P-3-05-07
USE OF NITI IMPLANTS IS AN ADVANCED STEP IN SURGICAL REHABILITATION OF THE DISABLED PEOPLE
Berman A.M., Zhukov D.V., Zhukov A.Y., Sleptsova T.A. (Orthopaedic Centre for Rehabilitation of Disabled People, Novokuznetsk, Russia)
Our study was aimed at efficacy assessment of application of implants and devices possessing shape memory effect in reconstructive orthopaedic interventions in patients with 1ocomotorium lesions and possibility of their use in various techniques.
In our Clinic from 1988 to 1995 we observed 236 patients with spinal and spinal cord injuries, affected stumps following the lower-extremity amputation, chondrodysplasia of the large joints, pseudoartrosis or defects of the long tubular bones.
NiTi alloy was applied as porous implants or original devices with shape memory effect for various surgeries, i.e. shin or thigh correcting osteotomy, stabilization anterior fusion with correction of kyphotic deformities and replacement of the injured vertebral bodies, replacement of extensive bony defects, osteoplastic below-the-knee amputation according to Pirogov and above-the-knee amputation according to Gritty, arthrorises or arthrodeses, tenomyoplasties.
Positive experience in application of shape-memorizing devices has been gained that allowed to advance movement adaptation of the disabled people, hence life quality has been improved. We believe that NiTi shape-memorizing devices will open new perspectives for people with severe injuries of the spine and extremities.
P-3-05-08
FEMORAL NECK FRACTURES IN HEMIPLEGIC PATIENTS
Osamu Mori, Shinya Horio (Kumamoto Takumadai Hospital, Kumamoto, Japan)
Purpose & Method: We investigated femoral neck fractures in 58 hemiplegic patients (15 males; 43 females) ranging in age from 53 to 91 for the purpose of presuming the gait ability after treatment.
Result: In approximately half of the patients, the fractures occurred within two years of the onset of hemiplegia. Thirty-four of the fractures occurred while the patients were at home, 16 happened while the patients were in the hospital, 6 of the patients were in a home for the aged and 2 were at a health facility for the aged. Forty-three of the patients walked with an independent gait prior to treatment, 2 used a cane, 5 used a walker and 8 of the patients were confined to wheelchairs. After treatment, these numbers changed to 29 with independent gait, 5 with a cane, 4 with a walker, and 16 confined to wheelchairs. In addition, 2 of the patients became bedridden after treatment and 2 patients died.
Conclusion: In those patients who exhibited independent gait ability after treatment, several factors were found to aggravate the ability. These included dementia, outside fracture and occurrence of injury, within 2 years of the onset of hemiplegia.
