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Biomedical subjects

Y Gerard

Publications and source records attributed to Y Gerard.

7 recordsLinked to original sources
PubMed1991

[Pseudarthrosis of the humeral shaft. Apropos of 58 cases].

We report 58 cases of humeral shaft non union following 28 times an orthopaedic treatment where persisted a space between the two fragments and 30 times an osteosynthesis but only 6 where satisfying. The sery contains 2 infected non union, dried in several months and 3 pseudarthrosis we did not operate because they were not inconvenienced. Among the 53 aseptic pseudoarthrosis the union has been to obtained after one operation for 42, two operations for 6 and three operations for 5. We analyse the consecutive mistakes having brought to the failures. We confirm that only an osteosynthesis not sufficient and that an associate graft is necessary. It could be an osteoperiosteum decortication, a spongious graft or a tibial graft (this last one is more safe but reserved to the iterative cases of the one with a big defect). The long evolution (more than a year for half at the cases) explains the fragment repercussions on shoulder or elbow.

Adolescent↗
PubMed1975

[Treatment of idiopathic femur head necrosis with an appropriate cup with cylindrical support].

The objective of treatment of necrosis of the femoral head by means of an appropriate cup is to protect the sequestrum and to avoid secondary arthrosis. Hemispherical cups have a tendency to be easily deformed; cups with cylindrical support should be used in preference as they are mechanically stable and make it possible to cover the femoral head in cases of relatively extensive necrosis. Good results are obtained quickly and are often spectacular : in 90 percent of the cases operated on, pain disappeared or was reduced and normal socio-professional activity was again possible. A clinical and radiological study of 30 hips treated at least 2 years previously, established that the result was stable in the majority of cases : there was one real clinical and radiological deterioration, two cases of pinching of the interspace. This operation is thus worth while in all cases of necrosis, at the stage when the sequestrum is clearly delimited and when there is clear deformation of the contour of the femoral head. It also seems to be worth while at the "eggshell" stage, when the lesions detected at the time of an operation are aften considerable and appear non-reversible : the quality of the results obtained mean that the criteria of tolerance should be much more severe.

Adolescent↗
PubMedDate not supplied

The management of abdominal wall stomata: skin protection, peristomal wound healing and support for the collecting bag. A multi-center study.

The specific properties of Stomahesive tested in 116 stomal and 20 fistulous patients render it really useful in stomatherapy where it increases the comfort of the patients: 1. it offers an excellent peristomal skin protection whatever the nature of the stoma or origin of the fistula; 2. it promotes rapid healing of skin lesions, even in ileostomy, transverse colostomy, ureterostomy and fistula patients; 3. it ensures an effective degree of impermeability; 4. it provides a large base for adhesion of the collecting bag; 5. it can be kept on for about 6 days in most cases; 6. The local tolerance is excellent (Acta chir. belg., 1977, 76, 533-537).

Abdominal Muscles↗
PubMedDate not supplied

Prophylactic use of a single dose of tobramycin in elective colorectal surgery.

The aim of this prospective study is to acquire clinical experience with a single high dose of tobramycin in prophylactic use. Sixty three patients undergoing elective colorectal surgery, were assigned to receive antibiotic prophylaxis (24 hours perioperatively) in the form of a single high dose of tobramycin and a classically recommended thrice-a-day (TID) administration of clindamycin. The planned dose for tobramycin was 3.3 mg/kg/day. Adjustment was made in case of impaired renal function. Serum levels of the drug were monitored. The results showed well predictable levels. Six out of fifty five evaluable patients (10.9%) presented postoperative infectious complications within the follow up period. No renal nor otovestibular toxicity was recorded.

Adult↗
PubMedDate not supplied

Hip arthroplasty by matching cups.

A total hip surface arthroplasty consisting of matching cups and uncemented prosthetic components is a noteworthy operation. The femoral cup obtains cylindrical support from the femoral head which is reamed in the shape of a cylinder. The acetabular cup is metallic with a polyethylene liner. It is mobile over the bone but its position is constrained by contact with the femoral cup and therefore "self-centering." On the femoral side, the cup must be placed strictly in the axis of the femoral neck. The main consideration in femoral head surface replacement is the vitality of the underlying bone. Necrosis was observed in the earliest clinical trials but there have been no cases of necrosis in the past 3 1/2 years. This is attributed to a more limited surgical approach in which only the anterior part of the gluteus medius is divided and all the posterior elements of the hip are preserved. The acetabulum is sufficiently reamed to receive the cup, which protrudes beyond the external margins of the acetabulum in all positions. Errors have been committed while perfecting the prosthetic material, but the results as determined by a 6 1/2 year follow-up on purely metallic cups are encouraging. Metal-polyethylene cups presently under investigation have almost a 2 year follow-up. The reaction of the acetabulum to an uncemented cup is not yet known. However, the existence of 2 sliding surfaces and the fact that the acetabular cup moves only during the extremes of hip movement, is reason to assume that if the acetabulum is not reamed to expose cancellous bone, the risks of protrusion are minimal or delayed. Total surface arthroplasty by concentric cups has been performed in 335 hips to date. The operation is especially recommended when osteotomy is no longer possible and disabling coxarthrosis is present in relatively young patients.

Acetabulum↗