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Biomedical subjects

J F Kouvalchouk

Publications and source records attributed to J F Kouvalchouk.

At least 37 records · Page 2Linked to original sources
PubMed1984

[Ruptures of the Achilles tendon. Comparison of the results of surgical and nonsurgical treatment].

The authors have compared the results obtained in 76 cases of rupture of the tendo Achillis treated conservatively with a previously published series of cases treated surgically. The same assessment of the results was used. The main complication of surgical treatment was skin necrosis; the main complication of conservative treatment was recurrent rupture. To objective assessment, the loss of strength in the triceps surae was about 20 p. 100 in both series. Subjectively, the conservatively-treated patients seemed more satisfied. These findings support the conclusions of other published comparative studies that conservative treatment is worthwhile since it avoids general anaesthesia and hospital treatment. It is indicated when the conditions are favourable. Surgical treatment should be used in young athletes because healing is quicker in cases of recurrent rupture or old ruptures.

Achilles Tendon↗
PubMed1982

[First human case of Drechslera longirostrata mycosis. Spondylodiscitis complicating prosthesis endocarditis. Treatment with combined ketoconazole and amphotericin B].

In a patient with spondylodiscitis secondary to cardiac valve prosthesis infection with endocarditis the fungus Drechslera longirostrata, which had not yet been known to cause mycoses, was isolated from cultures of prosthetic material and an intervertebral disc. The cardiac prosthesis had to be replaced and the vertebral lesion, which extended along 3 lumbar segments and was destructive enough to produce neurological disorders, required surgical immobilization of the spine. The disc infection was cured after combined administration of amphotericin B and ketoconazole, both drugs having proved unsuccessful when given alone. Infections caused by rare opportunistic fungi are becoming increasingly common and are difficult to diagnose since immunological methods are inapplicable. In some resistant or extremely severe fungal infections antifungal agents can be used in combinations for their synergistic effects, with subsequent reduction of dosage and potential side-effects. Combinations must be based on in vitro sensitivity tests.

Adult↗
PubMed1981

[Surface arthroplasty of the knee by marmor prosthesis. Study of 35 unicompartimental prosthesis seen with a follow-up of 1 to 5 years (author's transl)].

The Marmor prosthesis may be used for a surface arthroplasty of the knee by means of a system of unicompartmental modules including 4 sizes of condylar ramps and 6 thicknesses of tibial plateaux in two widths. It is thus possible to treat one or both compartments and correct any axial deviation. The operative technique must be careful and accurate with regard to the positioning of the prostheses and the choice of thickness of the plateau to be inserted. Preoperative radiological assessment must be very precise, and include in particular films with monopodal weight bearing and in forced position in order to study the joint surfaces and predict the correction which must be applied. Fifty operations have been performed (in 37 cases for osteoarthrosis), but the essential aim of the present study is to report the results of 35 unicompartmental prostheses with a follow-up of 1 to 5 years (mean : 2 years and 2 months). Thirty results were assessed as good or very good. The most spectacular features were freedom from pain and the rapidity with which the results were obtained. They would seem to be clinically stable. Nevertheless, the development of 3 deteriorations of the tibial plateau after Marmor would appear to contraindicate the use of 6 mm thickness plateaux. In contrast to widespread opinion, the remaining compartment does not degenerate, so long as it was normal preoperatively and there has not been any hypercorrection of the deviation after unicompartimental arthroplasty. Nevertheless, the latter has its limits and whilst it may play a role in the treatment of certain cases of osteoarthrosis of the knee, it cannot replace either tibial osteotomy for correction of the axis or bicompartimental prostheses or total prostheses anchored in the diaphysis, which also have their indications.

Follow-Up Studies↗
PubMed1979

[Valgisation osteotomy in the treatment of osteoarthrosis of the hip: 21 cases (author's transl)].

Study of 21 cases of femoral valgisation osteotomy, with a minimum follow-up of 5 years, confirms the value of this operation in the treatment of certain types of osteoarthrosis of the hip, and above all those types in which there is an inferior capital osteophyte. The indications depend upon: --clinical features: as in the case of all osteotomies, mobility must be at least equal to 70 degrees flexion. --radiological findings: reposition films in adduction should show widening of the joint space and above all improved congruence. The presence of geodes and lack of cover of the femoral head are not, in themselves, contraindications. The operation involves, in addition to valgisation inter-trochanteric osteotomy, relaxation of the peri-articular muscles (psoas, adductors, gluteus medius) in order that the relative lengthening of the upper end of the femur related to ventricalisation of the neck should not be in contradiction with the usual principles of surgery for osteoarthrosis. Valgisation osteotomy results in an increase in weight-bearing surfaces and thus a decrease in unit pressure. Indicated and performed in this way, this operation gives highly satisfactory and durable results, as shown by the follow-up period of our own cases.

Adolescent↗
PubMed1976

[Results of surgical treatment for rupture of the achilles tendon].

The authors analyse the results obtained on 53 cases of rupture of the Achillis tendon. Early minor complications were numerous (26 p. 100) the average follow-up, in 38 cases, was about 6 years. A number of ankle limitations, triceps weakness were noted. All patient had a calf atrophy. Final results were not related to the surgical technique (suture or grafting using plantaris). The authors conclude that the results obtained after surgical treatment are not as good as generally thought.

Achilles Tendon↗