"Tubalithiasis"; a late complication of laparoscopic cholecystectomy with stone spillage.
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Biomedical subjects
Publications and source records attributed to K J Bongers.
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Distal intra-articular bicondylar humeral fractures are usually treated by means of cancellous screw(s) for the condylar block and one or two plates for fixation of the block to the shaft. The method and results of double tension band osteosynthesis instead of double plating for fixation of the condylar block to the shaft are described here. The advantages of double tension band wiring are an easier and faster procedure, less periosteal and muscle damage, and symmetrical compression. The functional results and complications of patients treated by this method are compared with the results of patients treated with plate fixation.
Supracondylar fracture of the humerus occurs most often in fairly young persons. The incidence rate decreases during adolescence and is then seen to an increased degree again at an advanced age. Conservative treatment of this fracture leads in elderly patients often to restricted function of the elbow and shoulder. Even operative fixation by means of screws in combination with a semitubular or DC plate may be associated with difficulties. Combined use of tension banding and drill wiring is a good alternative.
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The functional treatment of humerus shaft fractures with a brace according to Sarmiento is described. Reported are the results of the functional treatment of 47 humerus shaft fractures. Every humerus shaft fracture normally treated conservatively, including the humerus shaft fractures in polytraumatised patients and those patients with a primary radial nerve injury, can be treated in this way. The functional treatment of humerus shaft fractures results in a quick and uneventful healing of the fracture with a good function and cosmetic aspect.
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Primary internal fixation of acute humeral shaft fractures is only seldom indicated. Following the late results, indication and technique must be very strict. This is shown by the number of 37 cases in seven years and the very low complication rate.
The classification of the different types of Smith's fracture is reproduced. The technique of operative treatment for type II and III fractures is discussed. The results of operative treatment in nine patients were excellent or good. This corresponds with the results of other authors. Removal of the metal is advised after three months. Leaving it longer in place results in overgrowth of bone, which may cause difficulty in removing the material.
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During the period from 1 January 1973 to 31 December 1978, 71 fractures of the carpal scaphoid were treated, 52 conservatively and 19 by primary surgery. For fractures treated conservatively, 12 weeks' immobilization is ample; in our opinion it may be reduced to 8-9 weeks for intracapsular and to 4 weeks for extracapsular fractures. The investigation by Alho et al. proves that immobilization of the elbow joint does not improve results, so that a short circular cast suffices.
The results of treatment of 52 supracondylar fractures of the humerus in children by means of percutaneous transfixation with two Kirschner wires are discussed and compared with the results of other methods of treatment, such as repositioning and immobilization in a plaster cast, and traction by the Baumann or Dunlop techniques. The functional results are equivalent to those of other methods of treatment. Although the number of cases studied was only small, it appears that the cosmetic results are better, while the duration of hospitalization is markedly shorter.