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PubMedDate not supplied

The dynamic elbow suspension splint.

Elevation of the upper extremity after elbow surgery has rarely been advocated and can be difficult to achieve. Usually the extremity is elevated with the elbow at 90 degrees of flexion, so that swelling from the hand drains to the elbow but the elbow remains dependent. Excessive swelling causes discomfort and compromised wound healing, makes early mobilization difficult, and predisposes to joint contracture. We report on a dynamic elbow suspension splint, which is analogous to the Thomas splint used for femoral shaft fractures. The arm is held in full extension with an above-elbow plaster slab and is secured to the Thomas splint with skin traction. The splint is suspended on a Balkan frame at an angle of 60 degrees. We prefer to use the new Zimmer Thomas splint, because it is radiolucent and has self-adhesive sheep-skin supports that can be simply applied. It allows the patient to mobilize in bed and is well tolerated by patients and nursing staff. The dynamic elbow suspension splint is a useful adjunct after complex elbow surgery or trauma, because it reduces swelling and maintains the elbow in extension.

Elbow Joint↗

PubMed1982

[Post-traumatic hemarthrosis of the knee joint--determination of the cause by arthroscopy (author's transl)].

Between December 1977 and February 1981, a series of 70 patients was examined because of an unclear hemarthrosis, the source of hemorrhage was determined by arthroscopy. In our opinion a hemarthros of the knee joint is not clear if the lateral ligaments are stable, no drawer can be loosened at an angle of 90 degrees, and if the X-ray radiograph does not clearly show a fresh fracture. In most cases, the symptom of uncertain hemarthros was provoked by a banal trauma hardly to reconstruct. Due to the violent pain caused by the thick effusion, the patients consulted the doctor early and had partly been pre-examined by several doctors. In all cases, the joint was described to possess stable ligaments and X-ray examination did not show any clear fracture sign. The thorough examination under anesthesia made by the author resulted in a suspicion of a ligament in 43% of the examined joints, however, the subsequent arthroscopy showed a rupture of the anterior cruciate ligament in 70%. A cartilage/bone lesion was found in 30%, a rupture of the posterior cruciate ligament, however, only in 5,7%. In two cases (3%), the hemorrhage was caused by a fatty body lesion or the rupture of an adhesion. In 41% of the patients we found severe combined lesions of the anterior cruciate ligament and the meniscus or cartilage lesions. In 56 patients, i.e. 80%, the lesion was so severe that they had to be treated by surgery. In 11%, we thought an immobilization by plaster cast to be sufficient. Only six patients i.e. 9%, had neither to be operated nor immobilized. The hemarthros of the knee joint which occurs even after small accidents is caused by severe inner lesions of ligaments and cartilages. In more than 50% of all cases, these lesions cannot be diagnosed even by careful clinical examination under anesthesia and special X-ray examination methods. With adequate skill and experience, however, arthroscopy allows an exact diagnosis in almost 100% of all cases. It is therefore the patient's interest to clarify by arthroscopy every case of unclear hemarthrosis.

Adolescent↗

PubMed2002

Measurement of adhesion of endodontic sealers to dentin.

The bond strength of root canal sealers to dentin seems to be an important property for maintaining the integrity of the seal of root-canal fillings. In the few studies published, various assessment methods were used so quantitative comparison is not possible. The purpose of this study was to develop an effective and easily reproducible model and to test it with nine contemporary, commercially available endodontic sealers. After slicing off the coronal 2 mm of extracted third molars, the exposed dentin served as test surfaces. The teeth were fixed with plaster in 1-inch phenolic rings. Five-mm long sections of polyethylene tubing, filled with freshly mixed sealer, were placed on the dentin and tested for shearing bond strength after setting. A custom-made holder allowed the rings to be attached to an Instron machine, activated at a cross-arm speed of 0.5 mm/min. The mean bond strength, ranged from 0 to 4.9 MPa. The sealers were ranked and those that did not differ statistically in their bond strength were grouped together. This model provides a simple and reproducible means for measuring the in vitro bond strength of endodontic sealers.

Adhesiveness↗

PubMed1995

[Functional treatment of acute rupture of the Achilles tendon. An experimental biomechanical study].

