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Biomedical subjects

O Kwasny

Publications and source records attributed to O Kwasny.

51 records · Page 3Linked to original sources
PubMed1990

[Transfixation in treatment of comminuted fractures of the distal end of the radius].

In comminuted fractures of the distal radius we apply our own method of transfixation. A Kirschner-wire is put through the bases of the metacarpal II-V, in addition an above elbow-plaster is applied. 47 persons (38 female, 9 male, age: phi 69 a) treated by this method have been checked-up after 16 months (26-5 months). In spite of the predominantly negative prognosis of the C3 fracture, according to the scheme of AO, we found out in our check-up considering principles of Sarmiento a good or a very good result in 41 cases (87%).

Adult↗
PubMed1990

[Results of plate osteosynthesis in comminuted fracture of the olecranon].

Comminuted fractures of the olecranon are an absolute indication for operative treatment. Adequate therapy is only possible when open reduction and plating are performed. In the last 20 years, 31 of our patients, i.e. 0.0001% of all patients treated for injuries, had this type of olecranon fracture, and in 25 follow-up examination was possible. The fracture type was classified according to the ASIF system. The range of motion, i.e., extension, flexion, pro- and supination, and pain, physical strength and rehabilitation were classified according to our own system. In cases with concomitant fracture of the radial head, reconstruction is necessary to provide adequate axial movement and strength in the forearm. Brief plaster fixation after the operation makes it possible to restrict the development of ankylosis in the elbow joint. The results were excellent in 10 patients, good in 5 patients, fair in 4 and poor in 6 patients. In 3 patients, i.e. 10% ankylosis was present in the elbow joint; this was considered to constitute an indication for arthroplasty, which gave a better postoperative range of motion.

Adult↗
PubMed1989

[Prevention of infection in implantation of femur head prostheses].

An account of 581 patients managed with head prosthesis after femoral neck fractures between 1975-1988 revealed that the administration of prophylactic antibiotics coupled with the use of a laminar airflow system in the operating room reduced the infection rate from 5% to 0.75%. The important risk factors which predispose infection are poor physical state, chronic urinary tract infection as well as diabetes mellitus.

Aged↗
PubMed1989

[Diagnosis of pelvic fractures: synoptic views of the pelvis versus CT].

An attempt has been made, using 21 patients with pelvic fractures, to determine the circumstances in which plain films provide adequate information and when additional information can be obtained by CT. It was found that in all cases of acetabular fractures the diagnosis could be suspected on plain films, but that it proved impossible to demonstrate accurately the position of fragments, the degree of dislocation or the presence of intra-articular bone fragments. These problems could be solved by using CT. In patients with injury to the sacro-iliac joints or of the sacrum, the extent of the injury and the degree of pelvic instability was better shown by CT. All other bony lesions, such as fractures of the ilium, pubis, ischium or the symphysis could be diagnosed adequately by simple radiographs.

Fractures, Bone↗
PubMed1989

[Surgical complications following implantation of femur head prostheses in a traumatology patient sample. Prevention and therapy].

At the 1st University-Clinic of Traumatology, Vienna, 420 patients with a medial fracture of the femoral neck received a femoral neck prosthesis (59 male, 361 female, phi age 81.3 years; range: 60-97 years). Severe early complications were fractures of the femoral shaft in 1.19%, that healed without problems after cerclage and plate osteosynthesis, and early infections in 3.1%. The rate of infections can be reduced to 1% prophylactic administration of antibiotics, surgery in an laminar airflow operating theater, and by the use of cement containing antibiotics. Dislocation of the prosthesis was observed in 2 patients (0.47%). the low rate of dislocation appears to be due to the antero-lateral operative approach according to Watson-Jones without osteotomy of the trochanter as well as to the precise technique of implantation of the prosthesis. More frequent late complications were periarticular calcification in 20 cases (4.7%) and protrusion in 18 cases (4.28%). However, only one out of the patients with calcification is restricted in his movements, and only 3 out of the patients with protrusion do complain of symptoms. The low rate of symptomatic protrusions is explained by a correct level of resection, by the implantation of a head prosthesis with appropriate dimensions and by the exclusion of patients with arthrosis of the hip or severe osteoporosis from the implantation of a femoral head prosthesis.

