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Biomedical subjects

P Rommens

Publications and source records attributed to P Rommens.

At least 19 recordsLinked to original sources
PubMed1998

The retrograde intramedullary supracondylar nail: an alternative in the treatment of distal femoral fractures in the elderly?

To find out whether retrograde nailing of distal femoral fractures is beneficial for the aged patient, we performed a prospective study of consecutive patients 65 years or older with distal femoral fracture treated with a retrograde femoral nail between 1 March 1993 and 30 April 1996 in our department. In total, 26 patients with unilateral distal femoral fractures had been treated in our department, and 24 patients had been followed up for more than 12 months. All fractures had healed. Six patients did not walk before the injury. According to the Neerscore we counted 10/18 excellent results (> or = 85 points), 6/18 good results (> or = 70 points), 2/18 fair results (> or = 55 points) and no failures (< 55 points). Retrograde intramedullary nailing makes a biological osteosynthesis of distal femoral fractures possible. Even in our aged patients good functional results could be obtained. Poor hold of the distal interlocking screws and difficult proximal locking are the two major technical problems encountered with this implant. Early weight-bearing is not advisable.

Aged↗
PubMed1996

Compartment syndrome as a complication of skin traction in children with femoral fractures.

We report the history of two 3-year-old children with femoral shaft fractures, who developed severe compartment syndromes after skin traction. Both children were admitted in our department for treatment of their compartment syndromes. In both, important and permanent disability persisted. The causative role of the skin traction is proved since, in one infant, the compartment syndrome developed in the nonfractured limb. Cautious application of skin traction, conscientious observation, immediate diagnosis, and aggressive treatment of threatening compartment syndromes will prevent these tragic complications.

Child, Preschool↗
PubMed1995

Severe liver rupture and tricuspid valve rupture in a patient with multiple trauma.

A patient with a severe liver injury and an acute cardiac failure due to a traumatic tricuspid valve failure is presented. During liver surgery, massive venous bleeding was caused by regurgitation of blood through the insufficient tricuspid valve. Right ventricular failure, leading to persistent hemodynamic instability, and caused by massive posttraumatic tricuspid regurgitation, has been treated with biological valve replacement. Diagnosis and management of posttraumatic tricuspid insufficiency are discussed.

Accidents, Traffic↗
PubMed1995

[Three-dimensional imaging of acetabular fractures using spiral CT].

Seven adult patients with acetabular fractures were investigated with conventional X-rays, axial spiral computed tomographic (CT) images and three-dimensional (3D) surface rendered reconstructions. Spiral CT has the advantage that it acquires the data much faster than incremental CT, resulting in less motion artefacts. A semi-automatic three-dimensional environment for segmentation has been developed in our institution. It created significant reduction of user interaction and improved visualization of acetabular and femoral joint surfaces. The main advantages of three-dimensional visualization of acetabular fractures included: creation of unlimited and unique views by which fracture location, fracture extension, fragment shape and fragment position became more clear, better visualization of acetabular dome and quadrilateral plate and more simple and easier interpretation of these complex fracture patterns. On the other hand, 3D surface reconstructions do not accurately demonstrate undisplaced fractures, intra-articular fragments may be obscured, congruence assessment is uneasy, and soft tissue injuries are not shown. Therefore, we consider 3D images of acetabular fractures as being complementary to and not a substitute to plain radiographs and axial CT scans.

Acetabulum↗
PubMed1994

Primary arthrodesis of the injured knee: still a solution in 1994?--case report.

We describe a case of a major trauma to a knee joint with extensive destruction of soft tissues, ligamentary structures, and bone loss. Although in extensive trauma of the knee, conservation and reconstruction of the joint structures is usually attempted, the massive destruction and gross contamination in this case prompted us to perform a primary arthrodesis in order to avoid life-threatening complications and to obtain early functional recuperation of the involved limb.

Accidents, Occupational↗
PubMed1993

Splenic function after splenic rupture treated with an absorbable mesh.