In 84 adult rabbits the biomechanical properties of healing Achilles tendon rupture were examined 2, 4, 8 and 12 weeks (21 each group) after the injury. For the first time a mop-end-tear was performed. The following treatment modalities were applied (7 rabbits in each subgroup): (a) operative functional treatment (resorbable suture; Kleinert techniques); (b) operative functional treatment (fibrin glue); (c) primary functional treatment (conservative). The functional after treatment in all groups was performed with a specially developed orthesis, which was taped to the limb. For biomechanical testing a newly developed fixation technique (cryo-clamp) was applied, which guaranteed secure intratendineal rupture. After 2 weeks the fibrin glue-treated tendon ruptures showed the best results with regard to stiffness, tensile stress and max. rupture force. These results and a higher tensile stress of the sutured tendons were significantly different from those in the conservatively treated groups. After 4 weeks the stiffness in the fibrin group and the energy and rupture force in the suture group were significantly higher than in the group treated conservatively. The 8-week results revealed comparable biomechanical properties. The only significant difference was a higher energy in the fibrin glue group than in the conservative treatment group. The experiment revealed no significant biomechanical differences after 3 months. Compared with the results recorded for plaster immobilization in the literature, the functional treatment resulted in a significantly faster course of healing.

Achilles Tendon↗

PubMed1993

Controlled trial of a semi-rigid bandage ('Scotchrap') in patients with ankle ligament lesions.

A randomized, controlled, parallel-group study was performed to compare the clinical efficacy of a semi-rigid bandage ('Scotchrap') with the standard adhesive tape treatment for ankle ligament injuries. The semi-rigid bandage support wrap consists of a knitted fibreglass fabric impregnated with a polyurethane resin. The cotton stockinet and the synthetic cast padding are used for protection of pressure points and any bony prominences. Prior to application, the 'Scotchrap' must be soaked in water after which it is applied in a way similar to that used for a plaster of paris bandage. The finished bandage remains elastic, allowing normal dorsal and plantar flexion of the foot, but preventing inversion and eversion, and pronation and supination. At rest, the bandage always redresses the immobilized ankle into the neutral position. One hundred and thirty-six patients were included in the study. The semi-rigid bandage group comprised 59 patients and the tape group had 57 patients. These two groups were statistically comparable. The intake questionnaire included a general and a specific anamnesis form as well as a physical examination form. Follow-up data were recorded every 2 weeks. After termination of the treatment, the patients evaluated treatment efficacy. Statistical analysis of 126 items per patient with chi 2-tests (p < or = 0.05) and Fisher's exact tests (p < or = 0.05) revealed no statistical significant differences in treatment result. The patient assessments of treatment efficacy of both types of bandage were also comparable. Both types of bandage gave sufficient stability (98%; p < 0.005) and were equally effective.(ABSTRACT TRUNCATED AT 250 WORDS)

Adhesives↗

PubMed2005

[Therapeutic effect of tissue engineered tendon in repairing old calcaneal tendon rupture and defects].

OBJECTIVE: To probe into the surgical methods and therapeutic effect of repairing old calcaneal tendon rupture and defects with tissue engineered tendons. METHODS: The tissue engineered tendons were prefabricated by co-cultivating allogeneic tendon cells with composite of carbon fiber and polyglycolic acid for 5 days. From August 1999 to June 2002, 7 patients with calcaneal tendon rupture and defects (5-7 cm in length) were treated with tissue engineered tendons. The defects were repaired by suturing repeatedly with tissue engineered tendons. Meanwhile, the defects were covered by gastrocnemius fascial flap for protection and strengthening. After surgery, the ankle joints were fixed with plaster 4 to 6 weeks, and then the functional exercise was done. RESULTS: All the patients were followed up 22 to 56 months (46.9 months on average). Six patients achieved healing by the first intention, only one patient had delayed union. No local or systemic complication occurred in all the cases. No patients were given the second operation for adhesion. In accordance with YIN Qingshui's criterion for therapeutic effect, the results were excellent in 5 cases, good in 1 case and moderate in 1 case. CONCLUSION: Repairing old rupture and defects of calcaneal tendon with tissue engineered tendons can achieve good clinical outcome, it is an optional therapy.

Achilles Tendon↗

PubMed1979

[Investigation of the allergens of colophony and its derivatives used in the manufacture of sticking-plasters (author's transl)].

