Psychological reactions and processes following replantation surgery: a study of 50 patients

Fifty consecutive patients admitted for replantation surgery received a psychiatric evaluation. In 28 percent of the patients there was evidence of preaccident psychopathology. Fifty-four percent of the patients reported a recent stressful life event predating the accident. Fifty-four percent of the patients were assessed as having an adverse postoperative emotional reaction. The presence of preaccident psychopathology, evidence of family dysfunction, and a history of a recent stressful life event were positively linked with an adverse postoperative emotional reaction. In addition, patients with hand or arm replants were significantly less likely to require a psychiatric intervention than patients with leg replants. The psychological processes pertaining to the replantation journey are described in five stages: the preaccident period, the initial response, the stage of uncertainty, the recognition of loss, and acceptance and reintegration. Finally, the role of a liaison psychiatrist on a replantation unit is outlined and further research is strongly urged.     

Helmet for infant skull fixation during stereotactic neurosurgery

A thermoplastic helmet was designed to allow the use of the Leksell stereotactic frame in infants.     

Results of bicondylar sledge prostheses with special reference to the gait pattern]

AIM: To establish whether the clinical results obtained with bicondylar sledge prostheses correlate with clinical findings, and whether clinical results influence gait pattern. MATERIAL AND METHODS: 15 patients with bicondylar sledge prostheses were compared with healthy controls. The clinical examination was documented using the HSS, Knee Society, Tegner, and patella scores, and the Visual Analogue Scale. Gait analysis was done with a three-dimensional motion analysis system and force platforms. RESULTS: A comparison of patients and controls showed significant differences in the clinical results, whereas the parameters gait function, muscle force and pain did not. No significant differences were found between the operated and non-operated legs. In comparison with controls, patients showed significant differences in the ground reaction forces. DISCUSSION: The abnormal gait findings showed no correlation with clinical results, nor did such parameters as age, weight and duration of follow-up appear to have any influence. The non-operated leg adapted to the gait pattern of the operated leg, to restore gait symmetry. CLINICAL RELEVANCE: Subjective complaints or clinical results show little relationship to gait parameters in patients receiving a bicondylar sledge prosthesis.