Overwhelming postsplenectomy sepsis remains a problem despite the introduction of a vaccine and antimicrobial prophylaxis. Removal of the spleen increases the risk of death from overwhelming sepsis to approximately 50 times that in healthy persons. The morbidity and mortality due to infection increase with the extent of associated injuries. Between 1987 and 1991, 24 patients were admitted at the Katholieke Universiteit Leuven for a splenic injury and treated with an absorbable vicryl mesh (woven polyglycolic acid mesh; Polyglactine 910). The injuries to the spleen were classified according to Barrett. Three patients died of severe craniocerebral trauma. A splenectomy was performed in one polytraumatized patient because of rebleeding. The spleen was evaluated in 20 patients after a mean of 20 weeks using 99mTc-denaturated erythrocyte scintigraphy together with tomographies. A type IV injury is a contraindication. All abnormalities on scintigraphy are mainly seen in type III lesions and less in type II and type I lesions. In type IV injury splenectomy and autotransplantation are indicated. Except for type IV lesions, we conclude that a ruptured spleen can be safely treated with a vicryl mesh without great loss of function.

Adolescent↗
PubMed1993

[Internal hemorrhages associated with fractures of the pelvic girdle. Importance of early stabilization using an external fixator].

Pelvic ring injuries due to high-energy forces are among the most serious involving the musculoskeletal system. Life-threatening hemorrhage, local and distant associated injuries, deformity, pain and diminished functional capacity are all potential problems for a patient with a disrupted pelvis. There is a clear correlation between total blood loss, incidence of associated injuries, final functional result and the type of pelvic ring injury. Between January 1987 and December 1990, 66 patients with an unstable lesion, type B or type C in Tie's classification, were treated in the University Hospital Gasthusiberg of the Katholieke Universiteit Leuven. In 42 cases, primary stabilization was achieved by means of an external fixator, of the type "Monofixateur". The overall mortality rate was less than 7%, and 53 patients could be seen for follow-up 6 months to 4 years after injury. Our findings confirm that compared to type B lesions there is a higher incidence of pain, permanent deformity and diminished functional capacity in type C lesions (P < 0.05). The external fixator used in the immediate post-injury period provides an effective splint that reduces bleeding from bone and veins but cannot maintain reduction in lesions with rotational and vertical instability. In these cases, a semi-elective internal fixation, after defining the exact pathoanatomy by means of a CT-scan, should be performed in selected centers.

Activities of Daily Living↗
PubMed1989

Intrinsic problems with the external fixation device of Hoffmann-Vidal-Adrey: a critical evaluation of 117 patients with complex tibial shaft fractures.

In the 1978-1986 period, 117 patients with 119 fresh and complex fractures of the lower leg were secured primarily with a Hoffmann-Vidal-Adrey external fixation device. Ninety-five fractures could be followed until bony consolidation. In 12 fractures (12.7%) a pseudarthrosis developed, and a deep infection in four (4.2%). The external fixation device was attached for an average time of 25.0 weeks. Pin loosening was seen in seven patients (7.3%), minor pin-tract infection in nine (9.4%), and major pin-tract infection in three patients (3.1%). Fourteen fractures needed a secondary internal fixation; in 17 other fractures a secondary transplantation of cancellous bone autografts without internal fixation was carried out. After healing of the soft tissues, the tibial fracture can be regarded as a closed one and other therapeutic procedures to accelerate bony consolidation should be taken into account. The advantages and disadvantages of a second internal stabilization should be evaluated for every fracture with bone healing problems. The alteration from external to internal fixation makes an early removal of the external fixator possible and prevents in this way the intrinsic problems combined with this fixation type such as delayed union, nonunion, pin loosening, or pin-tract infection.

Adolescent↗
PubMed1989

[Flexion-distraction injuries of the thoracolumbar spine with complete pancreatic rupture. Description of a case].

A case is reported of an unstable fracture dislocation of the thoracolumbar vertebral column combined with complete rupture of the pancreas. This combination of injuries is rarely encountered but is dangerous in severely injured patients. Rapid and decisive operative treatment of both injuries should be performed, whereby adequate treatment of the pancreatic rupture has the highest priority.

Accidents, Traffic↗
PubMed1987

[Significance of computerized tomography in the diagnosis and therapy of fractures of the posterior pelvic ring and hip joint].

Conventional röntgenologic examinations of fifty patients with posttraumatic pelvic bone injuries were compared with computertomographic examinations. The major advantage of computertomography of the pelvis is in our view the more precise evaluation of injuries of the dorsal pelvic ring. Almost fifty percent of the fractures of the sacrum and two thirds of the injuries of the iliosacral joint in our series could not be diagnosed on conventional examinations. Computertomography of fractures of the sacrum and fractures of the acetabulum give us important informations about the extension of the fracture, its dislocation, its degree of instability and accompanying soft tissue injuries. So planning of operative treatment becomes much easier.

