RESUMEN
Results of treatment for trochanteric fracture of the femur in 50 patients aged 25-91 (mean 71 years) are presented. In all cases reviewed the fracture has been stabilized with 3 or 4 Ender nails. In majority of cases bony union has been achieved. Short operating time, small incision remote from fracture site, early weight bearing constitute unquestionable advantages of the method. Most frequent complications as shortening of the extremity involved, excessive external rotation, pain related to migration of the nails, varus deformity at the fracture site were usually found in patients with marked osteoporotic changes.
Asunto(s)
Fijación Intramedular de Fracturas/métodos , Fracturas de Cadera/cirugía , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Envejecimiento/fisiología , Femenino , Fracturas de Cadera/diagnóstico por imagen , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Radiografía , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The paper presents the use of dual energy X-ray absorptiometry for selecting patients with high risk of proximal femur fracture. A group of 63 patients with fracture has been compared with a group of 306 patients who fell down but did not sustain a fracture, all individuals aged over 60. Most significant bone density decrease (p < 0.001) presented as Z indices related to young population was found in all three examined areas of the proximal femur. The difference between the groups ranged between 1.62 to 2.19 SD depending on the area and the sex. Threshold values for ZYA have been established. For the femoral neck it was -1.3 SD, for Ward's triangle -1.5 SD and for trochanteric area -0.4 SD.
Asunto(s)
Absorciometría de Fotón , Fracturas del Fémur/prevención & control , Osteoporosis/diagnóstico por imagen , Anciano , Anciano de 80 o más Años , Femenino , Fracturas del Fémur/diagnóstico por imagen , Fracturas del Fémur/etiología , Humanos , Masculino , Persona de Mediana Edad , Osteoporosis/complicaciones , Medición de Riesgo , Caracteres SexualesRESUMEN
Idiopathic scoliosis is a triplanar deformity associated with a rib hump. The quantitative assessment of the principal elements of spinal and rib cage deformity based on the chosen parameters measured on a-p radiographs and CT scans was done in a group of 89 children with idiopathic scoliosis. The average Cobb angle was 63 degrees. In regression and correlation analysis the statistically significant correlation among spinal lateral curve, axial rotation and kyphosis/lordosis index was found. Significant correlation between the elements of spinal deformity and the size of the rib hump were also found. The rib cage may play an important role in the pathogenesis of idiopathic scoliosis.
Asunto(s)
Costillas/anomalías , Escoliosis/diagnóstico por imagen , Vértebras Torácicas/anomalías , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Análisis de Regresión , Costillas/diagnóstico por imagen , Vértebras Torácicas/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Results of 29 forearm bones shaft fracture treatment with 3.5mm self compressive plate in 26 patients aged 18-64 (mean 33) are presented. Open reduction with 3.5mm self compressive plate fixation has been performed in all cases. Anderson et al criteria were used to assess functional and radiological outcome. Excellent and good functional results were achieved in 25 cases, one was rated fair, no poor results were observed.
Asunto(s)
Placas Óseas , Fracturas del Radio/cirugía , Fracturas del Cúbito/cirugía , Adulto , Diseño de Equipo , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Radiografía , Fracturas del Radio/diagnóstico por imagen , Resultado del Tratamiento , Fracturas del Cúbito/diagnóstico por imagenRESUMEN
The impact of head-neck A-O cancellous screw transfixation on subcapital growth plate in 20 children operated for slipped capital femoral epiphysis is presented. It was found, that early fusion of the growth plate may be attributed to the compression by A-O screw used for transfixation (p-0.0001). Resulting shortening of the femoral neck and relative overgrowth of the great trochanter did not influence the final outcome of treatment.
Asunto(s)
Epífisis Desprendida/cirugía , Cabeza Femoral , Fijación Interna de Fracturas/efectos adversos , Trastornos del Crecimiento/etiología , Adolescente , Desarrollo Óseo/fisiología , Tornillos Óseos , Niño , Femenino , Placa de Crecimiento/fisiopatología , Humanos , MasculinoRESUMEN
Pillar version of POLFIX fixator for treatment of compound C2 tibial shaft fractures presented. The method was employed in 9 cases and in 8 of them (89%) the fracture healed within 32 weeks on an average. In 1 case of IIIB open fracture infection developed and no union has been achieved. The fixator can be designed preoperatively; there is no need to dismantle the template when drilling, tapping or inserting screws what makes an osteosynthesis easy. The method may be used also in metaphyseal fractures. Pillar version of POLFIX fixator proved useful in treatment of compound tibial fractures.
