Biomedical subjects

J Deszczyński

Publications and source records attributed to J Deszczyński.

At least 19 recordsLinked to original sources

PubMed2000

[Post-traumatic lymphatic and venous drainage changes in persistent edema of lower extremities].

Mechanical injury of soft tissues and bones of the lower extremity is followed by chronic edema at the site of trauma and distally to it. This complication affects almost every patient with a fracture of the lower limb. The question is whether posttraumatic edema is due to lymphatic obstruction, venous thrombosis or both, or a local cytokine and growth factor hyperactivity at the fracture site. The aim of study was to assess the venous and lymph outflow in patient with chronic postraumatic edema of the lower limbs. A group of 19 patients with chronic edema lasting for more than 3 months was evaluated. Limb circumference, tissue tone measurements, skin temperature and Doppler enhanced ultrasonography were all taken down for the 19 patients in the evaluated group. Limb circumference was measured at the following level: foot, ankle, calf and thigh. Results showed an increase of circumference in comparison with the healthy extremity at each evaluated level of: 1.20 +/- 1.65 cm, 1.63 +/- 1.41 cm, 1.40 +/- 1.72 cm and 0.30 +/- 1.90 cm. Local temperature increase compared to the healthy extremity was also noted (0.93 +/- 0.81 degree C and 0.37 +/- 0.21 degree C measured at ankle and calf level). Tissue tone measurements and tone index (a quotient of tone measurement values in the extremity with edema and in the healthy extremity) were also increased by 0.86 +/- 0.57, 0.85 +/- 0.34 and 0.86 +/- 0.28, when measured with 40 g, 110 g and 180 g weights respectively. In 17 cases (89.5%) lymphoscintigraphy demonstrated an increased lymphatic outflow compared to the contralateral extremity. A marked increase in the inguinal lymph nodes was also noted. In the remaining 2 cases (10.5%) extravasation of the contrast medium into the skin indicated lymph outflow disorders. Only in 5 cases (26.3%) ultrasonography indicated deep vein thrombosis. The obtained results indicate that the pathophysiology of chronic postraumatic edema is linked with an inflammatory and restorative reaction at the fracture site. Only in a limited number of cases deep vein thrombosis and damaged lymphatic vessels are responsible for postraumatic edema.

Chronic Disease↗

PubMed2000

[Use of the Dynastab-K (knee) external fixator technique for functional treatment of intra- and peri-articular fractures of the knee joint].

The aim of this study was to validate the results of treatment of articular fractures using a Dynastab-K (knee) external fixator, which gives a good stabilisation, while retaining motion in the knee joint. A group of 6 patients with articular fractures of the knee joint was evaluated. Two fractures were located within the distal femur and 4 within the tibial plateau. After anatomical reposition of the bone fragments primary stabilisation was achieved by means of the Dynastab-K fixator and maintained for a period of 8-10 weeks. Passive motion of the knee was implemented in the first post-op day and active motion was implemented in the third post-op day. In all cases proper healing of the fractures, full extension and a minimally limited flexion (100 degrees) were achieved. Flexion limitation was corrected by means of an intensive rehabilitation programme. Use of the presented technique allows proper stabilisation of the bone fragments with maintenance of joint motion throughout treatment. Basing on our observations we concluded that implementation of an articulated external fixator in articular fractures of the knee leads to proper fracture healing with minimal loss of motion, which can be resolved by rehabilitation procedures.

External Fixators↗

PubMed2000

[The frequency of peri- and postoperative bleeding after prophylactic treatment with enoxapirin in patients with post-traumatic deep vein thrombosis].

The risk of moderate and major hemorrhage was assessed in patients who underwent surgery after trauma of the lower limb. Among 633 patients over 40 years of age, to whom enoxapirin was administered, signs of major bleeding (massive bleeding during surgery, a decrease of Hb concentration by at least 2 g%, a transfusion consisting of 2 or more units of blood, a loss of more than 200 ml of blood from the surgical wound in the first 24 hours post surgery, formation of a haematoma in the surgical wound requiring evacuation) was noted in 10 (1.6%) cases. In 48 (7.6%) cases signs of moderate bleeding were noted (a decrease of Hb concentration of less than 2 g%, either not requiring blood transfusion or a transfusion of no more than 1 unit of blood, a drainage of not more than 200 ml of blood from the surgical wound in the first 24 hours post surgery). The noted hemorrhages didn't lead to any life threatening conditions, nor to any deaths. No cases of pulmonary embolism were noted either. The presented cases seem to indicate that the risk of increased bleeding in trauma patients treated with enoxapirin is incomparably smaller than the risk of life threatening complications like pulmonary thromboses. The obtained results indicate the purposefulness of thrombosis prophylaxis in patients undergoing surgery because of mechanical trauma of the lower limbs.

