Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 5 de 5
Filtrar
1.
Clin Orthop Relat Res ; (292): 13-25, 1993 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-8519100

RESUMO

During a ten-year period (1978-1988), 143 of 1386 patients with proximal humeral fractures were treated with internal osteosynthesis. Ninety-seven proximal humeral osteosynthesis cases had adequate documentation, and 77 (80%) were available for clinical review. The 97 fractures were graded by the AO/ASIF classification and included 44 Group A, 32 Group B, and 21 Group C fractures. Exercise-stable osteosynthesis using T-plate, cloverleaf plate, or small condylar plate was performed in 70% of patients. In the remaining patients, a less rigid fixation, with Kirschner wires or screws and cerclage wires, was used. Fifty-two percent of the patients had excellent and good results, 15% had fair results, and 33% had poor results. Most poor results occurred in patients with four-part fractures (61% of poor results). Of the cases involving four-part fractures, however, 22% had an excellent result after internal fixation. Displaced four-part fractures or fracture-dislocations should be treated by reconstruction of the proximal humerus, especially in young patients. The use of minimal fixation rather than rigid fixation is considered after careful assessment of the condition of the soft tissue and blood supply of the humeral head fragments. Primary treatment with endoprostheses is required when internal fixation is impractical in AO/ASIF fracture Types C 2/3 and C3 fractures. Improved clinical results may be achieved, particularly in the more severe fracture types, with increased experience in techniques of internal fixation of proximal humeral fractures.


Assuntos
Fixação Interna de Fraturas/métodos , Fraturas do Ombro/cirurgia , Feminino , Fixação Interna de Fraturas/instrumentação , Humanos , Luxações Articulares/classificação , Luxações Articulares/cirurgia , Masculino , Dispositivos de Fixação Ortopédica , Radiografia , Fraturas do Ombro/classificação , Fraturas do Ombro/diagnóstico por imagem , Fraturas do Ombro/reabilitação , Lesões do Ombro , Articulação do Ombro/diagnóstico por imagem , Resultado do Tratamento
3.
Zentralbl Chir ; 121(8): 692-7, 1996.
Artigo em Alemão | MEDLINE | ID: mdl-8967218

RESUMO

Rehn-Delorme's procedure was introduced as one of a couple of methods to remove rectal prolapse with insufficiency of the pelvic floor. Rehn-Delorme's procedure wasn't well accepted until the last twenty years, when some authors reported good results with low recurrence rate of the prolapse, especially for old people with high risk or otherwise unfit for abdominal surgical procedures. On the German Clinic for Diagnostic during the years 1991-1994 in a therapeutical concept of the conjoint problems "chronic constipation--rectal prolapse-faecal incontinence" 205 patients, aged 20 to 86 years, were operated on with that procedure. In a retrospective study, evaluating 78 patients who underwent only that operation, we studied the change of faecal incontinence after removing the outlet obstructing mucosal prolapse. The mortality was zero, the total complication-rate was 15.1%, bleeding (2.9%), suture line disruption (7.3%), abscesses (1.5%) and stenosis (1%) acceptable. The Kirwan continence-score increased significantly. Three cases with normal continence before operation get worse because of removing the obstructing mucosal wall.


Assuntos
Incontinência Fecal/cirurgia , Diafragma da Pelve/cirurgia , Prolapso Retal/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Constipação Intestinal/complicações , Incontinência Fecal/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Prolapso Retal/etiologia , Resultado do Tratamento
4.
Langenbecks Arch Chir ; 380(3): 162-5, 1995.
Artigo em Alemão | MEDLINE | ID: mdl-7791488

RESUMO

Five patients with hyperextension injuries and dorsally instable motion segments are presented. In the diagnosis of posterior instabilities plain roentgenograms demonstrated no characteristic signs of an injured cervical spine. Flexion and extension views detected a mild degree (2 mm) of retrospondylolisthesis in four cases and a widened disc space in one case. In all five patients the MR findings that made use suspect a posterior unstable motion segment were disc protrusions; in addition, in two patients these was hemorrhage in the spinal cord and in one patient cord edema.


Assuntos
Vértebras Cervicais/lesões , Luxações Articulares/diagnóstico , Instabilidade Articular/diagnóstico , Imageamento por Ressonância Magnética , Traumatismos em Chicotada/diagnóstico , Adulto , Idoso , Vértebras Cervicais/patologia , Vértebras Cervicais/cirurgia , Discotomia , Feminino , Humanos , Deslocamento do Disco Intervertebral/diagnóstico , Deslocamento do Disco Intervertebral/cirurgia , Luxações Articulares/cirurgia , Instabilidade Articular/cirurgia , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Medula Espinal/patologia , Compressão da Medula Espinal/diagnóstico , Compressão da Medula Espinal/cirurgia , Espondilolistese/diagnóstico , Espondilolistese/cirurgia , Traumatismos em Chicotada/cirurgia
5.
Unfallchirurgie ; 22(3): 117-23, 1996 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-8767382

RESUMO

In a first experimental study we investigated the visualisation of metal implants in reference to dimension, shape, material (titanium, steel, biodegradable screws) and surface structures and an eventual change of the echo pattern in correlation to the surrounding structures, the vicinity to bone and the change of the sound angle. For this purpose ultrasound investigation was performed in artificial and cadaver bones and in cadaver limbs after implantation of screws, plates, K-wires and cerclage wires. We found that metal implants of a certain dimension can be localised by typical artefacts (resonance artefact, comet tile artefact). In the following clinical study we investigated the value of ultrasound in finding and localisation of implants after osteosynthesis. In patients with 25 locking femur nailing, 30 locking tibia nailing, 30 osteosynthesis done by screws and plating, metal was easily localised by typical artefacts. Ultrasound examination gave the possibility to define the number of screws, the localisation to surrounding tissue, loosening of screws and eventual as sociated inflammatory tissue swelling (bursitis, tendovaginitis).


Assuntos
Fixação Interna de Fraturas/instrumentação , Fixação Intramedular de Fraturas/instrumentação , Metais , Complicações Pós-Operatórias/diagnóstico por imagem , Próteses e Implantes , Osso e Ossos/diagnóstico por imagem , Desenho de Equipamento , Humanos , Ultrassonografia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA