Biomedical subjects

G Bakalim

Publications and source records attributed to G Bakalim.

At least 19 recordsLinked to original sources

PubMed1987

Treatment of delayed union and non-union of the carpal scaphoid with a compression staple and cancellous bone grafting--new method and preliminary results.

Scaphoid non-union (eight cases) and delayed union (three cases) were treated by compression staple and inlay of cancellous bone from iliac crest between the bony fragments. Union was achieved in ten of the cases (91 per cent). The consolidation time was 8-12 weeks in seven cases and 24 weeks or more in three cases. The compression stable fixation connected with bone grafting is a new and simple method to treat chronic fractures of the carpal scaphoid which is a difficult problem. The early results appear promising.

Adult↗

PubMed1986

Radial palsy in shaft fracture of the humerus.

Fifty-nine patients with immediate and 16 with secondary radial nerve palsy complicating a fracture of the shaft of the humerus were reviewed. According to the preferences of the surgeon in charge, the palsy was treated either with early exploration of the radial nerve and internal fixation of the fracture or with initial expectance. Of the latter, 12 were later explored. No useful recovery of motor function could be seen in 13/59 patients with immediate and in 2/16 patients with secondary palsy. In patients with immediate palsy treated by early exploration, there were 8/27 nonrecoveries. Among those treated with initial expectance, there were 5/32 nonrecoveries. For secondary palsy, these figures were 2/10 and 0/6, respectively. No support emerged for routine early exploration.

Adolescent↗

PubMed1985

Late results in supracondylar humeral fractures in children.

The end results of supracondylar humeral fractures in 151 children after an average follow-up period of 15 years are presented. The relationship between the carrying angle and the functional result was analyzed. A deformity of the carrying angle was not felt by the patients to be a cosmetic handicap, and the functional results were not problematic. However, the least satisfactory subjective results in the series were associated with a decrease of the carrying angle by at least 10 degrees and with a significant proportion of the limitations of movement of the elbow joint.

Biomechanical Phenomena↗

PubMed1985

Immediate radial nerve palsy complicating fracture of the shaft of the humerus: when is early exploration justified?

A series of 59 patients with immediate complete radial nerve palsy complicating a fracture of the shaft of the humerus was analysed. In 27 patients the radial nerve was explored and the fracture was fixed within 3 weeks of the accident. In 12 other patients exploration was performed after an average of 17 weeks. The remaining 20 patients showed signs of spontaneous recovery within 4 months and were managed conservatively. The mean follow-up time was 3 years. At exploration, laceration, interposition between the fragments or entrapment of the radial nerve in callus was found significantly (P less than 0.01) more often with longitudinal fractures of the distal third (46 per cent) than with transverse fractures of the middle third, in which 85 per cent of the explored cases showed the nerve to be no more than slightly bruised. Useful recovery was seen in 46 patients (78 per cent of the whole series).

Adolescent↗

PubMed1985

Flexor tendon division at "no-man's land" of the hand treated by primary suture and passive controlled mobilization.

Flexor tendon injuries to the no-man's land of the hand previously exclusively treated by delayed operation and tendon grafting can be treated successfully by primary suture and postoperative controlled passive mobilization. Ten patients with flexor divisions of fourteen fingers were operated on using a modified Kessler technique and mobilized passively under control. The outcome in two tendons was poor, in one it was fair and in all the others good. The reason for the poor result in the two cases was suture leakage. Primary tendon repair should be preserved for clean uncomplicated tendon divisions. Sufficient experience in surgery of the hand is necessary to achieve good results.

Adolescent↗

PubMed1977

Resection of the acromion in the treatment of persistent rotator cuff syndrome of the shoulder.

Partial or complete excision of the acromion was performed in 25 patients (29 shoulders) with long-standing pain in the shoulder typical of rotator cuff syndrome. There was no verified history of trauma in nine cases (13 shoulders), while injury was the cause of pain in 16 patients (16 shoulders). In nine shoulders there was a small and in two a large rupture of the rotator cuff. Twelve of the 13 non-traumatic shoulders became painless postoperatively and the pain was relieved in one. In the 16 traumatic shoulders the relief of pain was complete in six, partial in nine, and one remained unchanged. The condition was not aggravated in any of the cases. Mobility increased postoperatively in four cases and was in no case decreased by the operation. In this series the results were as favourable after partial as after complete excision of the acromion alone or excision in combination with other procedures appears to be a promising method of treatment of patients with long-standing rotator cuff syndrome.

Acromion↗

PubMed1976

Peripheral nerve injuries of the upper extremity. Sensory return of 137 neurorrhaphies.

The results of sensory recovery of 137 neurorrhaphies of the upper extremity in 96 patients are reviewed. There were 85 primary and 52 secondary repairs. Various factors influencing the results and an evaluation based on the 2-point discrimination test are presented. Secondary repair within 3 months in the hand area gives better results than primary repair.

Adolescent↗

PubMed1975

Primary mobilization after secondary flexor tendon surgery.

The value of immediate postoperative mobilization after secondary repair was studied in 63 patients with 93 flexor tendons. With grafts, an essential requirement is strong fixation. Distally, the graft was carried through a canal drilled from the distal phalanx to the upper side of the nail. Proximally, Pulvertaft's technique was used. The initial aftercare was very important, and required 3 weeks stay in hospital. Mobilization was started on the first postoperative day. The operating surgeon himself supervised the daily exercise for 3 weeks, after which the patient was discharged. The end-results show that, despite what has been alleged by the critics of primary mobilization, the graft is capable of development and grows stronger with this treatment.

Adolescent↗

PubMed1975

Surgical treatment of rupture of the rotator cuff tendon.

A total of 55 tears of the rotator cuff tendon were surgically treated at the Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, during the period 1960-1970. The rate of operative treatment was about 12 per cent. When more than half a year had elapsed since the accident, excision of the acromion was almost the only operative procedure carried out (10/12 patients). Excision of the acromion was performed as the only procedure in 16 cases and in connection with surgical repair of the rotator cuff tendon in 20 cases. This operation brings relief of nocturnal pain, but it is harmful in the treatment of large tears when used alone and sometimes also in connection with surgical repair of the rotator cuff tendon. Surgical repair of the lesion seems to give the best results, provided it is performed within 1 month of the injury.

Adult↗

PubMed1975

Surgical or conservative treatment of total dislocation of the acromioclavicular joint.

A follow-up investigation on 41 patients with complete dislocation of the acromioclavicular joint was performed. Nineteen patients had been treated surgically, 22 conservatively. The surgery performed had consisted of repair of the coracoclavicular ligament and fixation of the acromioclavicular joint by means of a Kirschner wire. In the conservatively treated patients, a strapping was applied to maintain reduction of the acromioclavicular joint. A good functional end-result is correlated with a good anatomical result. A good anatomical result was more frequent in the surgically treated group. Better functional results were achieved by operation than by conservative treatment. In general, post-traumatic arthrosis of the acromioclavicular joint was slight and was not correlated with the functional results.

Adult↗

PubMed1974