Biomedical subjects

J P Elsig

Publications and source records attributed to J P Elsig.

5 recordsLinked to original sources

PubMed1996

Percutaneous disc surgery at Balgrist since 1979--from discotomy to interbody fusion.

In 1979 percutaneous intervertebral surgery was introduced as an alternative to conventional open disc surgery. In 1982, discoscopy was developed for intraoperative monitoring of the selective removal of disc tissue at the site of herniation. The indication remains restricted to subligamentous contained herniations. In a series of 240 patients with a mean follow up of 53 months, 88% reached an at least satisfactory overall outcome. Newly developed endoscopic instrumentation demonstrate promising results for their use in the spinal canal as well as in the extradiscal spinal area. Since 1988, by means of new, specially adapted instrumentation, endoscopically controlled interbody fusion was introduced with temporary pedicular external fixation. In a series of 35 cases with monosegmental percutaneous fusion, at a mean follow-up of 25 months, the fusion rate--including initial pitfalls-- reached 29/35 (83%). The technique does not require blood transfusions, no remaining internal fixation is left. This minimally invasive approach facilitates functional rehabilitation. Some of the techniques presented in this article concerning percutaneous external fixation and percutaneous interbody fusion must be considered as experimental according to American FDA standards.

Adult↗

PubMed1994

[Foot problems in the elderly].

Foot problems in the geriatric patient are multiple and sometimes complex. The choices in treatment are frequently restricted because of contraindications for surgery. Common foot problems are common in the elderly patient, too, but in addition there is a specific pathology of this group of patients. Inexpensive, but institutionalized routine foot care is an essential medical need of the elderly to improve the quality of life.

Aged↗

PubMed1993

[Orthopedic technique following arthrodesis of the Lisfranc joint].

Of the 107 arthrodeses of the forefoot and the metatarsus performed in the 1980's, we controlled 13 arthrodeses of the Lisfranc joint. The mean time of follow-up was 2.3 years. Our postoperative results were excellent for 5 patients, good for 6 patients and fair for 2 patients. We obtained no poor results. As we found few references to the use of orthopedic techniques in the literature, it seemed of interest to study their use in our own sample. It was found that one patient did not require any orthopedic means, one patient needed orthopedic supports, 9 patients required modifications of their shoes, one patient needed an orthopedic shoe and one patient needed an orthosis. Moreover, we attempted to find which factors are associated with more complex orthopedic techniques. Our results seem to indicate that a complete arthrodesis of the Lisfranc joint requires the use of more complex orthopedic techniques than does a partial arthrodesis.

Adolescent↗

PubMedDate not supplied

[Osteochondrosis dissecans of concave joint surfaces: roof of shoulder joint, tibial plateau, distal tibia].

Typically an osteochondrosis dissecans occurs in the region of a convex articular surface, the most frequently localisation observed being the medial femoral condyle. Only few cases of an osteochondrosis dissecans in concave articular surfaces have been reported; these involved the tibial plateau, the distal tibia and the proximal surface of the navicular bone. Two more cases with an osteochondrosis dissecans in the proximal and distal tibial epiphysis are reported and additionally a hitherto unreported localisation in the glenoid fossa of the scapula. True osteochondrosis must be differentiated from ossification variants.

Adolescent↗

PubMedDate not supplied

False-negative magnetic resonance imaging in early stage of Legg-Calvé-Perthes disease.

We report a 7-year 6-month-old boy with Legg-Calvé-Perthes (LCP) disease in whom a magnetic resonance imaging (MRI) was normal during the early symptomatic phase when the 99mTc bone scintigraphy showed segmental hypoperfusion of the femoral head suggestive of bone infarction. Only later in the disease did the MRI also show the typical changes of LCP. The follow-up on this patient with bilateral disease leaves no doubt about the diagnosis of LCP. This sequence of a positive scintigram before positive MRI findings may be the exception, but it is important to realize that MRI is not always the most sensitive way to diagnose or exclude LCP as suggested hitherto by the literature.

Child, Preschool↗