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Biomedical subjects

D Delimar

Publications and source records attributed to D Delimar.

16 recordsLinked to original sources
PubMed2001

A secure locking knot for microsuturing.

Perfect balance between maximal suture strength and minimal foreign-body reactivity guarantees success, using microsurgical techniques. The proposed initial locking knot allows optimal edge approximation. It has strength, it is simple to master, and is not too bulky. The knot is kept in its first position, without danger of slipping, before securing it with an additional knot of two loops. No additional knots are necessary, because the completed knot may fail by breaking, but never by slippage.

Humans↗
PubMed2001

Treatment of defect pseudoarthroses with bone segment transport.

PURPOSE OF THE STUDY: The most severe injuries during defense war in Croatia were caused by projectiles of high kinetic energy. Shell fragments bone they break the bone, transferring bone segments into additional individual projectiles. During this process periostal and endomedullary circulation is cut off reducing to a minimum the possibility of healing, leading to defects in long bone diaphyses. These are referred to as defect pseudoarthroses and are among the most difficult problems in reconstructive surgery of the musculo-articular system. This article presents bone segment transport as a method of choice for treating defect pseudoarthrosis. MATERIAL: During the defense Croatian war, in six-years period, 62 wounded persons were treated with Ilizarov method of bone segment transport. Among them, only one was female. Average age was 33 years. METHODS: The authors performed modified Ilizarov's method as standard procedure for bone segment transport in treatment of defect pseudoarthroses. After all soft tissues are held, corticotomy in metaphysis is performed and free bone segment transport started with Ilizarov method. Physical therapy provided adequate mechanical load, essential for bone healing and restoring the functionality of injured extremity. RESULTS: In the group of treated patients, the largest bridged defect was 20 cm, and the smallest one was only 1 cm. Infection arises in 20 of 60 patients. Contracture complications were ankle contractures, knee contractures and one elbow contracture. We also found one n. peroneus palsy and one limb amputation should be performed. DISCUSSION: Ilizarov method of bone segment transport presents the only procedure that could successfully and completely treat pseudarthroses, thus avoiding necessaries for limb amputations. Requirements in this procedure are experienced and highly qualified surgical team and high motivation and compliance of the patient.

Adolescent↗
PubMed1999

Arthroscopic Bankart repair with extracapsular and extra-articular knot using the Mitek suture anchor.

The recurrence of instability after arthroscopic stabilization has been significantly higher than after open repair. One of the reasons for the high failure rate is the inability of arthroscopic repairs to address the plastic deformity of the capsule that occurs in the glenohumeral ligament-labrum complex. The arthroscopic technique is used to repair the torn labrum to the glenoid, but without adequate tightening of the anterior capsule, which is successfully accomplished with an open technique. This report describes the new technique of arthroscopic Bankart repair with extracapsular and extra-articular knot using suture anchors that allows tightening of the anterior capsule sufficiently as with an open Bankart procedure.

Arthroscopy↗
PubMed1999

External fixator for war purposes: the CMC fixator.

More than 75% of all injuries in modern wars are localized on the extremities, and more than one-third of these injuries are accompanied by bone fracture. Application of an external fixator is one of the basic procedures in the treatment of war fractures. In this article, we present an external fixator for war purposes of our own construction called the CMC (Croatian Medical Corps) fixator. Although designed as a transport fixator, because of good biomechanical properties it has been widely used for definitive osteosynthesis of war injuries. The CMC fixator is manufactured as a sterile set, ready to use, with all necessary parts for application. On the battlefields of Croatia and Bosnia and Herzegovina during the war from 1991 to 1995, more than 2,500 CMC fixators were applied. The fixator has satisfied all required conditions and considerably contributed to diminishing the consequences of war fractures.

Biomechanical Phenomena↗
PubMed1998

Initial throw locking internal knotting technique.

Internal knotting is a highly versatile technique that closely resembles classic suturing. However, most intracorporeal knots are cumbersome and require a long time to master. We describe a simple, easy, and safe method for internal knotting that can also be used in open procedures and practiced until mastery is achieved. With this technique, the initial throw will never fail to hold tissues in apposition until the whole knot is constructed. The completed knot combines the maximum in suture support with a minimum of foreign body reactivity.

Endoscopy↗
PubMed1998

Hill-Sachs lesion in recurrent shoulder dislocation: sonographic detection.

In a prospective study 61 patients with recurrent anterior shoulder dislocation were evaluated by sonography, radiography, and surgery to determine the value of sonography in the detection of a HillSachs lesion. The group consisted of 57 male and four female patients with an average age of 27 years. Hill-Sachs lesion was found in 54 (88%) shoulders of the 61 surgically treated patients. Using surgical findings as the gold standard, we found sonography to be 96% (52 of 54 cases) sensitive, 100% specific (seven of seven cases), and 97% (59 of 61 cases) accurate in the diagnosis of HillSachs lesion. The average size of the lesion measured by sonography was 19.2 mm long, 16.0 mm wide, and 4.1 mm deep. The lesion was of small or medium size (up to 6 mm deep) in 88% of patients. Results of our study show that sonography is a valuable imaging technique in the diagnosis of Hill-Sachs lesion. It produced only two false-negative results when compared with surgical findings.

