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E Lambiris

Publications and source records attributed to E Lambiris.

33 records · Page 2Linked to original sources
PubMed1994

Pattern of screw loosening in fractures fixed with conventional and functional plates.

Plate fixation depends mainly on the holding power of the screws. In the present study the pattern of screw loosening was investigated. Thirty-two adult female sheep divided into four groups were used. A mid-diaphyseal transverse osteotomy was made on the right radius of each animal, and then plated on the anterior (tension) surface. Half of each group were plated using a standard narrow 7-hole AO Dynamic Compression Plate (DCP), whereas in the remaining animals a 6-hole newly designed sliding plate (SP) was applied. The required torque of tightening intraoperatively, as well as for releasing the screws after killing the animals was recorded with a tension-calibrated screwdriver. The pattern of loosening was similar for all the screws and the three phases could be recognized. An initial loosening was observed 1 month after the operation. A slow recovery of the torque was measured from the second month onwards, becoming highest by the fourth month after the operation, whereas a slow decrease in torque was observed from the fourth to the sixth month. In the SP group, the overall loosening was much lower than the DCP group (P < 0.05), whereas there was no difference in the loosening between the proximally placed screws and the distally placed ones (P > 0.05) for both plates.

Animals↗
PubMed1993

Recurrence of pigmented villonodular synovitis of the knee 17 years after the initial treatment. A case report.

Pigmented villonodular synovitis (PVNS) is a benign proliferative process involving the synovial membranes bursas or tendon sheaths. The rarity of the process, the absence of well-documented long follow-up examinations, as well as reports on different forms of the disease from multiple anatomic sites has lead to some confusion. This is a case report of a 44-year-old woman with recurrence of PVNS of her right knee, 17 years after the initial limited knee synovectomy. It was proven impossible to differentiate the disease from soft-tissue malignancy despite the use of all the available investigation methods, including nuclear magnetic resonance. Eventually the diagnosis was made by an open biopsy. Marginal excision of the soft-tissue mass from the popliteal fossa was performed initially, followed by a total knee synovectomy within the next two weeks. The patient remains recurrence free 32 months after the operation.

Adult↗
PubMed1992

Trigger digit: the needle or the knife?

We report our experience in conservative treatment of 30 patients with trigger digits followed up for an average of 22.3 months. In 26 patients (86.6%) the pain disappeared and the others experienced a remarkable improvement. Locking resolved in 23 patients (76.6%): in 19 patients immediately after the injection and in the other four gradually thereafter. Only three patients needed a second injection. All were satisfied and none required any other form of treatment.

Aged↗
PubMed1986

The sustained release of cefotaxim from a fibrin-cefotaxim compound in treatment of osteitis. Pharmacokinetic study and clinical results.

Following a survey of the literature regarding clinical examinations and experimental studies of local absorbable carrier for an antibiotic in treatment of osteitis, a study is presented concerning clinical experience with 46 patients treated with a cefotaxim-loaded fibrin sealant. In connection with simultaneous focal sanitation the clinical results were satisfying. When autogenous cancellous bone was added at the same time, only one surgical operation was necessary in some cases to show results equivalent to other methods. Postoperatively, the cefotaxim levels in the blood and in the wound drainage fluid were measured. The serum cefotaxim concentrations were low and only identifiable for a period of 36h, whereas the wound drainage fluid contained very highly effective antibacterial concentrations over a measured period of 3.5 days. The best results were seen in cases of hematogenic osteomyelitis. The disadvantage of this system is the quick release of the antibiotic by diffusion. Therefore, high concentrations can be obtained only for a short period of several days.

Administration, Topical↗
PubMed1986

[Intramedullary nailing as an alternate method in the management of slow-healing or pseudarthrotic upper and lower leg fractures].

Intramedullary nailing of delayed healing fractures and non-unions in the lower extremity is the method of choice in biological and biomechanical aspects. With the technic of interlocking screws the indication is extended to the metaphyseal areas of tibia and femur. By nailing as alternative method an ossification of fractures and non-unions can be reached at a rate of about 90 per cent. This result is rather unique in the literature. In the treatment of shaft non-unions after cast fixation or rigid stabilisation by plates or external fixation nailing must succeed throughout its weight-bearing system and only fails in the case of infection and wrong indication.

Adult↗
PubMed1982

[Diagnosis of ankylosis].

An improved therapy planning--for conservative as well as for surgical treatment--depends on an exact diagnosis of the ankylosis. Above all, it is decisive to know whether the ankylosis has intraarticular or extraarticular causes or if there are obstacles in form of osseous parts or soft tissues. We dispose of the following diagnostic means: the clinical manifestations and the X-ray radiography. In most of all cases, these criteria are sufficient to make an exact diagnosis. Complementary examination methods such as arthrography, arthroscopy and, last but not least, thermography are only needed in exceptional cases.

Ankylosis↗
PubMed1981

[Aseptic complications in total alloarthroplasty of the hip joint (author's transl)].