Adult↗

PubMed1999

[Application of the Ottawa ankle rules in the ankle and midfoot injuries: verification of the method on the basis of own material].

The aim of study was to verify the specificity and usefulness of the Ottawa Ankle Rules in trauma patients. Prospective observations were made on 103 adult patients (48 males and 55 females aged 16 to 74 years). Clinical examination was subsequently verified by radiography. According to Ottawa Rules pain in the posterior aspect of distal 6 cm of tibia or fibula or pain at fifth metatarsal or navicular bone occurring immediately after injury suggests bone fracture. In 78 cases (75%) no fracture was seen on X-ray; ankle sprain and midfoot sprain was diagnosed in 49 (63%) and 19 (37%) patients respectively. Fractures have been found in 26 patients (25%); 19 in the ankle area and 7 within tuberosity of the fifth metatarsal. Diagnosis set according to Ottawa Ankle Rules was confirmed radiologically in 89 patients (86%). Clinically diagnosed fracture was ruled out radiologically in 14 cases (13%) and only once (1%) radiogram revealed fracture missed clinically. In our material specificity of the method was 86% and the risk of misdiagnosed fracture was less than 1 percent.

Adolescent↗

PubMed1999

[A modified direct lateral approach for total hip arthroplasty].

Literature based review of lateral hip approach (MacFarland, Osborne) modifications offered by Bauer, Harding, Mills, Moscal and Mann is presented. Surgical technique for the Moscal and Mann approach is described. The approach allows easy access to the proximal femur for reaming, cementing, prosthesis orientation and leg-length discrepancy correction. It offers visualization of the joint superior to all non transtrochanteric approaches and is successfully used for both primary and revision THR.

Arthroplasty, Replacement, Hip↗

PubMed1999

[New concepts of monitoring and assessment of bone union stiffness in fractures treated by Dynastab DK external fixation].

This paper focuses on heuristic techniques based on artificial intelligence namely artificial non-linear and multilayer neurons employed for assessment of bone union in fractures treated by Dynastab DK external fixation. The software used allowed for prediction of bone union curve at the early stage of treatment. The training of the neural net has been done on the ground of 56 cases of Dynastab DK treated fractures. The net served for periodical assessment of bone union and its further prediction in 17 long bone shaft fractures. Bone mechanical properties at the fracture site showed non-linear changes in time. Specifically great changes were noted 4 months postoperatively. Flexion at the fracture site is critical. Neuron net proved to be useful in predicting bone union curve.

Bone Regeneration↗

PubMed1996

[The issue of fracture healing of pathologic femoral shaft fracture in disuse osteoporosis].

The result of treatment for pathologic femoral shaft fracture in case of disuse osteoporosis is presented. The patient is 15 years old male, paraplegic since the age of 2 due to traumatic lesion of the cervical spine. Femoral fracture has been reduced operatively and fixed with 2 Rush pins. Bony union was evident both in clinical and radiological assessment despite absence of mechanical and muscle related stresses on the bone.

Adolescent↗

PubMed1993

[Dynamic fracture stabilization with the DYBASTAB--with the help of dynamic compensating stabilizers--DYNASTAB D-K--new outlook on treating fractures].

Dynamic stabilizer DYNASTAB D-K for functional, ambulatory treatment of fractures is presented. The possibility to include an active hinge enabling physiological movement of the injured or remaining in the injured zone joint allows for an early mobilization of the limb concerned. Solid, spatial screws anchoring enables early axial dynamization within the union zone. Plastic cubes reduce the weight and prevent disturbance of electrophysiology of the fracture healing. The hydraulic chamber pressure measurement taken at the load will permit the assessment of bony union consolidation.

Bone Screws↗

PubMed1993

[The structure of distracting-compressing stabilizers Dynastab DK intended for functional treatment of articular fractures].

The structure of the distracting-compressing stabilizers Dynastab DK intended for functional treatment of transarticular fractures is described. The stabilizers realize the idea of functional treatment of fractures outside the hospital bed making possible free moving around of the patient during the treatment. This has been made possible owing to building-in of a mechanical articulation imitating the physiological movement in the injured joint. The articulation in the stabilizer reduces also the load on the joint. In the stabilizers for the treatment of such fractures of the elbow joint and ankle joint the articulations are monoaxial (hinge-like). In the stabilizer for the treatment of the radiocarpal joint this is a hinge articulation making possible flexion in sagittal plane. In the stabilizer for knee fractures the movements in the injured joint are taken over by a mechanical articulation of special structure. The distracting-compressing action of the Dynastab DK stabilizers for the treatment of transarticular fractures is realized by the tension screw mechanism e.g. in the stabilizer for the treatment of knee joint fractures. In the case of stabilizers for ankle joint, radiocarpal joint and elbow joint this tension is provided by calibrated compressing springs.

Biomechanical Phenomena↗

PubMed1985