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ΑΝΑΚΟΙΝΩΣΕΙΣ– ΕΙΣΗΓΗΣΕΙΣ- ΔΙΑΛΕΞΕΙΣ – ΕΠΙΣΤΗΜΟΝΙΚΑ ΕΚΘΕΜΑΤΑ ΣΕ ΕΛΛΗΝΙΚΑ ΣΥΝΕΔΡΙΑ

 

Β. 1
ΚNEE JOINT EFFUSION FOLLOWING SURGERY ON THE IPSILATERAL FEMUR.

Christodoulou, P. Givissis, F. Sayegh, J. Pournaras,
P. Symeonides

Ανακοινώθηκε στο 102 Ετήσιο Συνέδριο της American Orthopaedic Association.
Colorado Springs, 12-15 June 1989, USA.

Μελετήθηκε βάσει πρωτοκόλλου η συχνότητα ελάττωσης ή κατάργησης του επιγονατιδικού αντανακλαστικού και η εμφάνιση ύδραρθρου του γόνατος σε 105 ασθενείς οι οποίοι χειρουργήθηκαν στο ισχίο ή στο μηριαίο οστούν για οστεοαρθρίτιδα (28 ασθενείς) και κατάγματα (77 ασθενείς).
Η προεγχειρητική συχνότητα μεταβολής του επιγονατιδικού αντανακλαστικού στηv ομάδα των ασθενών που έπασχαν από κάταγμα ήταν 14,2% και ο ύδραρθρος του γόνατος 11,6%.
Αμέσως μετεγχειρητικά υπήρξε 86,6% ελάττωση ή κατάργηση του αντανακλαστικού χωρίς εμφάνιση ύδραρθρου.
Τη δεύτερη μετεγχειρητική ημέρα ενώ δεν υπήρξε άλλη μεταβολή του επιγονατιδικού αντανακλαστικού εμφανίσθηκε ύδραρθρος του γόνατος στο 75,2% των περιπτώσεων, ποσοστό που ανήλθε μέχρι το 81% τις πρώτες επτά μετεγχειρητικές ημέρες.
0 ύδραρθρος και το επιγονατιδικό αντανακλαστικό επανήλθαν στα φυσιολογικά μέχρι την 30η μετεγχειρητική ημέρα.
Δείγματα αρθρικού υγρού ληφθέντα από 10 ασθενείς τυχαίως έδειξαν μη αντιδραστική φλεγμονή.
Φαίνεται ότι υπάρχει δυναμική ισορροπία μεταξύ της νευρομυϊκής λειτουργίας του τετρακεφάλου μυός και της ποσότητος αρθρικού υγρού του γόνατος. Δυσλειτουργία μυϊκή, ως επακόλουθο χειρουργικού ή κλειστού τραύματος, ελαττώνει την νευρική λειτουργία και έτσι αυξάνεται η ποσότης του αρθρικού υγρού.

Β. 2
COMMON ENTRAPMENT NEUROPATHIES IN THE UPPER LIMB.

P.Givissis.

Lecture. Hand Meeting, The Robert Jones and Agnes Hunt Orthopaedic Hospital
Oswestry, 29 January 1992 England.

The entrapment neuropathies of the upper limb is presented and the pathophysiology is analyzed. Both ischaemic and mechanical factors have been suggested as the cause of the symptoms.
Entrapment neuropathies are nevre injuries and an appropriate therapy must be introduced for its one of them.
The significance of clinical examination-sensitivity, motor function, Tinel’s test. Phalen’s tes – is stressed and the necessity of EMG/ nerve conduction studies.

B. 3
FRACTURE OF THE SCAPHOID

P. Givissis.

Lecture at the Hand meeting. Hand & Microsurgery service institute of Orthopaedics. The Robert Jones and Agnes Hunt Orthopaedic Hospital

Oswestry, U. K. 10 February 1992

The scaphoid fracture is the commonest one among the carpal bones. The fracture location is predictive for the final outcome and the blood supply is discussed.
The conservative treatment appears to be controversial. In the case at non-union the alternatives surgical treatments are presented.

B. 4
FLEXOR TENDON INJURIES

P.Givissis

Lecture, Hand meeting, Wrightington Hospital
Wigan, 24 October 1994, England

Tendons must be very carefully examined as errors are always possible when making an examination for tendon injuries.
Even when gross deformity is absent, the posture of the hand often provides clues as to which tendons are severed.
The basic tendons repair techniques are presented and a new epitendinal suture (cross-stich combined with a modified kessler) is discussed thoroughly. The cross-stich was found to have significantly greater strength per weave. The complications of flexor tendon repairs are :
A. Flexion contracture at PIP and DIP joints
B. Rupture of tendon repair
C. Infection
D. Adhesions formations
E. Contractures
F. Pulley failure
G. Lumbrical –plus finger
H. Triggering
The methods for preventing complications are introduced

B. 5
WHIPLASH INJURIES.

P. Givissis.

Lecture at the clinical meeting. Wrightington Hospital
Wigan 5 December 1994, England.

Whiplash injuries are soft tissue injuries of the neck. Occur almost exclusively in road accidents. The term s mow used loosely to cover virtually every neck injury without fracture, affecting principally asthenic, long-necked teenage girls.
X – rays are normal or a loss of lordosis is appear. Children commonly show changes that could be mistaken for signs of injury. (Localized kicking of greater significance in adults). Clinically neck movements are restricted but objective neurological signs are rare.
Collar and diazepam is an effective treatment.

B. 6
THE SURVIVALSHIP OF STANDARD STRATHCLYDE-SOUTER TOTAL ELBOW REPLACEMENT IN PATIENTS WITH RHEUMATOID ARHTRITIS UNDER 50 YEARS OF AGE

Givissis P., Talwalkar S., Nuttall D., Trail I., Stanley J.

Poster at 10th Congress of the European Society for surgery of the Shoulder and the Elbow.
Salzburg, 15-17 September 1997

The Souter – Strathclyde total elbow replacement database was used to produce a life table of the 186 operations measured. Revision was considered to be the endpoint of prosthesis life.
The total number of X-ray films was 433. The ratio of male /female TERs is approximately 1/3. Almost all the TERs were as a result of rheumatoid arthritis. The 30 primary revisions (23 control group, 7 under 50y of age) were all due to aseptic loosening. The cumulative failure over ten years was slightly under 12% for both groups.