Colophony and its derivatives play an important part in intolerances to sticking-plasters. Gas chromatography revealed resinic acids (derivatives) in numerous products of that kind, even in the so-called "hypoallergic" ones. The profiles of the resinic acids contained in some sticking-plasters that are sold in several countries under identic names, are rather different. The results of physicochemical analysis of Elastoplaste, the normal French product, and of a "hypoallergic" product, coincide with the results of allergologic studies.

Adhesives↗

PubMed2005

[Repair of the knee extension apparatus in the treatment of "extension contracture" after femoral lengthening].

UNLABELLED: Restriction of the knee flexion is one of the most frequent complications during femoral lengthening with Ilizarov method. In most severe cases the knee flexion reaches less than 90 degrees, which leads to impairment of patient's activity ("extension knee contracture") and represents difficult clinical problem to manage. MATERIAL: We reviewed 4 patients at the age of 14 to 22 years (mean 19), treated surgically because of severe knee flexion limitation as a complication of femoral lengthening with the Ilizarov method. The mean age at femoral lengthening was 17 years (12 to 20). The indication for lengthening was femoral shortening from 5 to 12 cm (mean 7.5) because of myelodysplasia with club foot deformity (1 case), fibular hemimelia (1 case), sequelae of septic arthritis (1 case) and Ollier disease (1 case). Lengthening with Italian modification of Ilizarov device was used in all cases. In two patients with knee instability the apparatus was extended to stabilize the knee joint (in one case tibial and femoral lengthening was made simultaneously). Femoral lengthening of 5 to 12 cm (mean 7.5) was achieved. Knee flexion before lengthening varied from 90 degrees to 150 degrees (mean 135 degrees) and after femoral lengthening decreased to 41 degrees (20 to 75 degrees). METHOD: Plasty of knee extension apparatus was done 16 months after removal of the Ilizarov device. The procedure includes extensive release of subcutaneous and fascial adhesions around the knee joint (4 patient), patellar retinaculum and ilio-tibial tract release (4 patient), lengthening of vastus lateralis muscle (4 patients), vastus medialis (2 patients) and vastus intermedius (1 patient), mobilization of patello-femoral joint (3 patients), fractional, intramuscular lengthening of rectus femoris 15 cm above the knee joint (2 patients). Intraoperatively 90 degrees flexion was achieved (80 degrees to 100 degrees). In after treatment plaster cast with knee flexion 45 degrees was used. After 4-5 days passive exercises were started using K2 apparatus (continuous passive knee motion) and posterior slabs: one with knee extension for walking and second with knee flexion at the night were used. Active exercises began at the 10th day after surgery. RESULTS: At follow up 10 to 47 months (mean 36) after surgery 105 degrees to 120 degrees of knee flexion (mean 114 degrees) was achieved with full passive and active knee extension at good muscle power. All joints were evaluated as stable in sagittal and coronal planes (including 2 joints with mild instability in coronal plane before surgery). CONCLUSIONS: 1. Femoral lengthening procedure should be realized with proper attention to prophylaxis of knee extension contracture. 2. Knee extension apparatus plasty is effective and save procedure for treatment of so called "extension knee contracture" as a complication of femoral lengthening.

Adolescent↗

PubMed2002

New characterization method for pore and packing structure in powder compacts using confocal laser scanning microscope.

The internal structure of powder assemble was observed by a confocal laser scanning microscope and the results were compared with those of other conventional methods. Two kinds of specimens were examined in this paper: powder compacts from alumina granules and set plaster of gypsum. The structure was sensitive to humidity during pressing of the granule compact of alumina containing polyvinyl alcohol as a binder. Narrow interstices were noted along the boundaries of granules in low humidity. However, uniform internal structure was noted in high humidity. The origin of the difference of packing structure was attributed to the change of binder characteristics with humidity. Interstices were formed in low humidity due to poor adhesion of binder and spring back after pressure removal. The superior capability of the present characterization technique can distinguish a minor difference of internal structure successfully.

Journal Article↗

PubMed1988

[Traumatic cartilage damage of the knee joint].

