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Biomedical subjects

F Chevalley

Publications and source records attributed to F Chevalley.

31 records · Page 2Linked to original sources

[Hospital management and short-term outcome of the severely injured: Lausanne experience].

Several physiological and anatomical methods of scoring severely injured patients have been developed since the 1970s, based on very large series of patients. In this study, 59 patients are assessed by the ISS (Injury Severity Score) and the RTS (Revised Trauma Score). The mean ISS is 28, and the mean RTS is 6; the overall evolution shows a 42.4% mortality. Analysis by the TRISS method shows 12 out of 18 "unexpected" deaths, the majority of which can be explained by the fact that the ISS underestimates severe neurological trauma, and that the RTS is not consistently obtained in the early patient notes in our emergency care system.

Adolescent↗

[Experimental study of external fixation of femoral fractures. Mechanical properties of different kinds of fixation. Clinical implications].

An in vitro assessment of the mechanical performance of 10 types of external femoral stabilization allowed the amplitudes of fracture site displacements during the initial loading phase of a comminuted fracture treated by external fixation to be established. The largest displacement to load ratios were observed in the sagittal plane for all tested configurations. The highest fixator stiffnesses were obtained by using large diameter tubes and pins. The most rigid fixators have a derigidification system which creates the problem of choosing the ideal time to change the rigidity.

External Fixators↗

[Progressive correction of an ulnar deviation of the hand following defective healing of the 2 forearm bones and probable sequellae of a Volkmann contracture].

The authors describe the progressive correction of a deformed forearm and an ulnar deviation of the hand as a result of a bullet wound. The injury comprised a fracture of the two bones of the forearm, with deformed callus and after effects of a probable Volkmann syndrome. The correction was obtained after 10 months. This report illustrates the interest and the difficulty presented by osteogenesis by distraction and osteotomy with a minimal cutaneous wound. This allows the reduction of risk to the cutaneum and vessels involved in extemporaneous corrections.

Adolescent↗

[An original rehabilitation method for the totally edentulous based on Ludwig's technique. 4. Articulator transfer. Mounting of artificial teeth].

Balanced occlusion is the occlusal concept used in full dentures. In this article, which describes the technique for mounting teeth according to LUDWIGS, the authors present a very typical equipment (guide punch, tooth guide, positioning and mounting plates...). This provides the dental technician with all the possibilities to create occlusal curves which are individualised for each case in order to achieve a balanced and rational mounting of artificial teeth.

Dental Articulators↗

[Original method for total edentulous rehabilitation based on the Ludwig technique. 2. The "Lutemat" and construction of custom impression trays (C.I.T.)].

Regardless of the schools or work habits in total prosthesis, the laboratory technician must, following the clinical session of primary imprints, prepare the latter and make models in hard plaster, on which he will develop the individual imprint constructions (IIC). By virtue of a special device developed by the author (the "Lutemat"), the IIC is equipped with two personalized occlusal rings adapted to the particular clinical case, adjusted as of the outset according to the intermaxillary relationships pre-established at the various levels. The final anatomophysiological imprint can be carried out under optimal conditions. Lutemat can be used with most current articulators. It has three principal uses: to permit the spatial orientation of maxillary and mandibular models and to pre-determine the height of the occlusal plan due to adjustable orientation points; to ensure the development of occlusal rings to a predetermined dimension and according to a privilege clinical situation on the occlusal plan, due to a "pocket" instrument; to permit the mounting, on an articulator, of models deriving from terminal anatomophysiological imprints. Following casting of the models and preparing the IIC base, the practitioner places and orients the mandibular model on the Lutemat base. The mandibular occlusal ring is shaped and modeled according to the individual criteria of the patient. The maxillary ring is then made depending on the intermaxillar relationships which were pre-established at the clinical session devoted to the primary imprints. The IIC's obtained using this technique are truly personalized and the later sessions of terminal imprints and recording of occlusion can take place with great ease and comfort.

Dental Articulators↗

[Pertrochanteric fracture in elderly subjects. Prospective non-randomized studies].

During a two-year period 237 patients were admitted for intertrochanteric fracture of the femur. 196 patients were included in this study with an average age of 79 years. Surgery comprised 163 nailings (Ender-Kempf), 31 blade plates and 2 prostheses. In this study the mortality rate and general complications were essentially related to the age and general condition of the patient; the general complications did not differ between methods. Walking ability at 6 months chiefly depended on the patient's general condition before the fall. The techniques allowing immediate weight-bearing diminished the length of hospitalization. Reoperation was required in 4% of nailings and 6.5% of blade plates.

Aged↗

[Atypical osteogenesis following multiple sequestrectomies for infected open fracture of the femur: a case].

The authors present the case of an open fracture of femur Cauchoix type II with an infection due to Escherichia coli, Clostridium perfringens, Enterococcus and Aspergillus fumigatus. After several sequestrectomies and five hyperbaric sessions, apyrexia was attained at the end of the third month, the femur having been stabilised with an external fixator. The 15 cm gap due to loss of bone substance, filled at each dressing with an antiseptic iodine based ointment, closed itself finishing as continuous bone five months after the accident, the granulation tissue having been recovered by thin skin grafts. A repeated fracture occurring forty-eight hours after the removal of the Hoffmann frame was treated by fitting an Ilizarov fixator arriving at consolidation in seven months. The authors examine different possibilities of accelerating osteogenesis and highlight the potential role of iodine ointment as inductive to osteogenesis stemming from a periosteal layer seemingly held in place.

Adult↗

[The surgical treatment of lumbar canal stenosis].

In a retrospective study of the results, 2 and 4 years after operation, of 52 cases of narrow lumbar canal, the most frequent preoperative symptoms were low back pain (82.7%), neurogenic claudication (61.5%) and sciatica (61.5%). 21 patients had a herniated disk in addition to the narrow canal. Sciatica was more frequent in this group than in narrow lumbar canal alone, where neurogenic claudication was more frequent. All patients underwent decompressive laminectomy, most often at level L4-L5. No spondylodesis was required. After 4.9 months, 84% of the patients were improved or cured. After more than 2 years 90% of the patients were cured of low back pain and 92% were cured of sciatica, but 22% were still under limitation in walking.

Adult↗