Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera最新文献_第9页

Percutaneous minimal osteosynthesis of fractures of the proximal humerus in elderly patients. 老年患者肱骨近端骨折经皮微创骨融合术。

Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera Pub Date : 2002-01-01 DOI: 10.1024/1023-9332.8.1.11

Urs Zingg, D. Brunnschweiler, H. Keller, Urs Metzger

{"title":"Percutaneous minimal osteosynthesis of fractures of the proximal humerus in elderly patients.","authors":"Urs Zingg, D. Brunnschweiler, H. Keller, Urs Metzger","doi":"10.1024/1023-9332.8.1.11","DOIUrl":"https://doi.org/10.1024/1023-9332.8.1.11","url":null,"abstract":"INTRODUCTION The aim of this study was to evaluate the subjective and objective outcome of the percutaneous minimal osteosynthesis in elderly patients. Untreated, unstable and dislocated proximal humeral fractures show poor functional and subjective results. Reduction and fixation of the fragments is essential to achieve a good clinical outcome. Especially noted in elderly patients, the osteosynthesis is concurrent with the implantation of a prosthesis. PATIENTS AND METHODS We examined 31 patients with a mean age of 72 years (51-87) after an average follow-up period of 15.8 months (9-31). To assess the functional and subjective results, we used the Constant Score as well as an adapted version of the Oxford Shoulder Score. Radiographs in two planes displayed the anatomical situation, the healing of the fracture, and the evidence or absence of avascular necrosis. RESULTS There were no local complications such as hematomas or wound infections. The results of the Constant Score showed an average of 63.5 Pts. (18-82 Points) and adapted to age and gender by 90.2% (28.1-118.8%). Compared with the uninjured arm with an average of 77.1 Points (20-89 Points) and 109.5% (29-129%) respectively, we achieved an average functionality of 82.6%, operated versus non-operated side. All but one fracture, that showed signs of avascular necrosis with disintegration of the humeral head, were fully consolidated. The subjective results were very good in 18 patients, good in 7, satisfying in 3 and poor in 3 patients. CONCLUSION Our data indicate that the percutaneous minimal osteosynthesis is a valuable method for the fixation of proximal fractures of the humerus in elderly patients. The technique has a very low rate of complications and the time of convalescence is short. If closed reduction fails or a stable percutaneous fixation of the fracture by K-wires is not possible, the change to open reduction and internal fixation or the implantation of a prosthesis is required.","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"37 3 1","pages":"11-4"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79905690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 19

[Apparent pseudarthrosis of the thumb]. [明显的拇指假关节]。

Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera Pub Date : 2002-01-01 DOI: 10.1024/1023-9332.8.4.197

D F Kalbermatten, U von Wartburg

引用次数: 0

[Blind loop syndrome]. [盲循环综合症]。

Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera Pub Date : 2002-01-01 DOI: 10.1024/1023-9332.8.5.220

N Halkic, A Abdelmoumene, R Kianmanesh, H Vuilleumier

引用次数: 1

[Bilateral popliteal artery entrapment syndrome. Is preventive operation on the asymptomatic side indicated?]. 双侧腘动脉夹持综合征。是否需要对无症状的一侧进行预防性手术?

Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera Pub Date : 2002-01-01 DOI: 10.1024/1023-9332.8.5.224

C Candrian, P Nussbaumer, M Furrer

引用次数: 3

[Combination of plate and external fixator for biological osteosynthesis of comminuted fractures]. [钢板与外固定架联合用于粉碎性骨折的生物植骨]。

Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera Pub Date : 2002-01-01 DOI: 10.1024/1023-9332.8.5.230

A Pippow, L Krähenbühl, M C Michel, P Witschger

{"title":"[Combination of plate and external fixator for biological osteosynthesis of comminuted fractures].","authors":"A Pippow, L Krähenbühl, M C Michel, P Witschger","doi":"10.1024/1023-9332.8.5.230","DOIUrl":"https://doi.org/10.1024/1023-9332.8.5.230","url":null,"abstract":"In a comminuted fracture, a unilateral plate doesn't always give enough stability because the contralateral cortex cannot be used as a buttress. New plate systems as the Locking Compression Plate (LCP) may solve this problem. Another method to stabilize the contralateral cortex is by using an External Fixator (EF) in addition to a conventional platte either on the opposite side of the plate or on the ipsilateral side over the plate. By doing so, a half frame of an EF acts as a substitute for the damaged cortex. This method is easily available and may also be considered when a conventional plate osteosynthesis must be mechanically improved after the conventional plate is already put in place. With this combination of a plate with a EF we treated twelve patients with comminuted fractures of the tibia, the humerus and the femur. Eleven fractures healed without further operations or complications. In one case, there was a superficial wound infection with Staph. epidermidis that lead to an early metal removal, but healing of the fracture was not impaired. We also tested this set-up in a model and found, that the additional EF increased the stiffness of the plate by 73% for axial load. The combination of a plate and a contralateral EP is a useful way to treat comminuted fractures biologically achieving enough stability to allow early motion of the adjacent joints and fast healing of the fracture. Especially for fractures adjacent to a joint, this method is an alternative to an intramedullary nail.","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"8 5","pages":"230-6"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22104071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Krukenberg's tumor, three years after a colic carcinoma. 克鲁肯伯格肿瘤，在结肠癌三年后。

Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera Pub Date : 2002-01-01 DOI: 10.1024/1023-9332.8.5.237

