need for radiologists to interpret orthopedic total joint radiographs.

We applaud the aim of Nayak and colleagues: to use our scarce economic resources as judiciously as possible. We have suggested several alternatives that would save more of our scarce health care dollars. We would be delighted to take part in a properly designed prospective randomized trial to address the issues presented in this paper. We believe the literature would be strengthened by the publication of a collegial paper, coauthored by orthopedic and radiology departments, addressing the issue of saving health care dollars by omitting unnecessary or redundant procedures.

Canada↗
PubMed1977

Orthopedic management of Paget's disease of bone.

The role of the orthopedic surgeon in the management of Paget's disease is in: evaluation and treatment of the cause of a patient's pain; evaluation of any deformities; treatment of fractures and tumors in affected bones. Pain due to active disease must be differentiated from nerve compression syndromes and arthritic pain because effective medical treatment is now available for pagetic bones. Spinal stenosis and sciatica are frequent in patients with Paget's desease because of vertebral body remodeling and collpase. Femoral and pelvic osseus pain may improve with treatment while an arthritic hip will remain symptomatic and require hip joint replacement. On one hand, bowed femora with inactive disease appear to be subject to an aching type of pain that does not respond well to antipagetic agents. On the other hand, for some unknown reason, tibial symptoms may respond dramatically to the same treatment. Biopsy is necessary only to exclude neoplastic transformation. Bone scans are useful to screen for distribution of the disease. The serum alkaline phosphatase and 24 hour urinary hydroxyproline determinations are the main indicators of the response of the disease to treatment.

Arthritis↗
PubMed1997

MR imaging of acute orthopedic trauma to the extremities.

This article outlines the imaging role of MR imaging in evaluating acute orthopedic trauma to the extremities. MR imaging is compared, where possible, with CT scan, scintigraphy, and ultrasound. The article specifically explores the role of MR imaging in evaluating soft tissue injury accompanying fracture, emphasizes an established role in occult fracture detection, reviews the role of MR imaging in evaluating neurovascular integrity following fracture, and underscores the utility of MR imaging in evaluating trauma to the growth plate.

Acute Disease↗
PubMed1997

Biomaterials for orthopedic surgery in osteoporotic bone: a comparative study in osteopenic rats.

UNLABELLED: To evaluate orthopedic devices in pathological bone, an experimental study was performed by implanting Titanium (Ti) and Hydroxyapatite (HA) rods in normal and osteopenic bone. Twenty-four rats were used: 12 were left intact ( CONTROL: C) while the other 12 were ovariectomized (OVX). After 4 months all the animals were submitted to the implant of Ti or HA in the left femoral condyle (Ti-C, HA-C, Ti-OVX, HA-OVX). Two months later the animals were sacrificed for histomorphometric, ultrastructural and microanalytic studies. Our results show a significant difference between the Affinity Index (A.I.) of HA-C and Ti-C (77.0 +/- 7.4 vs 61.2 +/- 9.7) (p < 0.05). No significant differences were observed between the osteointegration of Ti-C and Ti-OVX (61.2 +/- 9.7 vs 48.2 +/- 6.7). Significant differences also exist between the osteointegration of HA-C and HA-OVX (77.0 +/- 7.4 vs 57.6 +/- 11.5) (p < 0.01). Microanalysis shows some modifications in Sulphur (S) concentration at the bone/biomaterial interface of the Ti-OVX group. Therefore our results confirmed the importance of biomaterials characteristics and of bone quality in osteointegration processes.

Animals↗
PubMed1977

[Principles of antibacterial chemotherapy of wound infection in traumatology and orthopedics].

Staphylococci have been mainly isolated presently from the wounds of the traumatological and orthopedic patients. Sensitivity of the out-of hospital and hospital staphylococcal strains was studied. Higher sensitivity of the out-of-hospital strains was showed. Directed antibiotic therapy, control of the treatment courses, doses, drug levels in the blood serum and infection foci provided more effective results in patients with purulent complications.

Anti-Bacterial Agents↗
PubMed1996

Low molecular weight heparin for the prevention of deep vein thrombosis following orthopedic surgery.

Prophylaxis of postoperative thromboembolism is widely used because it has been shown to save lives and money. However, some surgeons are still reluctant to use general prophylaxis in high-risk orthopedic surgery. In total hip and total knee replacement the best method of prophylaxis is currently low molecular weight heparin started preoperatively and continued for 7 to 14 days or until the patient is fully ambulatory. A shorter prophylaxis period failed to be effective in an English study. At present there is an ongoing debate on the length of the period of risk, and whether there is a need for prophylaxis after discharge. Oral anticoagulation has been used for extended prophylaxis, but studies show that anticoagulant levels need to be monitored by repeated measurements by international normalized ratio. An alternative method would be to continue low molecular weight heparin injections for 4 to 5 weeks after surgery. No studies so far have evaluated the efficacy and safety of prolonged prophylaxis with low molecular weight heparin after discharge.