A perfect technic of implantation is the fundamental factor to guarantee a postoperative course free of complications. The position of the prosthesis and a high initial stability are important factors, too. In the OHH 1 561 patients were given 1 973 cemented total endoprostheses from 1968 to 1978. From 1975 to 1980, an additional number of 212 total endoprostheses without cement (ceramic prostheses) were implanted. The following aseptic complications were most common: (1) loosening, (2) luxation, (3) fractures of the shaft of the prosthesis, (4) bursting of the femur-shaft, (5) protrusio acetabuli, and (6) periarticular deposition of calcium. The rate of complications in cemented total endoprostheses was 2.7%, in cement-free endoprostheses 5.7%. In 10.3% of the cemented endoprostheses early complications were observed; among the patients with cement-free endoprostheses there occurred one luxation and one fatal case (pulmonary embolism). Late complications of the cemented endoprostheses were seen in 8%; among the cement-free endoprostheses 4 loosenings of the acetabulum, 3 loosenings of the shaft, 1 protrusio acetabuli and 1 fracture of the ceramic neck were found. 77.5% of the patients, with cemented prostheses judged their ability to walk as much improved, compared to the previous state. In 15.7% the results were unchanged, in 6.7% the state had deteriorated. Among the patients with cement-free endoprostheses 61% considered their walking ability to be much better, 29% moderately improved and 8.5% unchanged. 1% felt worse than before surgical treatment.

Femoral Fractures↗
PubMed1981

[Thermography in osteosyntheses and total endoprostheses of the knee joint with and without infection (author's transl)].

Thermography supplies information on the radiation temperature and hence on the blood supply in the body surface area. Together with the clinical findings this can contribute towards the recognition and recording of infections. During the normal course of a cure following osteosynthesis, the radiation temperature rose moderately up to +2 C degrees and returned to normal after 4 to 6 weeks. In case of infections, however, hyperthermia was very pronounced. Hyperthermia did not rise above +2 degrees C in case of mechanical loosening of an alloarthroplastic knee joint substitute. However, in infections temperature rises up to +44 degrees C were seen. Hence, thermography can supply additional pointers for further therapeutic approach.

Fracture Fixation, Internal↗
PubMed1979

[Fractures of the femoral neck in children (author's transl)].

Osteosynthesis is the preferred method of treatment in fractures of the neck of the femur in children. Operative technique requires attention to be paid to a few special features due to the problems caused by the neighbourhood of the joint of the femoral neck. Nine cases of fractures of the neck of the femur in children were treated by the authors during 1971 to 1978. Diagnosis of such lesions, which are no longer a rare occurrence, requires accurate x-ray films on two levels, because infractions are easily overlooked. The dreaded complications of necrosis of the femoral head can best be counteracted by immediate anatomical repositioning and exercise-stable osteosynthesis, as well as by temporary relief. The authors discuss the therapeutic procedure in detail, basing on the experience with their own patients, and the results are communicated.

Adolescent↗
PubMedDate not supplied

[Comparative study of the treatment of pertrochanteric fractures--trochanteric gamma nail vs. proximal femoral nail].

AIM: We have performed a retrospective comparative study between the trochanteric gamma nail (TGN) and the proximal femoral nail (PFN). METHOD: During the period 1998-2003, 97 TGN and 83 PFN were used for the treatment of pertrochanteric fractures. Most of the fractures were of the A3 type according to the AO/ASIF classification. Clinical and radiological follow-ups were available for 87 TGN and 65 PFN. RESULTS: The mean operative time for the TGN was shorter than that for the PFN. Intraoperative complications were noted in 17.5 % and 28.8 % for the TGN and PFN groups, respectively. Late complications occurred in 18.4 % for TGN compared to 27.6 % of the PFN. Union was achieved in 94.2 % and 89.3 % of the patients treated with the TGN and PFN, respectively. The reoperation rates were 10.3 % and 24.6 % for the TGN and the PFN, respectively. Clinical outcomes were good for both groups (65 % in the TGN, 62 % in the PFN group). CONCLUSION: Treatment of pertrochanteric fractures using the TGN and PFN implants is quite reliable. The major complication was cut-out and occurred mostly in the PFN group, while varus deformity was more frequent in the TGN group. The PFN was associated with a higher rate of reoperation and longer operative time, probably due to a more demanding technique.

Aged↗
PubMedDate not supplied

[Adaptation of the viscoelastic behavior of bone cement to bone as a stabilizing factor in endoprostheses].

Incompatibility of viscoelastic properties is a major factor contributing to the development and enlargement of microscopic cracks between bone and bone cement. In the study reported here the viscoelastic characteristics of fresh long bones were studied in vitro and compared with those of bone cement. Using strain gauges, creep elongation was measured over time spans ranging from 10(-2) to 10(3) seconds with an applied stress of 10 MPa. On the basis of these measurements creep compliance and permanent elongation at two points on a sheep femur were calculated by means of a rheologic Kelvin model with three parameters. The possibility of obtaining an optimal bone/cement bond was studied in the light of these results and of data published in the literature on bone cement creep related to cement composition factors.

Biomechanical Phenomena↗
PubMedDate not supplied

Comparative study of callus performance achieved by rigid and sliding plate osteosynthesis based upon dynamic mechanical analysis.

Operative management of long bone fractures is considered to be the treatment of choice all over the world. This could be achieved either by intramedullary nailing or plating. The former allows delivery of stresses into the fracture site, but it requires a well-equipped operating theatre and an experienced surgeon who is, unfortunately, continuously exposed to radiation. On the other hand, plates could easily be applied in every orthopaedic clinic, but the existing ones are rigid and protect the fracture site from stresses to which it is ordinarily exposed. Recently, various experimental attempts have been made to provide plates which allow partial loading on the fracture site and enhance callus formation (secondary fracture healing). Bearing that in mind, a two-part sliding plate (SP) has been developed at the Orthopaedic Clinic of Patras University, which allows intermittent loading into the fracture site. Both the conventional AO rigid plate and SP were applied to osteotomized sheep radii. The dynamic properties of the callus were estimated with its two dynamic mechanical characteristics (dynamic modulus of elasticity and the relative loss factor), whereas its static properties (strength) were evaluated by measuring the ultimate bending strength. A superiority of callus produced by the sliding plate was observed concerning all the parameters under consideration.

Animals↗