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P Vibe

Publications and source records attributed to P Vibe.

11 recordsLinked to original sources

Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee. A randomised study of 50 operations.

We describe the results of 50 operations carried out on 46 patients with medial osteoarthritis of the knee of Ahlbäck grade 1 to 3. Patients were randomised either to a closed-wedge high tibial osteotomy (HTO) or an open-wedge procedure based on the hemicallotasis technique (HCO). Their median age was 55 years (38 to 68). The preoperative median hip-knee-ankle (HKA) angle was 171 degrees (164 to 176) in the HTO group and 173 degrees (165 to 179) in the HCO group. After six weeks, the median HKA angle was 185 degrees (176 to 194) in the HTO group and 184 degrees (181 to 188) in the HCO group. In the HTO group, seven patients were within the range of 182 degrees to 186 degrees compared with 21 in the HCO group (p < 0.001). One year later, ten HTO patients were within this range while the HKA angulation in the HCO group was unchanged. At two years the numbers were 11 and 18, respectively. We evaluated the clinical results on the Hospital for Special Surgery, Lysholm and Wallgren-Tegner activity scores, and patients completed part of the Nottingham Health Profile questionnaire. An impartial observer at the two-year follow-up concluded that all scores had improved, but found no clinical differences between the groups.

Adult↗

Malignant melanoma. Changing trends in factors influencing metastasis-free survival from 1964 to 1982.

Seven hundred fourteen patients with cutaneous melanoma in clinical Stage I treated between 1964 and 1982 were included in this study. In an analysis of metastasis-free survival, thickness of the tumor, ulceration, gender, epithelioid cells as predominant cells in the tumor, and localization of the tumor were found to be independent prognostic factors. In a time trends analysis, the distributions of three of the prognostic factors (thickness of the tumor, ulceration, and inflammatory cell infiltrate) were found to shift during the last decade in the direction of improved prognosis, indicating that tumors are detected earlier than before. The distributions of two other factors (cell type and location of the tumors) shifted in the direction of deteriorated prognosis, suggesting partly that the biologic nature of the disease may have changed and partly that other behavioral factors may have played a role.

Female↗

Congenital nasal dermoid cysts and fistulas.

Eleven patients who underwent surgical excision of nasal dermoid cysts or fistulas are reported. The patients are discussed according to the aetiology, sex distribution, location on the nose, and possible inheritance. Our surgical results are satisfactory with only one case which required reoperation. We found that late diagnosed cysts had a higher frequency of deep involvement and therefore required more extensive surgery.

Adolescent↗

Bilateral orbital floor fractures.

Nineteen patients operated on suspicion of bilateral orbital floor fractures are described. All of the patients had severe comminute midfacial fractures. Orbital floor deficiency requiring transplantation was found in 68% of the cases, demonstrating homolateral maxillary and zygomatic fractures. On the basis of their findings, the authors recommend acute reposition of the fractures and routine exploration of the orbital floor in the case of deficiencies requiring transplantation and in cases of homolateral combined maxillary and zygomatic fractures.

Adolescent↗

Unilateral orbital floor fractures.

Ninety patients operated on, on suspicion of unilateral orbital floor fractures are described. Age, sex, and etiology are given. Operative indication is examined and related to the operative findings. Fifty-six of the patients had fractures requiring transplantation, 24 had fractures which did not. Ten patients had no fractures. Only autogenous bone graft was used. The patients were examined three months and one to 11 years postoperatively (questionnaire). Of 82 operated patients who answered the questionnaire diplopia was found in eight, enophthalmos in two, hypesthesia in 18, reduced mobility in four and sinuitis in four. Preoperative X-ray: Three patients showed false positive X-ray findings. In 19 patients with false negative X-ray findings 12 required transplantation. Twenty-five tomographed patients showed fractures, two of which proved to be false positives. In eight patients with negative tomographical findings, fractures were found, seven of which required transplantation. The frequency of complications assessed in relation to the time of operation shows no significant difference, if surgery takes place within seven days of injury. Surgery performed later than this seems to produce more cases of chronic sinuitis.

Adolescent↗

A new method of skin graft adhesion.

An industrially produced fibrinogen-Aprotinin and thrombin-calcium chloride 'tissue glue', Tisseel, has been tested for skin grafting. The 'take' of the graft was successful in 92% after grafting with Tisseel, and in 83% without gluing. In difficult areas, such as over mobile muscle or close to skin folds, 88% of cases were successful with tissue gluing and 44% without.

Adolescent↗