Biomedical subjects

Viktor Bialik

Publications and source records attributed to Viktor Bialik.

10 recordsLinked to original sources

PubMed2006

Pavlik's method: a retrospective study.

This retrospective study of the early work of Arnold Pavlik in the treatment of developmental dysplasia of the hip proves the success of his method in eradicating avascular necrosis (AVN) resulting from other modes of treatment. Authors analyzed some 100 charts of children treated for CDH, as it was known at that time, between 1969 and 1981, and assessed the influence of gender, clinical stability, severity of X-ray pathology and age at which treatment was started, according to duration, outcome of treatment and rate of AVN. Of the 100 children with 134 treated pathological hips, 62 children with 86 pathological hips were treated exclusively by Pavlik's method. Length of treatment for the 86 hips successfully treated by Pavlik's method only was an average of 6 months. No AVN was found for any hip treated by Pavlik's method only, including dislocated hips. The 65% of failure rate was for dislocated hips only. Late onset and prolonged duration of treatment using Pavlik's method contributed to relative high failure rate followed by AVN. This leads to the conclusion that Pavlik's method is safe and accurate for all dysplastic and subluxated hips, along with the vast majority of dislocated hips.

Age Factors↗

PubMed2006

Correction of deformities in children using the Taylor spatial frame.

The Taylor spatial frame is a unique external fixator. Despite its growing popularity, few reports on its use have been published. We evaluated the effectiveness of the Taylor spatial frame in the treatment of various deformities in 31 children and adolescents. All but one patient were anatomically corrected. Complications included superficial pin tract infection (45%), three fractures of the femoral regenerate, transient peroneal palsy, and injury to the genicular artery. Despite many challenging problems, our results compared favorably with the results achieved by others. We believe that the Taylor spatial frame is a very capable and accurate fixator for the precise correction of complex deformities.

Adolescent↗

PubMed2006

A novel elastic exsanguination tourniquet as an alternative to the pneumatic cuff in pediatric orthopedic limb surgery.

We describe our experience with a novel surgical exsanguination tourniquet (S-MART; OHK Medical Devices, Haifa, Israel) in clinical pediatric orthopedics. We evaluated the surgical exsanguination tourniquet's properties and clinical use in 51 patients and compared our observations with our long-standing experience with the Esmarch bandage, pneumatic tourniquet and sterile stockinet. Using the surgical exsanguination tourniquet, we found superior exsanguination quality, quick application and the ability to place the occlusion ring closer to the surgical field. No side effects or ischemic complications were observed. After removal, the skin under the ring was intact in all cases. We conclude that the surgical exsanguination tourniquet is safe and valuable in our practice.

Adolescent↗

PubMed2006

Arnold Pavlik (1902-62): an autobiography.

Professor Arnold Pavlik, a Czech orthopaedic surgeon, became famous mainly for the development of a functional, active method of treating developmental dysplasia of the hip, in his time called congenital dislocation of the hip. A translation is presented of the autobiography Pavlik prepared to achieve his doctorate in medical sciences, but which his early death in February 1962 denied him.

Czech Republic↗

PubMed2004

Acute rupture of achilles tendon in a 7-year-old girl.

Ruptures of Achilles tendon are a relatively common injury. Ruptures typically occur after the age of 30 years, and are more frequent in people of middle age or older. In children, rupture of the tendon is usually due to avulsion of the tendon from the calcaneus but not within the tendon itself. We describe a 7-year-old girl successfully treated conservatively for acute tear of her Achilles tendon. No general predisposing disease was found. We were unable to find any description of an acute rupture of the Achilles tendon in a child under the age of 10 years.

Achilles Tendon↗

PubMed2003

Treatment of true developmental dysplasia of the hip using Pavlik's method.

Ultrasound is the most sensitive method for detecting hip pathology in the first year of life. However, it has been shown that neonatal sonography, or combined sonographic-clinical screening, can cause some over-diagnosis which, when not used properly, can lead to over-treatment. We developed the concept of 'true developmental dysplasia of the hip' on the basis of our experience. Despite the still-growing popularity of Pavlik's method in the treatment of the condition, we were unable to find a study dealing with the relationship between sex, sonographic and clinical pathology, age at the start of treatment, and duration and outcome of treatment. To answer these questions, we assessed patients we had treated using Pavlik's method in a 5-year period at a special developmental dysplasia of the hip clinic. The influence of sex, clinical stability, severity of sonographic pathology and age when treatment was started was assessed according to duration, outcome of treatment and rate of avascular necrosis. In spite of the relatively small number of hips treated in this study, some conclusions can be drawn. The short period of treatment for clinically unstable hips can be surprising. As treatment was started before the age of 14 weeks, the favorable results can be attributed to this fact. There are hips which, according to our theory, will not improve spontaneously to normal; therefore, we believe that our figures reflect the real results of treatment using Pavlik's method. Practically 0% avascular necorosis for all the treated population (only one child had transient avascular necorosis of type 1) is, in our opinion, due to this fact. The high rate of success (98%) can also be attributed to early treatment.

