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41.
Zusammenfassung
Operationsziel Schmerzfrei belastungsf?hige Fü?e.
Indikationen Gehen und Stehen schmerzhaft.
Unbefriedigende Einlagen- und Schuhversorgung.
Unbefriedigende ?sthetik.
Kontraindikationen Schlechte Hautverh?ltnisse.
Operationstechnik Dorsaler Zugang beiderseits.
Resektion von intermetatarsalen Knochenbrücken.
Korrekturosteotomien fehlstehender Mittelfu?knochen.
Beseitigung des Hallux varus durch Reposition der Gro?zehe im Grundgelenk und tempor?re Kirschner-Drahtfixation des Gro?zehenstrahls
und der Mittelfu?fragmente.
Ergebnisse Zw?lf Jahre nach den Eingriffen an beiden Fü?en lag ein ?sthetisch und funktionell sehr gutes Resultat vor. Die Patientin
trug normale Kaufschuhe und belastete beide Fü?e tadellos. Die Fü?e konnten allerdings wegen ausgedehnter angeborener Synostosen
der Fu?wurzel- und Tarsometatarsalgelenke nicht befriedigend abgerollt werden. 相似文献
42.
Francisco M. Averhoff Walter W. Williams Stephen C. Hadler 《The Journal of school health》1997,67(7):298-303
SUMMARY: This report concerning the immunization of adolescents (ie, persons 11–21 years of age, as defined by the American Medical Association [AMA] and the American Academy of Pediatrics [AAP]) is a supplement to previous publications (ie, MMWR 1994;43[No. RR-1] 1–38; the AAP 1994 Red Book: Report of the Committee on Infectious Diseases; Summary of Policy Recommendations for Periodic Health Examination, August 1996 from the American Academy of Family Physicians [AAFP]; and AMA Guidelines for Adolescent Preventive Services [GAPS]: Recommendations and Rationale). This report presents a new strategy to improve the delivery of vaccination services to adolescents and to integrate recommendations for vaccination with other preventive services provided to adolescents. This new strategy emphasizes vaccination of adolescents 11–12 years of age by establishing a routine visit to their health-care providers. Specifically, the purposes of this visit are to a) vaccinate adolescents who have not been previously vaccinated with varicella virus vaccine, hepatitis B vaccine, or the second dose of the measles, mumps, and rubella (MMR) vaccine; b) provide a booster dose of tetanus and diphtheria toxoids; c) administer other vaccines that may be recommended for certain adolescents; and d) provide other recommended preventive services. The recommendations for vaccination of adolescents are based on new or current information for each vaccine. The most recent recommendations from AC1P, AAP, AAFP, and AMA concerning specific vaccines and delivery of preventive services should be consulted for details. 相似文献
43.
The forces to produce fractures of the os calcis are combined compression and shear under a cranio-caudal impulse of 10-40 kN and a short time of stroke about 10-40 ms. The main patterns in biomechanics of calcaneal fractures are the time of stroke and the geometrical position of the foot in the moment of impact. Furthermore individual structural changes of the calcaneal cancellous bone, age, diseases as Diabetes mellitus and vascular obliterations are to be respected. Operative treatment of these fractures needs an understanding of the pathomechanism of the intracalcaneal shear-tension-forces. With plantarflexion of the foot combined with vertical forces within 40 ms to the anterior talocalcanear facette impact-fractures of the anterior part can be expected. These forces develop a posterior directed shear tension parallel to the axis of the os calcis, dividing the bone horizontally in two parts (Typ A, 44-56%), well-known as tongue-type fracture. Compression of the posterior talo-calcaneal joint leads to an impact of this structure producing the joint depression type within about 30 ms in dorsoflexion of the foot (Type B, 42%) together with sagittal shear fractures. High-energy forces are supposed to produce the so-called primary fractures of the sustentacular process in about 10 ms in a supinated position of the foot (Type C, 2-10%); these fractures represent in cases of dislocation an indication for open reduction and internal fixation. In our own experience with 45 cases in 35 patients using the lateral or/and medial approach no infection happened. Palmer's lateral approach was preferred. 相似文献
44.
45.
This article describes how genetic components of disease susceptibility can be evaluated in case-control studies, where cases and controls are sampled independently from the population at large. Subjects are assumed unrelated, in contrast to studies of familial aggregation and linkage. The logistic model can be used to test collapsibility over phenotypes or genotypes, and to estimate interactions between environmental and genetic factors. Such interactions provide an example of a context where non-hierarchical models make sense biologically. Also, if the exposure and genetic categories occur independently and the disease is rare, then analyses based only on cases are valid, and offer better precision for estimating gene-environment interactions than those based on the full data. 相似文献
46.
The confrontation with one's body appearance as recorded on a video might have an impact on the body experience of anorexia nervosa patients. Such a video confrontation was applied to a group of 12 anorectic females. After the procedure, these patients rated their actual body (using Osgood's Semantic Differential) as thinner and more active; the control group of 12 female anorectics did not change their evaluations. The patients' evaluation of their ideal body image was not influenced. 相似文献
47.
Walter Daghino MD Luigi Milano MD Sergio Ronco MD Giorgio Ronco MD Angelo Dettoni MD Massimo Cartesegna MD 《The Journal of foot and ankle surgery》2003,42(3):155-160
This article is a retrospective study comparing the efficacy of Regnauld arthroplasty to first ray osteotomies for the treatment of hallux valgus. One hundred consecutive cases of Regnauld arthroplasties were compared with 100 consecutive first ray osteotomies. One hundred fourty-one patients were available for follow-up, and based on clinical/radiographic examinations, 72 were treated with the osteotomy protocol (group A) and 69 with Regnauld arthroplasty (group B). Age at surgery, clinical symptoms, and preoperative radiologic findings were similar for the 2 groups; there was a preponderance of female patients (90%). The average follow-up was 49 months in group A and 51 months in group B. Clinical evaluation showed in the osteotomy group a more stable correction (79% v 49%), greater pain reduction (measured in a visual analog scale from 0 = pain free to 10 = deep intolerable pain), increased residual articular excursion of the first metatarsophalangeal joint (27 degrees of active dorsiflexion from neutral position v 8 degrees ), and less presence of central metatarsalgia (15% v 34%) (P <.05). The radiographic evaluation expressed more stable correction values in group A for the following parameters: joint preservation, sesamoid position, intermetatarsal angle (7 degrees v 12 degrees ), abduction angle of the hallux (14 degrees v 20 degrees ), and proximal articular set angle (8 degrees v 18 degrees ) (P <.05). 相似文献
48.
Univ.-Prof. Dr. P. Walter 《Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft》2005,102(10):931-932
Ohne Zusammenfassung 相似文献
49.
50.
The effect of hydration water temperature (dip water) on the strength of orthopedic casts is discussed. Three methods of testing are used in an attempt to detect any differences and also to assess their clinical relevance. It was found that warmer water produced stronger casts, however, the differences were not found to be clinically relevant. It is suggested that water temperature be chosen on the basis of considerations other than strength. 相似文献