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A J Verbout

Publications and source records attributed to A J Verbout.

At least 55 records · Page 3Linked to original sources
PubMed1998

Changes in the disc space after fractures of the thoracolumbar spine.

We have studied the intervertebral discs adjacent to fractured vertebral bodies using MRI in 63 patients at a minimum of 18 months after injury. There were 75 thoracolumbar fractures of which 26 were treated conservatively and 37 by posterior reduction and fusion with an AO internal fixator. We identified six different types of disc using criteria based on the morphology and the intensity of the MRI signal. The inter- and intraobserver variability of this system was good. Most of the discs showed predominantly morphological changes with no variation in signal intensity. Some disc types were associated with progressive kyphosis in patients treated conservatively. In those managed by operation, recurrent kyphosis appeared to result from creeping of the disc in the central depression of the bony endplate rather than from disc degeneration. Changes in the disc space after posterior fixation should not be seen as a form of chronic instability but as a redistribution of the disc tissue in the changed morphology of the space after fractures of the endplate.

Adolescent↗
PubMed1998

Function of stiff joints may be restored by Ilizarov joint distraction.

Three patients with joint stiffness caused by trauma or infection are reported. The involved joints are the interphalangeal joint of the thumb, patellofemoral joint, and ankle joint. As an alternative for the indicated arthrodesis in these patients, treatment with articulating joint distraction was performed. By use of adapted Ilizarov external ring fixators, gradual distraction was applied to loosen the joint, followed after loosening by a period of exercise during distraction. In all three patients this experimental approach led to a decrease in pain and improvement of joint function that persisted for at least 2 years after treatment. With the use of Ilizarov joint distraction, joint function in cases of joint stiffness may be restored, and the need for an arthrodesis can be postponed.

Adolescent↗
PubMed1997

Release of tobramycin from tobramycin-containing bone cement in bone and serum of rabbits.

Tobramycin release from tobramycin-containing bone cement was studied in vivo in a rabbit model. After insertion of cement into the right femur, tobramycin concentration as a function of time for up to 28 days was measured in serum and bone of rabbits. Tobramycin release in the femoral cortex adjacent to the cement was found to exceed the minimal inhibitory concentration for Staphylococcus aureus Wood 46. Serum tobramycin concentrations were below the systemic toxicity threshold.

Journal Article↗
PubMed1995

Recurrent kyphosis after posterior stabilization of thoracolumbar fractures. 24 cases treated with a Dick internal fixator followed for 1.5-4 years.

24 patients with Th12-L1 fractures treated with a Dick internal fixator were analyzed to assess predictors of poor outcome. 4 patients had fixation without bone transplantation, 20 patients had a posterior fusion, and 12 of them had additional transpedicular spongioplasty. There were fractures of the transpedicular screws in 4 and screw migration in 2 cases. The increase in the local kyphosis angle was greater than the increase in the anterior compression angle and this did not correlate with spongioplasty or fusion. Fixation failure was in all cases related to a disproportionate increase in the local kyphosis angle. There was no difference between the patients with transpedicular spongioplasty and posterior fusion and the other patients with respect to results and complications. Bony collapse was not the major cause of failure and consequently there was no measureable contribution of transpedicular spongioplasty. We found that the Dick internal fixator for unstable fractures was associated with a higher complication rate than earlier reported.

Adolescent↗
PubMed1995

Can Ilizarov joint distraction delay the need for an arthrodesis of the ankle? A preliminary report.

We applied joint distraction using an Ilizarov apparatus in 11 patients with post-traumatic osteoarthritis of the ankle to try to delay the need for an arthrodesis. Distraction for three months resulted in clinical improvement in pain and mobility for a mean of two years, with an increase in the joint space. We considered that these effects may be produced by the absence of mechanical stress on the cartilage combined with the intra-articular hydrostatic pressures during distraction. We measured these pressures during walking with distraction, and found levels very similar to those reported to improve osteoarthritic cartilage when applied in vitro.

Adult↗
PubMed1993

[Good results of surgical treatment of idiopathic scoliosis using the Cotrel-Dubousset technique].

OBJECTIVE: To determine the results and complications of the Cotrel-Dubousset (CD) operation in idiopathic scoliosis. DESIGN: Retrospective. SETTING: Wilhelmina Children's Hospital, Utrecht, and University Hospital, Leiden. METHOD: Of the first 22 patients with idiopathic scoliosis operated on with CD instrumentation the results were determined: the Cobb angle, the percentage of rotational correction achieved, duration of the operation, amount of blood loss, complications and duration of the postoperative hospital stay. RESULTS: Compared with the Harrington technique, there were fewer complications resulting from instrumental failure (three in all), while the correction of the scoliosis was the same and in some cases even better. Advantages of the CD operation for the patient were rapid mobilization, short postoperative hospital stay and short duration of the after-treatment with use of a removable light plastic corset. CONCLUSION: The Cotrel-Dubousset operation appears to be a promising method for the treatment of patients with idiopathic scoliosis.

Adolescent↗
PubMed1993

Reconstruction of congenital tibial pseudarthrosis by revascularized fibular transplants.

Seven patients with congenital Boyd type II pseudoarthrosis of the tibia and fibula were treated with a revascularized osteocutaneous fibular graft from the contralateral side. Follow-up ranged from 20 to 96 months (mean 67 months). All patients had previously undergone major surgery (mean three operations). Union was successful in all patients although three required further surgery. At follow-up all patients were able to walk without external support. The results were classified as good in two cases and fair in five cases. The postoperative period was, however, often complicated by stress-fracture and nonunion. Leg length discrepancy and valgus deformity are still unsolved problems in some cases. It seems probable that a primary reconstruction at an early age will prevent many of these subsequent problems.