Thirty-five traumatic lesions to cartilage were recorded, together with other injuries, from 225 arthroscopic examinations in two years. Most of the lesions (20) were located at the femoral condyle. The patella was involved in eight cases. However, if the patellar surface was related to the surface of the femoral condyles, the former was just as strongly affected by traumatic effects as the latter. No unambiguous localisation was possible in six cases, most of them smaller cartilage abrasions. Optional therapy proved to be applicable via the arthroscope in seven cases, while small incisions in the form of mini-arthrotomy were necessary in five cases. Arthrotomy was performed on 21 patients, and no therapeutic action at all was required in two cases. Complications included one transient soft-tissue infection and haemarthrosis of one patients who had to be punctured. Following very short-time immobilisation in plaster cast, the use of forearm walking supports was considered appropriate for short-term weight relief. A weight-relieving orthotic device with dynamic partial-loading facility was fitted for longer-term weight relief.

Aprotinin↗

PubMed1980

Does early movement speed the recovery of function of repaired flexor tendon?

The effect of early movement on flexion return in the repaired deep flexor tendon of 85 chicken toes was assessed. Postoperatively, the leg was immobilized in plaster. Beginning 18 days after surgery, minimal flexion of the third toe was induced by electrical stimulation of the deep flexor muscle in 38 chickens. Thirty-five days after surgery the plaster was removed and during the next 25 days the flexion was measured 15 times and compared with preoperative findings in the same chicken. In birds with early movement, averages of the last 4 daily measurements of total flexion were significantly greater (p = 0.005) than in those without stimulation. The extent of the loss of flexion depended on the quality and anatomical location of the peritendinous connections. Greatly reduced flexion was seen in the presence of multiple fibrotic interflexor bridges and firm adhesions. There were significantly fewer dehiscences at the repair site in the stimulated than in nonstimulated birds (standard error of difference = 9.2, difference 21.9%).

Animals↗

PubMed1988

Transantral repair of cerebrospinal fluid fistulas using bone chips, Tisseel, fascia and plaster of Paris.

Cerebrospinal rhinorrhea is a potentially serious symptom due to the risk of an ascending infection, which may produce a fulminant meningitis. Plaster of Paris has been used to obliterate the sphenoidal sinus and posterior ethmoids in five patients with cerebrospinal rhinorrhea. The fistulas were identified by computed cisternography and repaired by a transantral approach using a microsurgical technique, and bone chips, Tisseel and fascia to seal the fistulas. There have been no postoperative problems or leakage in the three patients with fistulas to the sphenoidal sinus. The cerebrospinal rhinorrhea recurred four and six months after operation in the two patients with fistulas to the posterior ethmoids probably due to surgical, technical problems in one patient and to less support by the plaster of Paris, when the fistulas end in this region. However, the described surgical technique seems to be a good alternative for fistulas to the sphenoidal sinus and should be included in our surgical armamentarium.

Adult↗

PubMed1993

The long term durability of bond strengths to dentin.

The aim of this study was to investigate the durability, throughout one year, of tensile bond strengths (TBS) to bovine dentin using various commercial and experimental bonding systems. Specimens were stored in a controlled solution of ion-exchanged water containing plaster chips and sodium azide. From the results it was concluded that the changes in TBS were not uniform over time, but a significant decrease was usually observed. For Super Bond D-liner and KB-100, the TBS were the highest and exhibited remarkable stability over the test period. The mode of fracture was noted to vary depending on the treatment system used, and was independent of TBS. Generally, the fracture mode tended to show increases in adhesive/cohesive failures within the resin over time. Super Bond D-liner always exhibited adhesive type failure at the tooth interface, and later involved failure in the hybrid layer. KB-100 showed very little change in failure over one year, being usually adhesive between bonding resin and resin composite. The results from this study indicate the need to carry out durability studies for the basic evaluation of all bonding systems. It was shown that the use of a controlled storage solution is important.

Acid Etching, Dental↗

PubMed2006

Allergic contact stomatitis from colophony.

UNLABELLED: Colophony is an ubiquitous contact sensitizer which may be present in dental materials, such as periodontal dressings, impression materials, cements, fix adhesives and varnishes. Exposure to a sensitizer in a hypersensitive person may initiate an allergic contact dermatitis/stomatitis. This usually occurs after direct skin/mucosa contact with the sensitizer. This paper reports the case of a colophony hypersensitive male who developed contact stomatitis after dental treatment with a colophony-containing product. CLINICAL RELEVANCE: Sensitizing colophony is present in Duraphat 2.26%F varnish, a fluoride varnish used all over the world. A case of hypersensitivity to Duraphat 2.26%F varnish is presented in a patient who, at the initial visit, indicated only an allergy to sticking plasters.

