Biomedical subjects

A Schmalholz

Publications and source records attributed to A Schmalholz.

7 recordsLinked to original sources

PubMed2001

Ultrasound for diagnosis of infection in revision total hip arthroplasty.

Eighty consecutive patients (85 hips; 43 women; median age, 74 years [range, 33-90 years]) underwent a revision total hip arthroplasty. Preoperatively and guided by ultrasound, biopsy specimens of the joint pseudocapsule were taken, and joint fluid was aspirated for culture. Capsule morphology was investigated with light microscopy. When septic loosening was defined as 2 intraoperative cultures yielding the same microorganism, the prevalence was 12%. Sensitivity of the capsule biopsy cultures was 67%; specificity, 68%; positive predictive value, 22%; and negative predictive value, 94%. Joint fluid was often sparse and always falsely sterile. One specimen from a hip with septic loosening showed histologic changes (> or =3 foci, each with > or =3 plasma cells/high-power field) consistent with chronic infection. The remaining 8 septic loosenings eluded histologic detection, yielding 11% sensitivity. All aseptic loosenings were classified correctly (specificity 100%). Positive and negative predictive values were 100% and 89%. Ultrasound-guided aspiration and capsule biopsy with cultures and histology does not seem to be sufficiently accurate in the preoperative diagnosis of infected total hip arthroplasty.

Adult↗

PubMed2000

Revision total hip arthroplasty using third-generation cementing technique.

A total of 83 consecutive first-revision total hip arthroplasties were performed in 83 patients using pressurized vacuum-mixed cement, a third-generation cementing technique. At a median follow-up of 3.6 years (range, 1.5-6.3 years), the overall failure rates (radiographic loosening, re-revision, or both) were 39% for the femoral components and 30% for the acetabular components. With definite radiographic loosening as an endpoint, the cement-bone interface achieved was the only significant factor to predict stem durability, with an adjusted odds ratio of 1.8 (95% confidence interval, 1.1-3.0). On the acetabular side, bone stock was the only significant factor, with an adjusted odds ratio of 5.3 (95% confidence interval, 4.0-27.7). In this retrospective cohort study, femoral cement pressurization per se did not appear to improve the results over those of other studies using second-generation techniques.

Adult↗

PubMed1990

External skeletal fixation versus cement fixation in the treatment of redislocated Colles' fracture.

In a prospective investigation in 1984 and 1985, all Colles' fractures (not comminuted or intraarticular) that redisplaced after two closed reductions were allocated at random to one of two groups: Group I (n = 23), in which the dorsal bone deficiency was filled with bone cement (methylmethacrylate), and Group II (n = 25), in which the fracture was treated with external fixation. All were followed for one year and examined with respect to anatomy of the fracture, wrist movement, strength, appearance, pain, function, and complications. Roentgenograms, 12 months after treatment, showed that all fractures had healed and that the cement was enveloped in cortical bone. The final results were equal in the two groups, but Group I improved earlier and had no complications.

Aged↗

PubMed1989

Bone cement for redislocated Colles' fracture. A prospective comparison with closed treatment.

Colles' fractures (not comminuted or intraarticular) that redislocated after two closed reductions were randomized into two groups. In one group the dorsal bone deficiency was filled with bone cement (methylmethacrylate) at operation; in the other, the fractures were rereduced and immobilized in a plaster cast. All the patients were followed for 2 years and examined with respect to anatomy of the fracture, wrist movement, strength, appearance, pain, and function. The operated on group were better with regard to all objectively measurable characteristics; all operated on fractures had healed radiographically, and the cement was surrounded by cortical bone.

Aged↗

PubMed1989

Closed rereduction of axial compression in Colles' fracture is hardly possible.

Totally, 146 Colles' fractures that were displaced after the primary reduction were treated by closed rereduction and plaster immobilization. A permanently acceptable position was achieved in 11 of 27 cases, where dorsal angulation was the only malalignment. In fractures with both axial compression and dorsal angulation, both displacements improved to a permanently acceptable position in only 7 of 105 cases, and only the dorsal angle improved to an acceptable position in 26 cases. The axial compression was most difficult to correct. The chances of achieving a permanently acceptable position by rereduction are rather small in Colles' fracture with axial compression alone or combined with deviation of the dorsal angle. High age and the presence of dorsal comminution are further factors likely to worsen the prognosis.

Adult↗

PubMed1988

Epidemiology of distal radius fracture in Stockholm 1981-82.

During 1981 and 1982, 1,536 fractures of the distal radius were treated within the catchment area of Södersjukhuset (Southern Hospital), Stockholm. The age-specific incidence did not differ from that of three other Scandinavian investigations, except for women over 75 years of age, among whom the incidence decreased in Stockholm and Oslo and increased in Malmö and Hillerød. Using Frykman's (1967) classification, extraarticular fractures dominated.

Adolescent↗

PubMedDate not supplied

A scintimetric study of Colles' fracture. Comparison between cementation and closed treatment.

In order to study whether bone cement (methylmethacrylate) inserted in the medullary cavity of redisplaced Colles' fractures to fill the dorsal defect arising after repeat reduction is an obstacle to bony union, the course of healing was monitored by scintimetry in fractures thus treated (n = 10), in fractures treated by external fixation (n = 10), and in undisplaced fractures immobilized in a plaster cast. No differences emerged between the three groups. It is therefore assumed that the insertion of bone cement does not disturb the healing process.

Aged↗