Aged↗
PubMed1987

[First results after the use of a Y-plate for the stabilization of supradiacondylar humeral fractures].

A new implant for the stabilisation of supra- and diacondylar fractures of the humerus is assessed. If compared with other implants this y-shaped plate has a considerably better stability. Due to different diameters of the holes 4.5 mm screws may be used for the long part, 3.5 mm screws for the branches of the plate, which in most cases allow good stabilisation and early mobilisation of the limb. Out of twelve patients, operated since 1981, ten were reexamined for follow-up after a mean of 34.1 months. All of the fractures stabilised with the y-plate were healed with normal osseous consolidation. According to the scheme of Cassebaum, the result was excellent in five, good in four and unsatisfactory in one patient. For each of the two available types of plates the dimensions proved to be sufficient with respect to the branches. However, for cases with fractures continuing into the humeral shaft, an additional type with a longer mainpart would seem desirable.

Adolescent↗
PubMed1987

[Differential treatment of post-traumatic carpal tunnel syndrome].

The pathogenesis and treatment of posttraumatic compression of the median nerve in the carpal canal are analysed in 36 patients. Nine patients had mal-union of a Colles' fracture. In these patients the symptoms of median nerve compression were completely relieved by correction osteotomy of the radial metaphysis, which also improved radiocarpal joint function. At follow-up examination after four years the results were satisfactory and the median nerve appeared normal in clinical and electro-physiological tests. In the other twenty-seven patients there had been a Colles' fracture in seventeen, healed with a deviation of less than 10 degrees; a carpal bone fracture in three cases; in seven patients no osseous lesion was found. In these patients the flexor retinaculum was split and resected. An anterior callus was removed in three cases. At reexamination after four years four patients still noticed diminished sensibility in the median nerve distribution, and in four cases there was wrist joint pain in relation to exercise.

Adult↗
PubMed1986

[Surgical therapy of stenosing duodenal ulcer--results of an uncontrolled comparative study].

In an uncontrolled trial on 77 patients we investigated the results of different surgical procedures in stenosis secondary to duodenal ulcer. The assignment to a procedure was dependent on the preference of the surgeon. The follow-up investigation after a mean observation time of 40-42 months was performed without knowledge of the surgical procedure. The postoperative mortality was 6.6% after resection, 0% after vagotomy and drainage. Postoperative sequelae were lowest in highly selective vagotomy + gastroduodenostomy (Visick I in 15 out of 17). After resection only 15 out of 33 had Visick I. The worst result was obtained after selective vagotomy and pyloric dilatation (4 out of 9 Visick IV). This procedure has been given up.

Adolescent↗
PubMed1986

[Value of primary stabilization of femoral shaft fractures in patients with simple and multiple injuries].

There is a variety of opinions about the optimal time when to stabilise femoral shaft fractures. The data of 100 patients were analysed in order to compare primary versus secondary intramedullary stabilisation. The rate of wound infections and of other concomitant complications was significantly lower after primary osteosynthesis which is therefore superior to secondary stabilisation in both kinds of patients--those with single and those with multiple injuries. In the group of 50 patients with immediate surgery four complications altogether were found, including one wound-infection, whereas in the group of 50 patients with delayed surgery there was a total of twelve complications, including five wound-infections and six cases of fat- and pulmonary-embolism. The average duration of stay in hospital was only 17 days after primary but 28 days after secondary surgery.

Adolescent↗
PubMed1984

[Long-term results of selective proximal vagotomy].

Highly selective vagotomy was performed in 361 patients over the past 10 years. The mortality was 0.3% in uncomplicated, and 1.6% in complicated duodenal ulcer. With a mean follow-up period of 52 months the recurrence rate was 7.4%. The known advantages of this operation, namely low mortality and low postoperative morbidity (dumping 0.8%, diarrhoea 0.8%, unintentional weight loss 0%, food intolerance 1.9% and epigastric fullness after meals 1.9%), were confirmed in our patients. The overall clinical result was excellent or good (Visick I or II) in 87% of patients. Clinical failures were most often caused by recurrent ulceration. Highly selective vagotomy is still the operation of choice in uncomplicated duodenal ulcer. It can also be recommended in selected cases of complicated ulcer disease.

Adult↗