Algorithms↗

PubMed2003

Plantar puncture wounds in children: analysis of 80 hospitalized patients and late sequelae.

BACKGROUND: Puncture wounds in the feet of children present a clinical dilemma. OBJECTIVES: To evaluate our approach, we reviewed the charts and all available images of 80 children admitted to our institution because of plantar punctures from 1988 to 1999. METHODS: The charts of 80 children were reviewed retrospectively. RESULTS: Three groups of patients were found: 59 with superficial cellulitis, 11 with retained foreign bodies, and 10 with osteoinyelitis and/or septic arthritis. There was a significant presentation delay in patients from the second and third groups. Most common organisms were Staphylococcus aureus or Group A Streptococcus. Of the 80 children, 34 were treated surgically and 46 were treated with antibiotic therapy alone. All patients with osteomyelitis and septic arthritis were re-examined; at follow-up, all but one were asymptomatic apart from residual radiologic sequelae in four. CONCLUSIONS: Patients with an established infection 24-36 hours after a plantar puncture should be admitted to hospital for parenteral antibiotic therapy. Delayed presentation is a significant marker for deep-seated infection. Further infection or relapse after initial improvement suggests the presence of osteomyelitis or a retained foreign body. A bone scan is advisable in all patients with suspected osteomyelitis: a positive bone scan necessitates aggressive early debridement combined with appropriate antibiotics; while negative bone scan, X-ray and exploration suggest that the infection is due to a foreign body, which can be detected by computed tomography.

Adolescent↗

PubMed2002

Developmental dysplasia of the hip incidence in Ethiopian Jews revisited: 7-year prospective study.

We describe the sonographic and true incidence of developmental dysplasia of the hip among Ethiopian Jews compared with the general Israeli population. Previous results were based on a small number of Jewish Ethiopian children; this study is based on over 7 years of experience, during which 34,048 newborns, 768 of whom were Ethiopian, were examined clinically and sonographically. The incidence of sonographic developmental hip dysplasia was 5.5% in the general Israeli population, compared with 1.24% for the Ethiopian Jews. True developmental hip dysplasia incidence for Arabs and other Jews was 0.51%, as compared with 0.15% in the Ethiopians. Our data support the theory that either a single unknown gene or a multiple gene system plays a major role in the incidence of the dysplasia.

Arabs↗

PubMed2002

Ultrasonographic assessment of bone maturity in newborns.

BACKGROUND: Traditionally, the bone maturity at birth has been estimated from the radiological presence and size of the ossified distal femoral epiphysis. This study was conducted in a search for a sonographic tool for the evaluation of neonatal bone maturity. METHODS: We examined sonographically 256 neonates within 24 h of birth. Gestational ages ranged from 36 to 42 weeks (mean: 39.4; median: 40). Birth weights ranged from 1,945 to 5,000 g (mean: 3,175; median: 3,180). The distal femoral epiphysis was imaged on the coronal plane sonogram of the distal femur with the knee at 90 degrees flexion and the distal femoral epiphysis maximal height was recorded. The acetabulum was imaged using Graf's method in the coronal plane image and the acetabular diameter recorded. RESULTS: It was found that plotting the distal femoral epiphysis against neonatal birth weight and gestational age provided a simple method for assessing the bone maturity. According to our study, a neonate can be regarded as bone maturity percentile X when plotting distal femoral epiphysis height or acetabulum diameter against birth weight and gestational age or when averaging the four readings. CONCLUSIONS: We suggest performing sonography of the distal femoral epiphysis as a bedside tool for the assessment of skeletal maturity in newborns.

Acetabulum↗

PubMedDate not supplied

Pavlik: the man and his method.

Because of the high rate of avascular necrosis, Pavlik developed his harness and method of treating developmental dysplasia of the hip in infants. This historical review highlights Pavlik's career from the time he worked with Frejka and then later in his own clinic in Olomouc, Czech Republic (1938). In the 1950s, he wrote five articles on the results of his harness use in developmental dysplasia of the hip. Subsequently, Pavlik's harness has become the orthosis of choice worldwide for treatment of infants with hip dysplasia because of the principles he espoused.

Czechoslovakia↗