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Yoram Weil

Publications and source records attributed to Yoram Weil.

12 recordsLinked to original sources
PubMed2006

Sciatic nerve palsy due to hematoma after thrombolysis therapy for acute pulmonary embolism after total hip arthroplasty.

Sciatic nerve paralysis as a complication of bleeding due to hip surgery is a rare entity. The use of thrombolysis and full-dose heparin administration for the treatment of massive pulmonary embolism increase the risk for developing major bleeding. Prompt recognition and intervention in this condition are warranted. A case of sciatic nerve palsy due to expanding thigh hematoma as a complication of thrombolytic therapy for pulmonary embolism after total hip arthroplasty is presented with a literature review. Although rare, this complication should be promptly recognized and immediate decompression should take place because of the favorable results of the early treatment.

Acute Disease↗
PubMed2006

Talc sclerodhesis of persistent Morel-Lavallée lesions (posttraumatic pseudocysts): case report of 4 patients.

Large posttraumatic pseudocysts are infamous for their tendency to recur despite repeated aspiration. The standard practice has been repeated extensive surgical debridement. To avoid the need for such treatment, talc was used to sclerose the lesion in 4 patients treated between 2000 and 2003. The patients were between the ages of 20 and 73 and had thigh and buttock pseudocysts that persisted for an average of 3 months. Talc was administered under fluoroscopic guidance and suction drainage (wall suction followed by a bulb vacuum drainage system) was applied for an average of 12 days. The patients were followed for an average period of 27 months after talc sclerodhesis. All persistent pseudocysts showed an immediate cessation of fluid accumulation in the treated space without reccurence. One case which was complicated by infection, had to be treated twice with talc to cease the accumulation. In this case, the infection recurred, although fluid accumulation did not recur. Talc sclerodhesis proved to be a simple and rapid method of treatment in posttraumatic cases classically treated by repeated and aggressive surgical methods.

Adult↗
PubMed2006

Computerized navigation for the internal fixation of femoral neck fractures.

BACKGROUND: Accurate placement of cannulated screws is essential to ensure secure fixation of femoral neck fractures. We compared computerized navigation and conventional fluoroscopy with regard to the accuracy of screw placement for the fixation of femoral neck fractures. METHODS: We retrospectively compared two groups of twenty consecutive patients with a femoral neck fracture who underwent internal fixation with three cannulated screws. Computer-based navigation was used to guide screw placement in one group, and conventional fluoroscopy was used in the other group. Radiographic evaluation included the measurement of screw parallelism and spread, the calibrated distance from the lesser trochanter, and joint penetration. The follow-up period was two years. The rates of complications in both groups were evaluated. RESULTS: The navigation-assisted group had better screw parallelism and greater spread of the screws. There was a tendency for fewer reoperations and significantly fewer overall complications in the patients in whom computerized navigation was used (p < 0.018). CONCLUSIONS: Computerized navigation improves the accuracy of cannulated screw placement in the internal fixation of femoral neck fractures. It may provide better mechanical stability and improved fracture outcome.

Aged↗
PubMed2005

Percutaneous compression plating for intertrochanteric fractures. Surgical technique, tips for surgery, and results.

OBJECTIVE: Fixation of intertrochanteric fractures by a minimally invasive technique using the Percutaneous Compression Plate (PCCP) allowing anatomic reduction and immediate postoperative weight bearing. INDICATIONS: Intertrochanteric fractures. CONTRAINDICATIONS: Intertrochanteric fractures that cannot be reduced by closed manipulation, subtrochanteric and reverse oblique fractures (AO/OTA 31-A3). SURGICAL TECHNIQUE: Placement of patient on a fracture table with a posterior reduction device (PORD) supporting the fracture. Reduction of the fracture by closed manipulation. Percutaneous insertion of the plate through a lateral proximal incision. Adaptation of the plate to the lateral aspect of the proximal femoral shaft with a bone clamp inserted through a second, more distal incision. Insertion of telescoping compression neck screw through the plate into the neck and securing of plate to the femoral shaft with three additional screws. Finally, completion of fracture fixation with second neck screw. RESULTS: Of 130 patients with intertrochanteric fractures treated using the described technique at the Orthopedic Surgery Department Hadassah University Hospital, Jerusalem, Israel, between May 2000 and December 2001, 108 were available for this study. Patients' age averaged 81 years (+/- 8 years). Mean surgical time was 67 min and mean hospital stay 11.5 days. 40% of patients did not require a transfusion during hospitalization, while 8.3% needed more than three units of packed cells. Complications occurred in four patients: two implant failures that were successfully revised with a Compression Hip Screw, one nonunion treated with hip arthroplasty; the fourth patient had a shortening of 3 cm needing a heel lift. Three patients developed an infection, one requiring surgical debridement.

Aged↗
PubMed2005

Percutaneous compression plating versus compression hip screw fixation for the treatment of intertrochanteric hip fractures.

