Biomedical subjects

V Schwartsman

Publications and source records attributed to V Schwartsman.

4 recordsLinked to original sources

PubMed1992

Tibial fractures. The Ilizarov alternative.

Between February 1988 and May 1989, 17 consecutive patients with 18 tibial fractures were treated using the Ilizarov method and apparatus. Injuries included four closed fractures and 14 open fractures. There were three Grade I open, four Grade II open, and seven Grade III open tibial fractures. Indications for application of the Ilizarov frame included fractures that were determined to need surgical management primarily, or fractures that had failed to heal by other treatment methods, either operative or nonoperative. Patients averaged 17.7 months of follow-up treatment. One patient was lost to follow-up treatment after the fracture healed and the device was removed. To date, all fractures are healed. There was one delayed union, which subsequently healed with a second application of the device. Complications included two late wound infections, both in Grade III open fractures. These occurred after removal of the Ilizarov apparatus. The average time from application of the device to complete fracture healing was 5.6 months, with a range of 3.25 to 13 months. This compares favorably with the results described for other treatment modalities. These results indicate that the Ilizarov method is indeed a useful adjunct in the orthopedic armamentarium for the treatment of either open or closed tibial fractures. No practical contraindications to the use of the Ilizarov device in the management of tibial fractures were encountered.

Adolescent↗

PubMed1992

Corticotomy.

A correctly performed corticotomy is essential to the success of distraction osteogenesis and prepares for deformity correction, limb lengthening, elimination of bone and soft-tissue defects, reshaping of bones, and treatment of cavitary osteomyelitis. The modern corticotomy has evolved from the initial open osteotomies, which eventually proved to be traumatic to bone's osteogenic elements, and closed bone osteoclasis, which proved time consuming and difficult to control. Ultimately, this led to the combination of an open partial subperiosteal cortical osteotomy, followed by manual osteoclasis of the remainder of the bone cortex. The various types of corticotomy, each with its own special purpose, include transverse or oblique, longitudinal, "splinter," and partial. The techniques and indications for each are outlined. Consideration is given to the latency period--the time from corticotomy to onset of distraction. Morphologic studies have shown that optimally this period should be from seven to ten days. The complications of corticotomy include damage to the osteogenic elements through rough surgical technique, displacement of the fragments after corticotomy, and incomplete corticotomy.

Bone Lengthening↗

PubMed1991

Wolf blade plate ankle arthrodesis.

Fifteen patients, each of whom had a Wolf blade plate ankle arthrodesis, were followed for a mean of 56 months. The mean age at the time of operation was 46.7 years. The preoperative diagnosis was posttraumatic arthritis in 16 cases and one each of degenerative arthritis, rheumatoid arthritis, and avascular necrosis of the talus. Eighteen of the 19 cases fused for a fusion rate of 94.7%. The average fusion position was 2.9 degrees of plantar flexion and 5 degrees of valgus. All patients whose ankle fused were satisfied with their results. The average Mazur postoperative score was 75 (range, 33-91). Five patients had delayed wound healing. The Wolf blade plate is a simple and easy method to fuse the ankle. Minimal dissection is required and a fusion rate of 95% is obtainable.

Adult↗

PubMed1990

Tibial nonunions. Treatment tactics with the Ilizarov method.

The key to the success of the Ilizarov method is that the rigid systems, such as plates and traditional external fixators that bypass the nonunion, have been replaced by the axially elastic system of Ilizarov. The cyclic axial telescoping mobility, not rigidity, at the nonunion or fracture site is an important requirement for the formation of reparative callus. As we gain more experience with the method, we find ourselves capable of solving increasingly more difficult problems with a level of success rarely, if ever, achieved with more conventional methods.

Adolescent↗