Asunto(s)
Fijación Intramedular de Fracturas/métodos , Fracturas Abiertas/cirugía , Fracturas de la Tibia/cirugía , Adulto , Estudios de Seguimiento , Fijación Intramedular de Fracturas/instrumentación , Curación de Fractura , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The aim of this paper is to evaluate the reproducibility of tibial shaft densitometry in own method under development. It will be expressed as percentage value of coefficient of variability (%CV). Bone mineral content (BMC) and bone mineral density (BMD) were measured with a dual energy X-ray densitometer Lunar DPX; the data were analyzed with a "Orthopedic" software. Three tibial bone scans were done in 10 males. High reproducibility was found, ranging from 0.98% to 1.45% and from 1.45% to 2.08% for BMC and BMD respectively. Reproducibility increases as the analyzed surface increases. Reproducibility so high allows for further investigations; it might be interesting to monitor BMC and BMD of the tibia in course of fracture treatment by Polfix or Zespol method.
Asunto(s)
Absorciometría de Fotón , Densidad Ósea , Tibia/diagnóstico por imagen , Adulto , Humanos , Masculino , Valores de Referencia , Reproducibilidad de los ResultadosRESUMEN
Results of surgical treatment in 7 patients with slipped capital femoral epiphysis have been presented. Slip angle ranged from 12(to 42(. Closed, in situ neck-head fixation with a single cannulated screw was performed. The screw was introduced percutaneously, through the anterior surface of the femoral neck into the center of the head and perpendicularly to its base. The method employed rendered very good results. No head or neck perforation occurred. No progression of the slip was observed. Soft tissue trauma was only minimal; mobilization was commenced the first postoperative day.
Asunto(s)
Tornillos Óseos , Epífisis Desprendida/cirugía , Cabeza Femoral/cirugía , Adolescente , Niño , Humanos , MasculinoRESUMEN
Results of surgical treatment for 13 femoral shaft fractures in 12 children and adolescents with multitrauma have been presented. In 12 cases plate has been used, in one case Kuntcher nail was employed. Age of the patient at the trauma was 3 years 4 months on an average. There was no infection in postoperative period. The fracture healed after 8 weeks on an average. Anatomical reduction has been achieved in all cases. Some physical activity limitation (not related to the treatment) has been found in two patients. Surgical treatment for femoral shaft fracture in children and adolescents with multitrauma rendered good results.
Asunto(s)
Fracturas del Fémur/cirugía , Traumatismo Múltiple/cirugía , Adolescente , Clavos Ortopédicos , Placas Óseas , Moldes Quirúrgicos , Niño , Femenino , Fijación Interna de Fracturas , Humanos , Masculino , Tracción , Resultado del TratamientoRESUMEN
The occurrence of nine elements in the coxarthrosis human femoral capitula is described. The atomic absorption spectrophotometry (AAS) method was used to determine Cd, Pb, Cr, Cu, Mn, Fe, Zn, Ni and Co concentrations in the three kinds of tissues: spongious and cortical bone and joint surface cartilage. Based on the Pb bone concentrations, an ecotoxicological Pb contamination risk for the industrial region can be predicted.
Asunto(s)
Contaminantes Atmosféricos/análisis , Cabeza Femoral/química , Plomo/análisis , Análisis de Varianza , Humanos , Oligoelementos/análisisRESUMEN
A new method for lower extremities length measurement in patients destined for surgical legalization is presented. It is based on a scan in investigational CT. Reference points are marked and the distance between them is calculated. The record is inclusive of synthetic, diminutive anterior-posterior image of the extremity along with the measurement. Since September 1990 to December 1993, 34 patient underwent this procedure. The advantage is sensitivity better than 1 mm, flexibility in choosing reference points, good reproducibility and little exposure to the radiation. The result is more precise and trustworthy then obtained with other radiological or clinical methods.
Asunto(s)
Diferencia de Longitud de las Piernas/diagnóstico por imagen , Pierna/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Humanos , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
In a group of 20 children with idiopathic scoliosis the degree of axial rotation was measured with the use of radiography (Drerup's method), ultrasonography and computer tomography. The measurements obtained by Drerup's radiographic method and by ultrasonography were compared with the results of the CT measurements, the latter being considered as the most precise. According to the statistical analysis of the results the spinal axial rotation measurements according to the Drerup's radiographic method appeared to be more precise than the ultrasonographic method. An equation was presented permitting to calculate the tomographic rotation angle RAsag on the basis of the results of the Drerup's radiographic measurement.
Asunto(s)
Vértebra Cervical Axis/diagnóstico por imagen , Escoliosis/diagnóstico por imagen , Adolescente , Vértebra Cervical Axis/patología , Femenino , Humanos , Masculino , Análisis de Regresión , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Results of treatment for 104 forearm shaft fractures in 70 patients have been presented. In all cases included in this study an open reduction of the fracture was followed by AO plate stabilization. Functional and radiological assessment was carried out according to the criteria of Anderson et al. Excellent and good functional results were achieved in 48 cases, fair in 10 and poor in 12 cases. The ulna united in 75%, the radius in 78% (delayed union included). Cross- union occurred in three patients, one case of destabilization at fracture site was observed, no infection has been noted. AO plate osteosynthesis proved to be still valuable mode of treatment for forearm shaft fracture.
