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Biomedical subjects

G A Zych

Publications and source records attributed to G A Zych.

11 recordsLinked to original sources
PubMed1992

[Treatment civilian gunshot fractures of the femur shaft].

35 consecutive cases of fractures of the femoral diaphysis due to gunshot wounds (GSW) treated at Jackson Memorial Hospital of the University of Miami between January 1988 and February 1990 were reviewed. There were 32 low velocity and 3 high energy transfer wounds. The treatment protocol for low velocity GSW consisted of 3 days i.v. antibiotics, balanced skeletal traction (for logistic reasons) and delayed closed intramedullary nailing. There was no formal debridement performed. 3 out of 32 patients declined any operative intervention. The remaining 29 patients were treated according to the above protocol. 12 patients could be followed until complete osseous consolidation. In this group the only complication consisted of one late infection. 17 patients were lost to follow-up before complete consolidation. Out of this group, 8 showed advanced fracture callus formation on the last radiograph available, whereas 9 patients were lost to follow-up almost immediately after discharge. Since GSW victims were generally uninjured and treatment of indigent patients in the Miami area is declined by all other hospitals, we assume that there were non major complications even in the group of patients lost to follow-up. We therefore conclude, that intramedullary nailing of low velocity gunshot fractures of the femoral diaphysis without formal debridement is the treatment of choice under civilian circumstances.

Adult↗
PubMed1990

Complex upper-extremity fractures.

Complex proximal humeral fractures are a challenge to the orthopaedic surgeon. Achieving fracture healing while avoiding loss of function is best accomplished by early rigid fixation or prosthetic replacement, depending on the fracture type and characteristics.

Forearm Injuries↗
PubMed1988

Diaphyseal fractures of the humerus. Treatment with prefabricated braces.

Using a prefabricated brace, we treated 233 patients who had a fracture of the humeral shaft. One hundred and seventy patients were available for follow-up, which ranged from five weeks to forty-eight months. In these patients (forty-three open and 127 closed fractures), the average time to union was 10.6 weeks; the average varus-valgus angulation, 5 degrees; the average anterior-posterior angulation, 3 degrees; and the average shortening, as measured radiographically, four millimeters. All but three of the patients had an excellent or a good functional result with a nearly full range of motion of the extremity. There were a minimum of complications, including three non-unions. Because of the low morbidity and high rate of success, we concluded that the treatment of choice for diaphyseal fractures of the humerus is the prefabricated brace.

Adolescent↗
PubMed1987

Acute fracture of the proximal humerus superimposed on a chronic posterior dislocation of the humeral head.

We have reported the case of a 73-year-old woman with a posterior shoulder dislocation and comminuted fracture of the proximal humerus occurring during a seizure. Surgery disclosed an acute humeral fracture superimposed on a chronically dislocated humeral head. Endoprosthetic replacement yielded a satisfactory clinical result. We found no similar report in the literature.

Acute Disease↗
PubMed1987

Treatment of isolated ulnar shaft fractures with prefabricated functional fracture braces.

In a prospective study, from September 1980 to December 1984, 146 isolated ulnar shaft fractures were treated with prefabricated fracture braces. Clinical and roentgenographic follow-up data were available for 73 fractures. Functional results were rated excellent in 64 fractures (88%), good in seven (9%), and poor in two (3%). All fractures healed in an average time of 57 days. The mean angulation measured 6 degrees in the mediolateral plane and 4 degrees in the anteroposterior plane. The complication rate was 18%, relating mostly to residual angulation. Most isolated fractures of the distal one-half of the ulnar shaft can be treated successfully with prefabricated fracture braces.

Adult↗
PubMed1986

An unusual fracture of the talus associated with a bimalleolar ankle fracture. A case report and review of the literature.

A 53-year-old man sustained a fall from 1.25 m, injuring his hindfoot and ankle. Roentgenographic examination demonstrated a displaced vertical fracture through the neck of the talus with dislocation at the subtalar and tibiotalar joints (Hawkins Group III) and an ipsilateral bimalleolar fracture. Prompt anatomic reduction of the talus and bimalleolar fracture with rigid internal fixation was performed. Roentgenograms three years postinjury confirmed solid union of all fractures. Avascular necrosis of the talus had not occurred. Minimally disabling post-traumatic arthritis as both the ankle and subtalar joints was the only sequela. Only four similar injuries seem to have been reported previously in the literature. Despite the generally high incidence of avascular necrosis in Hawkins Group III talar neck fractures, none of these four cases developed this complication. A possible explanation is that with the presence of ipsilateral bimalleolar fracture, there is preservation of the extraosseous vascular supply that accompanies the deltoid and talofibular ligamentous complexes.

Ankle Injuries↗
PubMed1979

Clinical experiences with a titanium alloy total hip prosthesis: a posterior approach.

Using a titanium alloy femoral prosthesis (STH Zimmer) and an ultra high molecular weight polyethylene acetabular cup with a posterior surgical approach to the hip joint, 237 consecutive total hip arthroplasties in 215 patients were performed between December 1975 and May 1977. The preliminary results and early postoperative complications suggest that this system can be considered an alternative to total hip arthroplasty using other materials and surgical approaches.

Adult↗
PubMedDate not supplied

Acute psoas abscess in a newborn infant.

A 1-month-old neonate was seen for an acute toxic illness, suggestive of septicemia. No obvious focus of infection was present. During attempted femoral venipuncture, purulent material, thought to originate from the right hip joint, was encountered. Because of this aspirate, as well as suggestive local signs, septic arthritis of the right hip was diagnosed. Arthrotomy failed to confirm the diagnosis, and on further surgical exploration a purulent psoas abscess was discovered. The patient made an uneventful recovery, and at follow-up 48 months later was asymptomatic with a normal clinical examination. This case illustrates the difficulty of differentiating acute psoas abscess from septic arthritis of the hip in the neonate.

Abscess↗