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Biomedical subjects

M Oransky

Publications and source records attributed to M Oransky.

12 recordsLinked to original sources
PubMed1997

Associated lumbosacral junction injuries (LSJIs) in pelvic fractures.

OBJECTIVE: To study lumbosacral junction injuries (LSJIs) associated with displaced sacral fractures. DESIGN: Prospective. SETTING: University hospital. PATIENTS: Eighty-nine patients with pelvic fractures. INTERVENTIONS: All patients underwent standard x-ray examination consisting of anteroposterior and inlet and outlet views of the injury. In 50 percent of the cases, oblique views were also obtained. Computed tomography (CT) scans were obtained for all vertically unstable lesions and for fifteen of the lateral compression lesions. MAIN OUTCOME MEASURES: Pelvic fractures were classified according to Tile's classification. LSJIs associated with pelvic ring fractures were classified according to Isler. RESULTS: Lumbosacral junction injuries, including one bilateral lesion, were found in thirteen patients. One lesion was associated with a compression fracture, and the other twelve were associated with vertically unstable fractures. In one patient, a facet fracture was associated with a contralateral sacroiliac joint dislocation. A new type of LSJI was identified in three patients: it was characterized by disruption of the annulus fibrosus associated with rising of the hemipelvis and inclination of the L5 body. CONCLUSION: Lumbosacral junction injuries should be suspected in cases of transforaminal sacral fracture, especially when these fractures are displaced. In such cases, we recommend that the lumbosacral junction be evaluated with appropriate CT scans.

Adolescent↗
PubMed1993

Surgical treatment of displaced acetabular fractures: results of 50 consecutive cases.

Results of the surgical treatment of 50 consecutive displaced acetabular fractures were reviewed after a minimum of 2 years and a maximum of 6 years. Twenty-five fractures were complex, and 15 were treated at > or = 3 weeks postinjury. The quality of the reduction was anatomic in 74% of the patients. The rate of osteonecrosis of the femoral head was 10%. Heterotopic bone appeared in 24% of the patients, but function was impaired in only three. Excellent and good results were noted in 76% of the patients. Fractures operated on at > or = 3 weeks (delayed) had a failure rate of 40% compared with 17% for fresh fractures. The failure rate of delayed fractures was negatively influenced by nonoperative treatment initiated before surgery in other centers. Surgical treatment is considered the method of choice for displaced acetabular fractures, provided it is performed by knowledgeable and proficient surgeons.

Acetabulum↗
PubMed1989

Embryonic development of the posterolateral structures of the knee.

The development of the structures in the posterolateral corner of the knee was studied in fifteen human embryos and seventeen fetuses by means of serial sections in the coronal and sagittal planes. The attachments of the lateral meniscus and fibular head to the popliteal tendon and muscle are formed during the process of cavitation that forms the bursa. The connection between the tendon and the posterior border of the lateral meniscus forms obliquely to follow the direction of the muscle and tendon. The edge of the bursa is limited by attachments that connect the tendon to the lateral meniscus and fibular head. In this study, no direct ligamentous continuity was found to exist between the posterolateral femur and tibia during development. The only ligament that indirectly connects the lateral femur posteriorly to the proximal segment of the tibia, which has never been reported in human development, is the one that links the popliteal tendon to the fibular head. We have designated this the popliteo fibular ligament which was also found in adult specimens. This ligament should not be confused with the arcuate popliteal ligament.

Fibula↗
PubMed1981

Experimentally induced synovial sarcoma.

Synovial sarcoma has been induced in the knee joints of rats by intra-articular injection of 9-10-dimethyl-1-2-benzanthracene. Tumours developed from three to six months after the last injection. The neoplasms obtained were classified as synovial sarcoma (50%), fibrosarcoma (25%), giant cell sarcoma (15%), malignant fibrous histiocytoma (10%). The synovial membrane in the treated knee joints presented a chronic synovitis associated with fibrosis and proliferation of the lining cells. The primitive tumour spread locally infiltrating muscle and the adjacent bones. Metastases occurred most frequently to the lungs (70%) and liver (20%); lymph nodes were involved in 10%.

9,10-Dimethyl-1,2-benzanthracene↗
PubMedDate not supplied

[Impact of an integrated treatment approach of the severely injured patients (ISS =/> 16) on hospital mortality and quality of care].

BACKGROUND: Outcome of severely injured patients is sharply influenced by the level of prehospital and hospital organization. OBJECTIVE: To evaluate the impact of the re-organization of the trauma care process on the quality of care and final outcome of major trauma (ISS =/< 16) victims. SETTING: the Emergency Department (ED) of a 1600 bedded tertiary care hospital. INTERVENTION: a standardized approach to major trauma patients (MT) was implemented: Written protocols were established and trauma teams were organized. All anesthesiologists and trauma surgeons involved in trauma care were enrolled in an educational program including ATLS Courses and the Italian Resuscitation Council Prehospital Trauma Care Course. One of the targets was to assure the early orthopedic stabilization of limb and pelvis fractures. METHODS: Data of all major trauma victims admitted to the ED during 3 comparable periods of time: before (Jan-May 1998), during (Jan-May 1999) and after (Jan-May 2000) the implementation of the process, were retrospectively and prospectively collected and analyzed. RESULTS: MT patients admitted to the hospital increased from 39 in 1998 to 106 in 2000. For similar ISS (30.2 +/- 11.3 in 1998, 29.6 +/- 13.7 in 1999 and 30.5 +/- 12.9 in 2000) hospital mortality dropped from 42% in 1998 to 20.8%. The mean time from hospital admission to surgical orthopedic stabilization was 12 days in 1998, 4.6 in 1999 and 1.3 in 2000. In 2000, 86% of the patients with limbs fractures who required surgical stabilization, were treated within 36 hours from admission vs 11% in 1998. CONCLUSIONS: The implementation of written protocols for trauma care, the organization of trauma teams, educational programs including ATLS and PTC-IRC Courses and a strategy of early stabilization of limb fractures are associated with a dramatic decrease in hospital mortality for major trauma.

Emergency Medical Services↗