Adult↗

PubMed2005

Reduced adherence of Candida to silane-treated silicone rubber.

Silicone rubber is widely used in the construction of medical devices that can provide an essential role in the treatment of human illness. However, subsequent microbial colonization of silicone rubber can result in clinical infection or device failure. The objective of this study was to determine the effectiveness of a novel silane-treated silicone rubber in inhibiting microbial adherence and material penetration. Test material was prepared by a combination of argon plasma discharge treatment and fluorinated silane coupling. Chemicophysical changes were then confirmed by X-ray photoelectron spectroscopy, contact-angle measurement, and atomic force microscopy. Two separate adherence assays and a material penetration assay assessed the performance of the new material against four strains of Candida species. Results showed a significant reduction (p < 0.01) of Candida albicans GDH 2346 adherence to silane-treated silicone compared with untreated controls. This reduction was still evident after the incorporation of saliva into the assay. Adherence inhibition also occurred with Candida tropicalis MMU and Candida krusei NCYC, although this was assay dependent. Reduced penetration of silane-treated silicone by Candida was evident when compared to untreated controls, plaster-processed silicone, and acrylic-processed silicone. To summarize, a novel silicone rubber material is described that inhibits both candidal adherence and material penetration. The clinical benefit and performance of this material remains to be determined.

Argon↗

PubMedDate not supplied

Fibrin glue osteosynthesis of epiphyseal injuries.

Osteosynthesis of epiphyseal injuries by fibrin glue was tested in an experiment on ten dogs. In was successful in types II and III epiphyseal injuries (Salter and Harris) but failed in 50% of unstable type IV fractures. Plaster fixation of the extremity was necessary for the completion of osteosynthesis. Histology revealed uncomplicated bone healing. Clinical application of fibrin glue is to be expected primarily in the therapy of more stable type II and III epiphyseal injuries (Salter and Harris) with the fragments not exposed to major traction.

Animals↗

PubMed2005

Scaffold fabrication by indirect three-dimensional printing.

Three-dimensional printing (3DP) has been employed to fabricate porous scaffolds by inkjet printing liquid binder droplets onto particulate matter. Direct 3DP, where the final scaffold materials are utilized during the actual 3DP process, imposes several limitations on the final scaffold structure. This study describes an indirect 3DP protocol, where molds are printed and the final materials are cast into the mold cavity to overcome the limitations of the direct technique. To evaluate the resolution available in this technique, scaffolds with villi features (500 microm diameter, 1 mm height) were produced by solvent casting into plaster molds, followed by particulate leaching. Scanning electron microscope (SEM) showed highly open, well interconnected, uniform pore architecture ( approximately 100-150 microm). The ability of these scaffolds to support intestinal epithelial cell (IEC6) culture was investigated in vitro. IEC6 cells attached to scaffolds uniformly in vitro and grew preferentially in the villi region. To exploit the freeform nature of this technique with large pore size, anatomically shaped zygoma scaffolds with 300-500 microm interconnected pores were produced and characterized. Indirect 3DP provides an alternative method to complement other direct solid freeform fabrication methods.

Biocompatible Materials↗

PubMed2003

Shearing bond strength of endodontic sealers to gutta-percha.

Strength of the bond of root canal sealers to gutta-percha seems to be an important property for maintaining the integrity of the apical seal. In the few studies published, different models and assessment methods were used. The purpose of our study was to adapt an effective and easily reproducible model and to test it on nine contemporary commercially available endodontic sealers. Gutta-percha disks with a diameter of 10 mm and thickness of 2 mm were prepared by warming gutta-percha cones and then fixed with plaster in 1-inch phenolic rings. Five-millimeter long sections of polyethylene tubing, filled with freshly mixed sealer, were placed on the gutta-percha and tested for shearing bond strength after setting. A custom-made holder was attached to the rings and placed in an Instron machine, which was activated at a cross-arm speed of 0.5 mm per minute. The bond strength ranged from 0 MPa to 6.4 MPa. The sealers were ranked, and those that did not differ statistically in their bond strength were grouped together. This model provides a simple and reproducible means for measuring the in vitro bond strength of endodontic sealers.

Adhesiveness↗