Asunto(s)
Fijación Interna de Fracturas/métodos , Fracturas del Radio/cirugía , Fracturas del Cúbito/cirugía , Adolescente , Adulto , Placas Óseas , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Fracturas del Radio/diagnóstico , Resultado del Tratamiento , Fracturas del Cúbito/diagnósticoRESUMEN
Results of Imhauser osteotomy for treatment of slipped capital femoral epiphysis grade II and III performed in 32 patients (33 hips) are presented. The average correction of the slip angle was 39.7 +/- 14.9 degrees. Excellent results were found in 16 hips (48.5%), good in 10 (30.3%), fair in 5 hips (15.1%) and poor results in 2 hips (6.1%). No head-neck fixation after osteotomy did not lead to further slippage and decreased the risk of other complications. In 6 hips (18.2%) chondrolysis occurred. In one case prolonged immobilization of the hip was to blame, perforation of the femoral head in another, no cause has been identified in remaining cases. Avascular necrosis of the head was not observed.
Asunto(s)
Epífisis Desprendida/cirugía , Cabeza Femoral , Osteotomía/métodos , Adolescente , Niño , Femenino , Humanos , Masculino , Resultado del TratamientoRESUMEN
The study deals with clinical assessment of results of surgical treatment of 13 snapping hips. Bringnall and Stainsby procedure has been employed; the surgical technique has been described. The mean age at the operation was 19 years, mean follow-up was 21 months. In 11 cases (84.6%) the symptoms abated completely. The results justify conclusion, that Z-plasty with transposition of created flaps should be recommended as a mode of surgical treatment for snapping hip.
Asunto(s)
Articulación de la Cadera/cirugía , Artropatías/cirugía , Adolescente , Adulto , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Colgajos Quirúrgicos/métodos , Tendones/cirugía , Resultado del TratamientoRESUMEN
The results of treatment of 29 hips with slipped capital femoral epiphysis stabilized "in situ" with one or two AO cancellous screws have been presented. Excellent and good results have been achieved in 26 hips, the remaining 3 cases were rated as fair and poor. At the follow-up examination no early osteoarthritic changes of avascular necrosis of the femoral head were found in any case. The complications seem to decrease in number with the use of one screw only.
Asunto(s)
Tornillos Óseos , Epífisis Desprendida/cirugía , Cabeza Femoral/cirugía , Adolescente , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Resultado del TratamientoRESUMEN
Electromyography of the gluteus medius muscle in arthritic patients after total McKee-Farrar hip replacement has been presented. The control group consisted of nonoperated arthritic hips and normal hips. It was found that arthritis of the hip or total hip replacement do not significantly influence the average score of the integrated gluteus medius electomyogram. The gluteus medius strength on Trendelenburg sign testing is 1.5-2 times greater than on acting against maximal resistance with patient in supine position.
Asunto(s)
Prótesis de Cadera , Cadera/fisiopatología , Músculo Esquelético/fisiopatología , Adulto , Anciano , Electromiografía , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Osteoartritis de la Cadera/cirugía , Posición Supina/fisiología , Resistencia a la Tracción/fisiologíaRESUMEN
Clinical assessment of the results of surgical treatment of 105 congenital clubfeet by peri-talar release has been carried out. There were 58% of soft and 42% of stiff clubfeet in this group. The average patient age at the operation was 17.8 months. The Wynne-Davies point scale modified by Marciniak was used to assess the results. Forty nine feet (46.4%) were rated good, 28 (26.7%) satisfactory and 28 (26.7%) poor. Fifty percent of stiff feet were rated poor and 68.9% of soft ones were rated good. Plantocontourography revealed marked decrease of internal rotation in the operated feet. The authors conclude peri-talar release is an effective method of treatment of soft congenital clubfoot.
Asunto(s)
Pie Equinovaro/cirugía , Tendones/cirugía , Articulación del Tobillo/fisiopatología , Preescolar , Pie Equinovaro/fisiopatología , Femenino , Humanos , Lactante , Masculino , Ortopedia/métodos , Rango del Movimiento ArticularRESUMEN
Advantages of intraoperative bone scintigraphy are presented on the basis of surgical treatment of 50 osteomyelitis patients. Tc99m was given either intravenously or into the fistula and the radiation was measured by a set of scintillating probe and radiometer. Small size, simple handling and quick measurement make this set extremely useful for intraoperative diagnostics contributing to complete removal of infected tissue from the operating site. This method requires only one tenth of usual dose of radioisotope what must be recognized as an additional advantage.
Asunto(s)
Huesos/diagnóstico por imagen , Osteomielitis/diagnóstico por imagen , Osteomielitis/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Humanos , Periodo Intraoperatorio , Persona de Mediana Edad , Dosis de Radiación , Cintigrafía , TecnecioRESUMEN
Hundred hips in 84 arthritic patients after Mc Kee-Farrar total hip arthroplasty were reviewed. Biomechanical measurements in operated, arthritic non-operated and normal hips were compared. The moment of adductive forces, adductive forces, the strength of abductors, Hamacher-Roesler index and Wozny coefficient were determined. In nonoperated arthritic hips these measurements were abnormal. They were close to normal values in operated hips with negative Trendelenburg sign.