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Biomedical subjects

S Weller

Publications and source records attributed to S Weller.

At least 19 recordsLinked to original sources

Health and safety in day care: parental knowledge.

Because injuries and illnesses occur among children, even in licensed child care facilities, parents need to be aware of existing hazards. We developed a questionnaire to assess parental knowledge of 16 health and safety features in their child's care facility. These health and safety features were identified by parents, in a pilot study, as being the most important features in a child care facility. This questionnaire was completed by 91 parents who use day care. Parents were well-educated employees of a health care institution. Our results indicate that even well-educated parents often do not check child care facilities for health and safety features. Parents tolerated a mean of 9.3% of 16 unsafe features and did not know the status of 22.4% of the features. Fifteen percent of the children has been removed from their child care facility because of health and safety concerns, 7.7% reported an injury. Our results suggest that it is important that physicians, during well child visits, include discussions about health and safety issues in the day care environment.

Accident Prevention

[Primary valgisation osteotomy in femoral neck fractures].

Technique and results after primary valgisation osteotomy in 41 patients with femoral neck fractures are described. 2 non unions and 9 avascular femoral head necroses were observed. The primary valgisation most probably does not influence the rate of necrosis. When performed by accurate technique it lowers the incidence of non union of the femoral neck. Postoperative leg lengthening is always evident. The most current avoidable mistake is an external rotational deformity. The procedure requires proper preoperative planning.

Adult

Detection of infection in postoperative orthopedic patients with technetium-99m-labeled monoclonal antibodies against granulocytes.

A prospective study of 106 orthopedic patients was performed for the detection of infection in the early postoperative stage using 99mTc-labeled murine Mabs directed against epitopes on granulocytes. Accuracy was 81% in the hips (n = 26), 81% in the thigh (n = 21), 84% in the knee (n = 19), and 100% in the tibia (n = 27). The technique did not work well in the spine where false-negative results were observed in the three patients studied. One patient suffered transient swelling of the eyelids following injection. Optimal imaging results were obtained 2-6 hr postinjection.

Adolescent

[External fixator montage].

In connection with the workshop on External Fixation of Fractures, some introductory remarks concerning indications, biomechanics, some technical details, aftercare, and possible complications are given. Each implant and technical system has advantages and disadvantages. Experiences with different implants and systems are described and demonstrated.

Biomechanical Phenomena

[Arthrolysis as a surgical treatment concept of post-traumatic stiffness of the knee joint].

In the period from 1977 to 1989 105 arthrolyses were performed in 102 patients. There were mainly posttraumatic fibroarthroses: 51 consecutive to fractures, 39 after ligamentous injuries, 13 post-infectious of which 11 were also post-traumatic and only 2 patients with rheumatological diseases. Remarkable is the increased number of fibroarthrosis after polytrauma (n = 26). The preoperative range of motion was under 30 degrees in 26 patients and 48 patients had a severely limited range of motions between 30 and 60 degrees. The follow-up examination performed in an average of 2 years after the operative mobilization showed that the initial mobility was more than doubled. These results are related to atiology, operative procedure and degree of severity of the preoperative stiffness. Fair to excellent results were obtained in almost 3/4 of the patients. We explain these results by an adapted extraarticular or combined procedure which were used in 63 cases. The open release is backed by an intensive rehabilitation program in which painlessness through PDA and an immediate postoperative continuous passive motion are of most importance.

Adolescent

[The dynamic hip screw in comparison with Ender nailing].

Mainly the Ender, Simon-Weidner nailing and the dynamic hip screw (DHS) of the AO compete along with other procedures for the treatment of proximal femur fractures by elderly individuals. The opportunity was taken to control the operative strain and postoperative development of 51 patients with Ender-nailing and 45 patients with DHS from the years 1985 to 1987. Prompt ability to walk and full load bearing capability is obtained by both procedures. Both procedures have slight strain due to operating time and operative trauma. Specific technical complications such as wandering of the nail and defective external rotational positioning were found mainly by the Ender-nailing. Reoperations were necessary in a few cases. The complication rate could be sunk further through the application of the DHS.

Aged

[Soft tissue injuries in compound fractures (author's transl)].

Problems in the management of soft tissue injuries in compound fractures are presented. They usually originate from the initial traumatic force, but may be the result of pitfalls of the primary treatment as well. The management of open fractures--as it is performed in this clinic--is presented in detail. After primary stabilization of the fracture attention is directed to the associated soft tissue injuries, which require utmost care in the further course of treatment. Primary wound closure should never be forcefully obtained, since closure under tension will result in severe secondary tissue damage. In our experience temporary open wound treatment and delayed closure is the method of choice in the initial management of open fractures. For temporary cover we successfully use the synthetic skin substitute Epigard. Since we adopted this policy, the rate of infection declined drastically, and anaerobic infections as well as generalized sepsis could be totally avoided.

Debridement

[Valgus osteotomy in treatment of osteoarthrosis of hip (author's transl)].

The article reports on Bombelli's theory on the genesis of arthrosis of the hip. Clinical experience has shown that valgus and extension osteotomy is indicated in dysplasia arthrosis, in cystic changes and formation of osteophytes. Although the good clinical results cannot be accepted as a proof of the biomechanical deliberations, they do extend the range of indications pointing to surgery of the diseased hip joint performed for the purpose of preserving the femoral head.

Bone Plates