Adolescent↗
PubMed1991

Magnetic resonance imaging in acetabular residual dysplasia.

Eighteen hips in 15 children showed persistent roentgenographic evidence of congenital acetabular residual dysplasia at four- to eight-year follow-up evaluations. The mean follow-up period was 5.8 years. These hips were subsequently evaluated by magnetic resonance (MR) imaging. MR imaging studies revealed thick unossified chondroepiphyseal cartilage of the acetabular roof adjoining the ilium in all hips. The cartilage in these hips counterbalanced the steep acetabular slope seen on roentgenograms. Initially these hips were regarded as candidates for an acetabular reconstruction, but 11 hips displayed sufficient cartilaginous acetabular coverage on MR images. MR imaging promotes more accurate selection of patients for acetabular reconstruction and aids in the choice of the most appropriate type of acetabular reconstruction.

Acetabulum↗
PubMed1991

Treatment of severe kyphosis in myelomeningocele by segmental spinal instrumentation with Luque rods.

Myelomeningocele leads to kyphosis of the dysplastic spine in 12-20% of cases, resulting in a severe gibbus. In three patients (at the age of 9, 13 and 16 years) with a thoracolumbar kyphosis (90 degrees, 120 degrees and 95 degrees respectively), and a compensatory thoracic lordosis (35 degrees, 105 degrees and 90 degrees) a resection or a wedge osteotomy of the gibbus was performed with segmental sublaminar wire fixation to Luque rods. In addition, a spondylodesis with autogenous bone and an allograft was performed. Correction of the kyphosis (to 30 degrees, 60 degrees and 50 degrees) and lordosis (to 15 degrees, 65 degrees and 55 degrees) was attained. This posterior procedure was sufficient for correction; there was no need for an anterior release. Cord and dura were left intact. During follow-up (27, 60 and 30 months) no progression of the curves has been noted. This one-stage posterior correction with L-rod fixation proved to be a method of choice for this difficult-to-treat spinal deformity.

Adolescent↗
PubMed1990

A correlative study of MR images and cryo-sections of the neonatal hip.

The complex anatomy of the neonatal hip is often difficult to image. Recently, magnetic resonance imaging (MRI) has been used to evaluate the normal and abnormal neonatal hip. We correlated the MRI scans of the hip of a newborn cadaver with multiplanar cryo-sections stained according to Mallory-Cason, to detail the anatomic structures of the normal hip joint space. In our experience, MRI was shown to provide excellent depiction of hip anatomy.

Hip Joint↗
PubMed1989

A model of the human knee, derived from kinematic principles and its relevance for endoprosthesis design.

A mainly deductive kinematic model of the human knee is described. The modelling procedure is based upon the application of a four-bar mechanism. Emphasis has been laid upon elucidating the functional anatomical relationship between several morphological characteristics concerning the shape of the articular surfaces and the constellation of the cruciate ligaments. Starting from a simple planar model, which simulates motions in a sagittal plane only, a spatial model was developed, which allowed an additional longitudinal rotation of the tibia also. The conclusions drawn from this modelling procedure have been used to evaluate from an functional anatomical point of view the current designs of presently available endoprostheses for the knee.

Humans↗
PubMed1988

Free vascularized fibular graft for tibial pseudarthrosis in neurofibromatosis.

Four patients with neurofibromatosis and a dysplastic type of congenital pseudarthrosis of the tibia were treated by resection of the lesion and reconstruction of the extremity with a free vascularized fibular graft. Solid union of the graft was achieved within 3 months in 3 children. However, valgus malalignment of the tibia progressed in all 3. One child was treated with resection of a lateral fibrotic band and another with distal tibial epiphysial distraction and realignment. In the fourth patient, who was skeletally mature, a nonunion developed proximally.

Adolescent↗
PubMed1988

[Congenital defects of tibia and fibula].

This study comprised 7 patients with longitudinal anomalies of the knee and leg classified in accordance with the 'classification of congenital limb deficiencies' introduced by Frantz and O'Rahilly. The anomalies were paraxial hemimelia of the fibula (4 instances), paraxial hemimelia of the tibia (6 instances). In the absence of the proximal tibia, therapy consisted of knee reconstruction according to Brown. In the absence of the distal part of the tibia a proximal tibiofibular synostosis was performed. In one instance corrective osteotomy of the tibia was required in the absence of the fibula. Exarticulation according to Syme was resorted in order to cope with an incorrigible abnormal position of the foot and for leg length inequality. The therapy should aim at giving the child walking ability at a normal time. Exarticulation has to be preferred to amputation in the treatment of these patients.

Child, Preschool↗
PubMed1988

[Bacterial infantile coxitis and its sequelae].

Septic arthritis constitutes a serious threat for the infant hip. Literature data mention a favourable outcome only after surgical drainage within 3-4 days after the onset of symptoms. Clinical observations impose the idea that recognition of this disease often occurs too late, which brings about a subsequent serious damage to the hips involved. In order to verify this idea and to demonstrate the grave sequela of late recognition an investigation was carried out among 18 patients known as having suffered from this disease, collected from 2 children's hospitals and one university clinic. Thereby literature data were confirmed. The variety of hip joint damage is described.

Anti-Bacterial Agents↗