Administration, Oral↗
PubMedDate not supplied

Cost analysis of the American College of Chest Physicians guidelines for deep vein thrombosis prophylaxis in patients undergoing orthopedic arthroplastic surgery.

Guidelines for prophylaxis of deep vein thrombosis secondary to orthopedic surgery have been developed. In selecting a specific drug for formulary inclusion, it is ideal for an individual institution to determine the cost of therapy, as well as the frequency of adverse events and the cost of treating them for each agent undergoing consideration. Cost-effectiveness analysis using incremental cost-effectiveness ratios and sensitivity analyses are useful for determining which drug may be most cost effective.

Anticoagulants↗
PubMed1997

Bioresorbable fracture fixation in orthopedics: a comprehensive review. Part II. Clinical studies.

Bioresorbable materials overcome two major disadvantages of the metal alloys most commonly used in fracture-fixation devices: their extreme stiffness, which causes stress shielding of the underlying bone, and the necessity, in a significant number of cases, of removing metallic implants after fracture healing is complete. The orthopedic surgeon now has the use of polylactic acid, polyglycolic acid, and polydioxanone implants for the fixation of small cancellous bone fractures. The currently available bioresorbable materials lack strength and stiffness and are associated with inflammatory reactions and osteolysis in a significant number of cases. Surgeons should use the available pins and screws with extreme care and attention to the characteristics of each individual injury, particularly its healing characteristics, as well as to the material's initial mechanical properties, degradation rates, and associated complications.

Biocompatible Materials↗
PubMed1997

[Orthopedic therapy in rheumatic diseases].

The treatment of rheumatic disease requires an interdisciplinary approach in which the orthopedic surgeon is also involved. His contribution includes both conservative and operative procedures. Early synovectomy applied to joints and tendons is considered a preventive measure. Arthroscopic synovectomy belongs in the hands of an experienced operator. Joints that are not directly involved in weight-bearing can be treated by means of arthroplastic procedures, provided the cooperation of the patient is ensured. Arthrodesis is used preferentially to treat articular destruction of the ankle joint, the metacarpophalangeal joint of the thumb and the middle joints of the finger. Osteoporosis represents a relative contraindication. The treatment of rheumatic diseases of the joints using endoprostheses produces good primary results. The rate of loosening is not significantly increased, but late infection is somewhat higher than in other forms of articular disease.

Arthritis, Rheumatoid↗
PubMed1998

Commonly missed orthopedic problems.

When not diagnosed early and managed appropriately, common musculoskeletal injuries may result in long-term disabling conditions. Anterior cruciate ligament tears are some of the most common knee ligament injuries. Slipped capital femoral epiphysis may present with little or no hip pain, and subtle or absent physical and radiographic findings. Femoral neck stress fractures, if left untreated, may result in avascular necrosis, refractures and pseudoarthrosis. A delay in diagnosis of scaphoid fractures may cause early wrist arthrosis if nonunion results. Ulnar collateral ligament tears are a frequently overlooked injury in skiers. The diagnosis of Achilles tendon rupture is missed as often as 25 percent of the time. Posterior tibial tendon tears may result in fixed bony planus if diagnosis is delayed, necessitating hindfoot fusion rather than simple soft tissue repair. Family physicians should be familiar with the initial assessment of these conditions and, when appropriate, refer patients promptly to an orthopedic surgeon.

Achilles Tendon↗
PubMed1997

[Orthopedic hippotherapy--new methods in treatment of segmental instabilities of the lumbar spine].

The orthopedic hippotherapy represents a new form of therapeutic exercise in the conservative treatment of segmental instabilities in the lumbar spine region. This kind of therapy works on the principle of conveying to the patient the three-dimensional swinging motion of the horse's back. The patient reacts to these movement impulses by moving up and down (vertical movement of the spine), back and forth (sagittal movement) and to the right and the left (horizontal movement). The small movements of the spine thus produced bring about a mobilization of the segments involved in movement and therefore eliminate articular hypomobilities. Moreover, the short monosegmental muscles of the back are subjected to an excentric training which leads to a muscular stabilization of segmental hypermobilities. Due to the varying pressure load during the riding exercise the trophic conditions of the active and passive structures of the spine are improved.

Adult↗
PubMedDate not supplied

[Orthopedic shoes and their modifications].

The bone structure of the foot, knee and hip and their principle deformities are presented. With this in mind, the orthopedic shoe and its modifications are discussed as an extremely important element in correcting deformities that cause walking alterations, pain, etc.... How the shoes are made, the basic characteristics they should possess, which shoes are appropriate for which age, and problems the wrong shoe type can provoke are also discussed.

Equipment Design↗