Adolescent↗
PubMed1996

A secure arthroscopic knot.

The proposed arthroscopic knot tying technique procedure is simple, easy to master, time saving, and the knot formed is not bulky. The initial tie loop holding capacity securely overcomes tension force between structures repaired. The completed know, secured with additional two throw square knot or with a three half-hitches incorporating the post switching and/or loop direction reversal, will fail by breakage rather than by slippage (for the most commercially available 0, 2/0, 3/0, absorbable and nonabsorbable, monofilament and braided sutures.

Arthroscopes↗
PubMed1995

[Arthrosis of the hand: epidemiologic and clinical characteristics].

The trial included 641 subjects, 200 (31.2%) of whom were found to have hand arthrosis. There were 135 (33.1%) women and 65 (27.9%) men with an average age of 54 (ranging from 35 to 75 years). Interphalangeal arthrosis was found in 33.1% of women and 25.8% of men, and rhisarthrosis in 8.3% of women and 7.3% of men. No significant differences in sex and age was found between these two groups of subjects (P = 0.45, P = 0.70). The relative incidence of arthrosis of the right hand was slightly higher than that of the left hand, but this difference was not significant because it was below 5% and 3.7%, respectively. Distal interphalangeal joints were more than three times more frequently affected than proximal interphalangeal joints. Pain and functional inability were found in two thirds of patients with rhisarthrosis and in one third of patients with interphalangeal arthrosis, and were closely correlated with the menopause. A significant correlation was found between the onset of menopause and clinical symptoms (r = 0.87, P = < 0.001).

Adult↗
PubMed1995

The effect of different traumatic experiences on the development of post-traumatic stress disorder.

This investigation was conducted during the war in Croatia from 1991 to 1993. General characteristics, traumas, and frequency of post-traumatic stress disorder (PTSD) were compared in three groups of soldiers: (1) soldiers who sustained non-disabling injuries; (2) soldiers who sustained permanently disabling injuries; (3) active soldiers (controls). Significant differences were found in general characteristics and in PTSD in the groups observed. Both groups of wounded soldiers were significantly younger (mean of 8 years), fewer of them were married, and they had fewer children than active soldiers (controls). The differences in marital status and the number of children were obviously due to the age difference. Soldiers who sustained non-disabling injuries developed PTSD significantly more often than soldiers who sustained permanently disabling injuries and active soldiers (controls). Possible reasons for the differences of PTSD in compared groups of soldiers are discussed.

Adult↗
PubMed1994

Characteristics of patients who attribute chronic pain to minor injury.

Eighty-four chronic low back pain (CLBP) patients were studied in order to determine whether personality differences existed between patients reporting a minor injury at work as the cause of their disability and ensuing insurance claims, and patients who did not. Twenty-three of the CLBP patients studied reported that their pain resulted from a accident at work. All the subjects underwent a variety of psychological and somatic tests. The results indicate that the "accident" patient group is characterized by specific psycho-dynamic personality patterns significantly different from the characteristics of the "non-accident" group. The characteristics of the patients in the "accident" group suggest that these patients tend to hold on to minor injuries, and that one possible reason for this might partly be related to the liberal insurance policies in Sweden.

Accidents, Occupational↗
PubMedDate not supplied

The role of blood pressure, cortisol, and prolactin among soldiers injured in the 1991-1993 war in Croatia.

Ninety soldiers with at least three months of combat exposure--60 injured soldiers (30 with permanent disabling and 30 with nondisabling injuries), 30 noninjured soldiers and 30 healthy controls--were interviewed and investigated with physiological (Prolactine, Cortisol, BP, Hb) and psychological tests (MMPI), IES-15 (Impact of Event Scale), PTSS (Post-Traumatic Symptom Scale). Their war related injuries had a different effect on the physiological stress response of the soldiers as reflected in the levels of prolactine, cortisol, hemoglobin and blood pressure. In a report of personality characteristics of the same soldiers, we demonstrated that the experience of posttraumatic stress was not dependent upon physical injury, but rather on the psychological appraisal of the situation. The results of the present article confirm earlier findings that the relationship between physiological and psychological consequences of trauma are complex, and that the perception of an event and the social context within which the traumatized soldier exists is as important as the event itself. The physiological response to the trauma varied greatly among the soldiers regarding the psychosocial impact of the consequence of the injury. So the anticipation of future possible trauma among less severely wounded soldiers (expected to go back to war) was followed by pathological stress responses. Trauma seems to operate somewhat independently from the overt conscious appraisal of the situation and relationship between psychological, psychosocial, and physiological aspects are interrelated in a multifactorial way. An integrative approach is therefore of great importance in assessment as well as in treatment of Posttraumatic Stress Disorder (PTSD).

Adult↗