Acetabulum↗
PubMed1987

Ten years of experience with the operative management of tibial shaft fractures.

Two hundred ninety-three consecutive fresh tibial shaft fractures in 276 patients were treated operatively in a 10-year period. Eight patients required amputations. The early and late complications in both closed and open tibial shaft fractures are separately described and discussed. More than 90% of the closed fractures needed a normal healing time; osteitis developed in 2.5%. Eighty-eight per cent of the closed fractures had an excellent or acceptable end result. In the open fractures delayed union occurred in 9.0% and nonunion in 6.8%. Osteitis developed in 8.35%. Seventy-five per cent of open fractures and an excellent or good end result; one fourth had an acceptable or poor end result. In the series discussed there was a high incidence of direct trauma with soft-tissue injury in both closed and open tibial shaft fractures. There was a positive relationship between the degree of soft-tissue damage of the fractured lower leg at admission and the frequency of early postoperative problems. The frequency of late complications was more dependent on the fracture form and the method of the first operative stabilization.

Adult↗
PubMed1986

External fixation of tibial shaft fractures with severe soft tissue injuries by Hoffmann-Vidal-Adrey osteotaxis.

The operative results in 65 patients with 66 tibial shaft fractures and severe soft tissue injuries, stabilized by an external fixation frame according to Hoffmann or Vidal-Adrey, are reviewed and the treatment principles are discussed. Four patients required secondary amputations. Fifty-three patients could be followed up for an average of 23.2 months. The infection rate was 9.2% and nonunion was found in 11.1% of cases. Two patients had a refracture after removal of the fixation device. Twenty-three patients (42.6%) required one or more secondary operations. Of the 65 patients, 70.4% had very good or good end results, 16.7% acceptable, and 12.9% poor. External fixation according to Hoffmann or Vidal-Adrey affords excellent definitive stabilization in simple fractures of the lower leg with soft tissue injuries. In comminuted fractures of the lower leg with loss of bone fragments and severe tissue damage, external fixation is better used as a means of temporary stabilization until soft tissues permit definitive rigid stabilization.

Accidents, Traffic↗
PubMed1986

[Follow-up results of 102 tibial shaft fractures stabilized by dynamic compression plate osteosynthesis].

From 1978 to 1982, 102 tibial shaft fractures in 100 patients were treated with a dynamic compression plate in our trauma center. Only 61 fractures were operated upon primarily. 84 fractures were followed for an average of 19,8 months. The mean hospital stay was 21.5 days. Postoperative minor would problems were present in ten fractures. The infection rate was 1.2% and non-union developed in 1.2%. In six fractures a second stabilisation was necessary. 88.1% of the patients had a good end result. The plate osteosynthesis of closed and first degree open tibial shaft fractures proved to be a reliable treatment procedure, when it is made by expert surgeons and in accordance with the AO-principles of fracture treatment.

Adolescent↗
PubMedDate not supplied

The retrograde intramedullary nail: prospective experience in patients older than sixty-five years.

HYPOTHESIS: To determine whether retrograde nailing of distal femoral fractures is beneficial for the elderly patient. METHODS: Prospective study of consecutive patients, aged sixty-five years or older, whose distal femoral fractures were treated with a retrograde femoral nail between January 3, 1993, and April 30, 1996. RESULTS: Twenty-four of twenty-six patients were followed for more than twelve months. There were twenty AO/ASIF 33A and four AO/ASIF 33C fractures. Twenty-three were closed. There was one Gustilo type 1 fracture. All fractures healed. Six patients did not walk before injury. Using the Neer scoring system, there were ten (56 percent) excellent (85 or more points), six (33 percent) good (70 or more points), and two (11 percent) fair (55 or more points) results; none of the cases were considered as failures (less than 55 points). CONCLUSIONS: Retrograde intramedullary nailing makes possible a biological osteosynthesis of distal femoral fractures. It also produces good functional results in elderly patients. The two major technical problems encountered with this implant are the poor hold of the distal interlocking screws and difficulties with proximal interlocking. Early weight-bearing is not advisable.

Aged↗