Percutaneous compression plate (PCCP) devices are used for the fixation of intertrochanteric hip fractures by a minimally invasive technique. One hundred and eight patients who underwent this procedure were retrospectively compared with 155 patients who underwent compression hip screw (CHS) fixation. The general characteristics of the two groups, including age, sex, side of injury and co-morbidities assessed by the ASA score were similar. The operative time was significantly shorter in the PCCP group (67 versus 87 min, p=0.00). Postoperative blood transfusions were not required in 40% of the patients in the PCCP group compared to 24% of the patients in the CHS group (p<0.01). The rate of systemic postoperative complications was lower in the PCCP group (p=0.02) both in univariate and multivariate analyses. A considerable reduction was observed in cardiovascular complications (OR=3.1, p<0.05). Length of hospitalisation, implant failure and mortality rates were not significantly different between the two study groups. We conclude that the PCCP device offers several advantages over CHS device and may improve the current treatment of intertrochanteric hip fractures while maintaining a similar success rate in fracture fixation.

Aged↗
PubMed2004

Correlation between pre-employment screening X-ray finding of spondylolysis and sickness absenteeism due to low back pain among policemen of the Israeli police force.

STUDY DESIGN: A historical prospective case/control study of the significance and correlation between pre-employment findings of L5-S1 spondylolysis and sickness absenteeism due to low back pain among police officers. OBJECTIVES: Examining the importance of pre-employment lumbar spine radiographs as a prediction of work absenteeism. SUMMARY OF BACKGROUND DATA: Spondylolysis is a defect in the pars interarticularis. Its etiology remains controversial, it is a common condition among young athletes, and it carries genetic predisposition. Although described mostly as an incidental radiographic finding in the adult population, spondylolysis is implicated as a contributing factor to low back pain, although the cause-and-effect relation is not clear. METHODS: One hundred and sixty-nine police officers with L5-S1 spondylolysis were identified out of 3988 examined. Incidence density of sickness absenteeism due to low back pain was calculated for the patients and the controls. The Cox's proportional hazard model was used for comparison between the two groups, controlling for possible confounding variables. RESULTS: Similar incidence of sickness absenteeism due to low back pain was found among the patients and controls. The total duration of sickness absenteeism, however, was 2.7 times higher in the spondylolysis group than the controls. Prevalence of spondylolysis is origin specific, denoting genetic predisposition to this condition. Total sickness absenteeism not related to low back pain was not significantly different between the two study groups. CONCLUSIONS: There is low predictive value of pre-employment lumbar spine radiograph as a screening tool predicting sickness absenteeism due to low back pain. Spondylolysis, however, may increase the duration of sickness absenteeism in patients with low back pain.

Absenteeism↗
PubMed2004

First generation computerized fluoroscopic navigation in percutaneous pelvic surgery.

Percutaneous internal fixation of pelvic fractures has gained popularity allowing rapid mobilization with reduced surgical related morbidity; however, this method depends on conventional fluoroscopy, which exposes the patient and the surgeon to a significant amount of radiation. The use of computerized fluoroscopic navigation systems enables the simultaneous use of several radiographic projections. These preliminary fluoroscopic views are taken when the operating team stands at a distance from the radiation source. No further fluoroscopic radiation is used later during the surgical procedure. Computerized fluoroscopic navigation was used in the percutaneous insertion of 45 cannulated screws in 29 patients, including sacroiliac screws, pubic ramus screws, posterior column screws, and a supraacetabular transverse screw. Fluoroscopic verification of screw placement demonstrated a deviation <or=2 mm and <or=5 degrees. We believe the system saves fluoroscopic radiation time, yet improves the precision of the procedure. We believe that the use of this system is adequate for a selected patient population with pelvic fractures amenable to percutaneous screw fixation.

Acetabulum↗
PubMed2004

The use of computerized navigation in the treatment of gunshot and shrapnel injury.

OBJECTIVE: Trauma surgeons encounter numerous penetrating injuries nowadays. In some cases, missiles causing infection, pain and discomfort, or those retained within joints, bursae and other strategic sites, must be removed. This paper describes an innovative high-tech modality for use in the immediate removal of shrapnel and bullets from strategic anatomical sites. METHODS: Surgical computerized navigation based on real-time acquisition of fluoroscopic data was employed. Several fluoroscopic images of the required anatomical site were obtained. The accurate spatial location of the foreign object could be seen on the images displayed on the computer screen. No further fluoroscopic radiation was necessary. During surgery, the infra-red camera tracked the position of a surgical probe on the patient's anatomy and continuously updated its three-dimensional position simultaneously on all displayed images until the missile's location was reached. RESULTS: The use of percutaneous fluoroscopic navigation to remove retained metal objects, including bullets and shrapnel, has proved itself in 12 cases as an accurate measure involving reduced exposure to radiation. In contrast to CT- or MRI-based navigation, computerized fluoroscopic navigation does not require long preliminary preparation. Thus, it is highly efficient in the treatment of acute trauma victims. CONCLUSIONS: The use of this accurate technique in complex and dangerous situations where the foreign body is located in proximity to blood vessels, nerves and narrow 'safe-zones', is promising. This innovative technique reduces surgical time and radiation exposure. In our experience, it has rendered percutaneous missile removal much safer, even in hazardous situations.

Adult↗
PubMed2004

Using computerized fluoroscopic navigation to remove pelvic screws.

Orthopedic surgeons have recently recognized the benefits of using percutaneous fixation to treat pelvic-ring disruption. Surgical removal of pelvic internal fixation is performed in an anatomically "crowded" area, with no direct vision, and harbors its own risks. Computerized fluoroscopic navigation, which makes implant location easier and reduces radiation exposure, operative time, and soft-tissue damage, can make this procedure short and relatively safe.

Bone Screws↗