ISSN:0885-9698    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Dynamic fiscal and social pressures are dictating changes in our traditional health care delivery system. An overview of these factors and medical provider responses is outlined

ISSN:0885-9698    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The success of surgical procedures in patients with systemic rheumatic diseases is dependent on many factors that are not usually evaluated preoperatively. Patients must be evaluated in the context of their socioeconomic condition, including insurance coverage, extent of disability, social support systems, and cultural beliefs and values. This article attempts to present the constellation of factors that may endanger a technically adequate procedure and result in a less than acceptable outcome

ISSN:0885-9698    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Patients with inflammatory arthritis and the diffuse connective diseases have multisystem disease and require multiple medications. Complications may result from rheumatic disease expression, medications, and associated psychological disorders. The treating physician must be attentive to the whole patient to ensure successful, complication-free surgery.

ISSN:0885-9698    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The Ilizarov circular external fixator achieves circumferential three-dimensional fixation to bone through multidirectional, multiplanar, 1.5- and 1.8-mm Kirschner wires under tension. Once fixation of limb segments is achieved, its modular construction allows for gradual or immediate correction of length, angulation, rotation, and translation. Simultaneous fixation of both femur and tibia allows for balancing of both anatomic and mechanical axes in complex deformities. A systematic, scientific approach to deformity correction that has proven to be both reliable and reproducible is presented, including a step-by-step description of the operative techniques. This method has proven advantageous not only for the correction of complex deformities, but also for the simpler uniplanar ones because of its unequaled precision, accuracy, and adjustability combined with minimally invasive surgery

ISSN:0885-9698    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A preoperative detailed plan to ensure proper alignment following osteotomy about the knee is described. The techniques used to obtain the necessary preoperative information are simple and precise. These step-by-step methods used for both a proximal lateral closing wedge tibial osteotomy for a varus knee or a closing wedge medially based osteotomy of the distal femur for a valgus knee have been found to produce an accurate surgical plan. Since there is no consensus regarding the ideal magnitude of angular correction of varus or valgus deformities, we prefer a valgus alignment of 8° to 10° for varus deformities. In most cases this avoids both under- or overcorrection. For supracondylar varus osteotomies, 0° to 3° of anatomic valgus is preferred. Absolute anatomic varus is to be avoided

ISSN:0885-9698    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Upper tibial osteotomy is designed to correct the abnormal axial alignment of the femur and tibia and to realign it, in the case of the varus knee, to an overcorrected valgus position. A wedge of bone is removed from the upper tibia proximal to the attachment of the patellar ligament and the osteotomy site closed and held with a staple. The head of the fibula is removed to give better exposure for this wedge removal and to also allow for resuturing of the fibular collateral ligament and biceps femoris tendon under physiologic tension following the osteotomy. Careful attention to technique is essential to obtain the amount of valgus that has been planned preoperatively as well as to avoid complications. When this technique is followed, the resulting alignment should be within a very few degrees of the preoperative planning. Healing should occur promptly and in the position the surgeon desires

ISSN:0885-9698    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The results of high tibial osteotomy for gonarthritis are highly dependent on postoperative knee alignment. The surgical technique reported here utilizes an osteotomy jig to assure precision cuts and adequate correction. A buttress plate secures the osteotomy site, thus maintaining angular correction and allowing for early motion

ISSN:0885-9698    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Distal femoral varus osteotomy can be a successful surgical treatment for the painful valgus knee. This osteotomy is indicated in patients with painful lateral tibiofemoral osteoarthritis and valgus deformity. This osteotomy is contraindicated in patients with inflammatory arthritis or stiff knees. A surgical technique including a precise medial distal femoral closing wedge osteotomy with rigid internal fixation will be described.

ISSN:0885-9698    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Varus osteotomy of the upper femur is a highly effective method of surgically managing certain cases of arthritis of the hip secondary to acetabular dysplasia, valgus deformities of the upper femur, and Perthes disease. It is an effective alternative to premature total hip arthroplasty

ISSN:0885-9698    

出版商:OVID    

年代:1989

数据来源: OVID