V Praz, P Nordback, A Billing, M Merlini

引用次数: 6

[Prevention of thromboembolism in conservative ambulatory fracture treatment. Verification of an out-of-court FMH (Federation Mediation Helvetica) expert assessment]. 保守非卧床骨折治疗中血栓栓塞的预防。验证庭外FMH(联邦调解黑体字体)专家评估]。

Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera Pub Date : 2002-01-01 DOI: 10.1024/1023-9332.8.6.285

B Hohendorff, A Burckhardt

引用次数: 0

[Hemilithotomy position for intramedullary nailing of the femur and compartment syndrome of the healthy leg]. [股骨髓内钉半切开位与健康腿间室综合征]。

Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera Pub Date : 2002-01-01 DOI: 10.1024/1023-9332.8.4.193

M Christodoulou, R Garofalo, S Echeverri, S Pelet, E Mouhsine

引用次数: 6

Morbidity and outcome after sentinel lymph node dissection in patients with early-stage malignant cutaneous melanoma. 早期恶性皮肤黑色素瘤前哨淋巴结清扫后的发病率和预后。

Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera Pub Date : 2002-01-01 DOI: 10.1024/1023-9332.8.5.209

R Blumenthal, A Banic, C U Brand, H B Ris, D Lardinois

{"title":"Morbidity and outcome after sentinel lymph node dissection in patients with early-stage malignant cutaneous melanoma.","authors":"R Blumenthal, A Banic, C U Brand, H B Ris, D Lardinois","doi":"10.1024/1023-9332.8.5.209","DOIUrl":"https://doi.org/10.1024/1023-9332.8.5.209","url":null,"abstract":"Objective: Prospective analysis of the morbidity and outcome of the sentinel lymph node (SLN) technique in a consecutive series of patients with early-stage melanoma.Methods: Between 1997 and 1998, 60 patients with stage IB-II malignant melanoma underwent SLN dissection. Preoperative dynamic lymphoscintigraphy with mapping of the lymph vessels and lymph nodes and location of the sentinel node was performed the day before SLN dissection. SLN was identified by use of the blue dye technique. SLN was assessed for histopathological and immunohistochemical examination. Postoperative morbidity and mortality were recorded. Follow-up consisted of repetitive clinical examination with lymph nodes status, laboratory and radiologic findings.Results: Tumor-positive SLN was observed in 18% of the patients and stage II disease was found in 91% of the patients with positive SLN. Breslow thickness was the only significant factor predicting involvement of a SLN (p = 0.02). In 36% of the positive SLN, metastases could be assessed only by immunohistochemical examination. Postoperative complications after SLN dissection were observed in 5% in comparison with 36% after elective lymph node dissection. After a mean follow-up of 32 months, recurrence was observed in 3% with a mean disease-free survival of 8 months. Overall survival was 82% and 90% in patients with positive and negative SLN, respectively. Overall mortality was 15%, due to distant metastases in 78% of the cases.Conclusions: Staging of early-stage melanoma with the SLN dissection by use of the blue dye technique combined to lymphoscintigraphy and immunohistochemistry is reliable and safe, with less morbidity than elective lymphadenectomy. Long-term follow-up is mandatory to establish the exact reliability of SLN dissection.","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"8 5","pages":"209-14"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22103498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 28

[Merkel cell carcinoma. Retrospective analysis of 4 cases with special reference to diagnosis, therapy and long-term outcome]. [默克尔细胞癌]。回顾性分析4例病例，特别参考诊断、治疗及远期疗效。

Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera Pub Date : 2002-01-01 DOI: 10.1024/1023-9332.8.5.215

C Candrian, Th Ruedi, M Furrer

{"title":"[Merkel cell carcinoma. Retrospective analysis of 4 cases with special reference to diagnosis, therapy and long-term outcome].","authors":"C Candrian, Th Ruedi, M Furrer","doi":"10.1024/1023-9332.8.5.215","DOIUrl":"https://doi.org/10.1024/1023-9332.8.5.215","url":null,"abstract":"Background: Merkel cell carcinoma is an aggressive neuro-endocrine skin tumor with early regional lymph node involvement and early distant metastases. Diagnostic work-up may be difficult because of the low incidence of the tumor. Treatment concepts are individual and long-term-outcome are varying markedly.Methods: Retrospective analyse of four cases with special regard to the diagnostic, therapeutic approach and the long-term follow-up.Results: In every case diagnosis has only been made histologically. In the first patient, suffering from a tumor on the upper arm, after the tumor removal, local and axillary radiotherapy has been performed. In a second case with an extended tumor on the shank, a palliative tumor-debulking was followed by a chemo- and radiotherapy. The third Patient had a tumor in the gluteal region with involvement of the regional lymph nodes. He was treated by a complete surgical excision and lymphadenectomy followed by a local radiotherapy with subsequent chemotherapy. The fourth patient with tumor on the elbow, without lymph node involvement, refused surgical intervention, therefore she has been treated by radio- and chemotherapy. All patients are respectively 1.2 and 3 years are alive without evidence of recurrence. One patient died after 1.5 year because of tumor relapse.Conclusion: Diagnosis of Merkel cell carcinoma is difficult and is established only by in- or excision biopsy of the tumor. If ever possible surgical excision combined with regional lymphadenectomy should be performed. Adjuvant radiotherapy is established, whereas the value of chemotherapy has not yet be defined and might be beneficial only in cases of expansive or disseminated growth. In our series we did encounter the often described metastatic involvement of other organs just in one case.","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"8 5","pages":"215-9"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22103499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0