摘要:

SummaryNineteen adolescent patients who presented with mechanical-type back pain and vertebral changes consisting of intravertebral disc herniation, disc space narrowing, and minimal wedge deformity are described. The symptoms and signs were primarily located at the dorsolumbar junction. A specific strenuous activity or traumatic event was clearly associated with the onset of symptoms in 16 of the 19 patients. Spondylolysis or spondylolisthesis (grade I or II) at L5-S1 was also found in 32% of the patients. Most patients responded well to a program of rest, exercises, salicylates, and temporary avoidance of the particular activity involved. Some required orthoses to obtain relief. No patient had a progressive kyphotic deformity during the follow-up period. The relationship of this condition to increased stresses applied to the immature spine, particularly in a preflexed posture, is emphasized.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

SummaryKinematic gait analysis was carried out on 42 hips, including normal joints and joints affected with Legg-Calvé-Perthes disease. Data were analyzed by a computer algorithm that calculated three-dimensional femoral head contact with the acetabulum (containment). Patients were studied in and out of various abduction orthoses. The three-dimensional containment of the hip is reproducibly altered by various devices; specifically, the Atlanta brace increases posterior coverage and slightly increases lateral coverage, and Petrie casts improve lateral and anterior coverage at the expense of posterior containment. This analysis allows modeling of osteotomies and enhances clinical assessment of actual changes in containment with bracing.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

SummarySixty-one children with ganglia treated surgically at the Singapore General Hospital were reviewed. At the wrist the predominance of dorsal ganglia over volar ganglia, which is the pattern in adults, was found only in older children. In children < 10 years old, volar ganglia predominated. A high recurrence rate (36%) following surgery was observed, putting in question the value of surgery. An expectant regimen is therefore advocated at first. A modified technique for excision of volar wrist ganglia without attendant risk to the radial vessels is discussed.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

SummaryFifty-three patients with 56 fractures of the lateral humeral condyle were reviewed and the results were assessed to determine the amount of displacement that could be relied on to produce satisfactory results. Closed treatment resulted in satisfactory results if the initial displacement did not exceed 2 mm. This required close follow-up for detection of displacement. Percutaneous pinning of nondisplaced and minimally displaced fractures is an acceptable alternative in any situation in which close scrutiny cannot be ensured. Those fractures with >2 mm of displacement should be reduced, pinned, and immobilized for 6–8 weeks. Evidence of delayed union after 8 weeks is an indication for internal fixation and possibly bone grafting. Established nonunions in good position are best treated by open reduction and bone grafting. In this series, varus deformity was the most common deviation from a normal carrying angle. The functional results were invariably good regardless of the radiographic or clinical findings.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

SummaryTo determine the effect, if any, of needle aspiration on99mTc bone scanning, three different areas of 15 dogs were first aspirated and then imaged with technetium bone scintigraphy. The hip joint was aspirated, the distal femoral metaphysis was drilled and aspirated, and the tibial periosteum was scraped with an 18− or 20-gauge needle. Varying amounts of trauma were inflicted to simulate varying difficulties at aspiration.99mTc bone scans were obtained from 5 h to 10 days later. There was no evidence of focal technetium uptake after any hip joint aspiration. This was consistent regardless of the amount of trauma inflicted or the time from aspiration to bone scanning. Metaphyseal cortical drilling and tibial periosteal scraping occasionally caused some focal uptake when scanning was delayed >2 days. When osteomyelitis or pyarthrosis is clinically suspected, joint aspiration can be performed without fear of producing a false-positive bone scan.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

SummaryShear fractures were created through the capital femoral physes of rabbits 2, 4, 6, 10, and 14 weeks of age. Biomechanically, the load to complete failure (i.e., fracture) increased with maturation. The load to failure increased with increasing area of the capital femoral physis. The shear stress increased with age and then began to plateau at 10 weeks of age. Histologically, the zone of failure involved the columnar zone in the specimens from rabbits 2–6 weeks old, progressed to the junction of the columnar and hypertrophic zones in the specimens from 10-week-old rabbits, and occurred within the zone of hypertrophy in the specimens from 14-week-old rabbits. Fractures progressed from a type I physeal fracture in the specimens from rabbits 4–6 weeks old to a type II physeal/metaphyseal fracture in the specimens from older animals, with the metaphyseal fragment increasing in size with increasing chondroosseous maturation of the specimen.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

SummaryGrowth plate fractures were producedin vitroin the rabbit capital femoral physis by applying shear loading parallel to the physeal complex in four different directions. Load-displacement curves were recorded and histologic sections were prepared from each specimen. Different histologic patterns were observed with different directions of shear loading. The histologic level within the growth plate through which the fracture propagated varied with each specimen and with the different directions of shear loading. The “classical” pattern of failure through the hypertropic cellular zone of the physis was not uniformly seen. The mechanical patterns of failure also varied with the direction of shear loading. The shear strength of the physeal complex was significantly greater with anterior to posterior loading than with posterior to anterior loading. The possible factors contributing to this mechanical anisotropy are discussed, and the literature on related studies is reviewed.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

SummaryCore biopsy specimens of slipped proximal femoral epiphyseal growth plates and of normal controls were examined by light microscopy and histochemistry. Slipped growth plates showed diminished cellularity with an overall excess of matrix as well as severe disorientation and misalignment of chondrocytes. Decrease in number of argyrophilic fibers in the longitudinal septa suggested deficiency in collagen. Histochemical staining of slipped plates did not deviate from normal except in severely deformed areas. Anatomic and histochemical observations did not conclusively support or exclude biochemical or biomechanical factors in the etiology of epiphyseal slipping.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

SummaryTwenty-three core biopsy specimens from patients with slipped capital femoral epiphysis and 11 control growth plates were studied by electron microscopy. Block staining with toluidine blue for demonstration of proteoglycans at the ultrastructural level was also used. The proliferative and hypertrophic zones of slipped growth plates showed diminished cellularity and marked distortion of the architecture with disarray of the cartilage columns. There was a deficiency and abnormality in the supporting collagenous framework of slipped plates. Chondrocyte degeneration and death were seen at all levels of the proliferative and hypertrophic zones, suggesting a disturbance in the life cycle of chondrocytes. The significance of these findings and their relationship to mechanistic, endocrine, and other proposed etiologies of epiphyseal slipping is discussed.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

SummaryDeep, late infection associated with internal fixation is well known in adults, but has not been previously reported in children. We report here six cases of deep, late infection in children associated with internal fixation of the proximal lemur. All patients had cerebral palsy and had undergone a proximal femoral osteotomy for hip subluxation or dislocation. The patients presented with infection between 7 and 24 months after a period of total recovery. The clinical presentation was variable, although many patients had increasing hip pain. Radiographs showed radiolucency around the lag screw. The bacteriologic finding was usuallyStaphylococcus aureus, and patients responded to wound debridement, hardware removal, and intravenous antibiotics. In light of these cases of deep, late infection, we strongly urge routine removal of metallic implants as soon as bony healing will allow.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID