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Biomedical subjects

A Catterall

Publications and source records attributed to A Catterall.

At least 55 records · Page 3Linked to original sources
PubMed1982

The treatment of Perthes' disease. The results of a trial of management.

Eighty-four children suffering from Perthes' disease are reviewed. The policy of management for these patients was one by which 55 per cent of the cases had no active treatment and the remainder were treated by operation. Results of the series show an improvement over a previously reported series of untreated controls, particularly where clinical management had been possible throughout the disease process. The importance of early definitive treatment for Group 4 cases is stressed. It is concluded that in the early stages where "head-at-risk" signs are not present, treatment may be conservative. Should these signs develop later the long-term result is not prejudiced if operative treatment is undertaken promptly.

Adolescent↗
PubMed1980

A controlled study of the results of femoral osteotomy in severe Perthes' disease.

We compared 63 hips (Catterall Groups 3 and 4) contained by femoral osteotomy with 85 untreated hips and found that 50.7 per cent of treated patients developed congruous spherical femoral heads in contrast to 14.1 per cent of those untreated. We have also considered certain other features relevant to the outcome. We suggest that the indications should not be modified on the grounds of early age of onset. Relief from weight-bearing does not appear to improve the results of containment. We have assessed the shortening which follows femoral osteotomy and conclude that this is only significant when there is growth disturbance at the capital epiphysis. These changes are at least as frequent in untreated patients.

Adolescent↗
PubMed1979

Metabolic alterations in human synovial lining cells in pigmented villonodular synovitis.

Synovial tissue from 3 patients with villonodular synovitis has been examined by quantitative cytochemistry. Considerable changes in the metabolism of the synoviocytes have been observed. These included a massive rise in the activity of glucose 6-phosphate dehydrogenase to levels even greater than those found in rheumatoid arthritis, and a significant rise in the activity of 2 glycolytic enzymes, glyceraldehyde 3-phosphate and lactate dehydrogenase. Lysosomal napthhylamidase showed raised activity with no latency. The sulphydryl content in the synoviocytes was raised, as was the amount of available phospholipid. This pattern of metabolic alterations is similar to that found in human rheumatoid synoviocytes.

Adult↗
PubMed1977

Pentose-shunt oxidation in the periosteal cells in healing fractures.

The activity of pentose-shunt dehydrogenases is very low in periosteal cells of normal rat metatarsals, but increases one day post-fracture and rises linearly over the next two days. By four days post-fracture, the distribution of this activity along the bone shows two centres of high activity: the first in the region of proliferation to form callus and the second at the site where new bone is first seen, one day later. The high rate of generation of NADPH would be expected to reduce glutathione; reduced glutathione has been shown to inhibit alkaline phosphatase activity in these cells.

Alkaline Phosphatase↗
PubMed1976

Changes in alkaline phosphatase activity in periosteal cells in healing fractures.

The quantitative changes in alkaline phosphatase activity in the periosteal cells close to the fracture in rat metatarsal bones has been measured during the first 5 days postfracture. This study has been made possible by two technological advances, firstly the development of cryostat microtomy for cutting unfixed, undemineralised bone, and secondly the use of scanning and integrating microdensitometry for quantifying the activity in each periosteal cell. The results showed a loss of alkaline phosphatase activity close to the fracture site, with activity rising to normal values 0.8-1.0 mm from the site. No alkaline phosphatase activity was found in the cells which proliferated from the periosteum. It is suggested that reduced glutathione could cause such inhibition.

Alkaline Phosphatase↗
PubMed1976

A controlled study of the indications for and the results of femoral osteotomy in Perthes' disease.

We have considered the reasons for securing containment of the femoral head in Perthes' disease and have reviewed briefly the methods used. The present investigation describes the outcome in a controlled series of forty-eight hips treated by containment by femoral varus-rotation osteotomy in selected patients. In assessing the results we have emphasised that controls are essential, and for this purpose we have used two comparable groups, one untreated and the other treated by methods other than containment. The same factors were considered in assessment--namely age, duration, group, and the presence or absence of "at risk" signs. The results were graded similarly as good, fair and poor in all groups. We have concluded that containment by femoral osteotomy is the treatment of choice in patients with "at risk" signs provided that severe deformity has not already occurred. There is no evidence that treatment of any kind favourably influences the course of the disorder in the remainder. Although this is predominantly a radiological study some clinical features are discussed.

Adolescent↗
PubMed1972

Coxa Plana.

Explore the source record for details and available documents.

Age Factors↗
PubMedDate not supplied

Bone growth following lengthening for congenital shortening of the lower limb.

Bone and limb growth velocity ratios were studied in patients undergoing lengthening for unilateral congenital shortening of the lower limb. In 15 patients before lengthening, the length ratio (LR) between the normal and short sides remained constant with age. Consequently, the growth velocity ratio (GVR) between the normal and short sides also remained constant and equal to the LR. In 20 children, no significant change in GVR was observed after lengthening was carried out at a mean age of 9.6 years. Our results suggest that final limb length remains reasonably predictable and that an acceptable discrepancy can be expected, especially following lengthening after age 9 years.

Adolescent↗
PubMedDate not supplied

Lateral shelf acetabuloplasty: an operation for older children with Perthes' disease.

Although 59% of children with Perthes' disease have a good result without treatment, poor results are common when the disease has onset in older children. Femoral osteotomy at this age will control the disease but may leave shortening and a persisting limp if there is insufficient capacity for remodeling and growth. Twenty children aged greater than 8 years with early disease were treated by lateral shelf acetabuloplasty. The results are compared with those in 14 children for whom no treatment had been advised. Lateral shelf acetabuloplasty has improved early outcome for these children as compared with untreated children for whom a poor prognosis has been confirmed.

Acetabulum↗
PubMedDate not supplied

Congenital hip dislocation or dysplasia with subluxation: a radiologic study.

We studied the behavior of hips in congenital hip dislocation. Two types were identified: those that developed normally after closed reduction and those that required an osteotomy. Children with hips that required an osteotomy were older at presentation and at follow-up had worse subluxation, with shallower acetabula. In this group, the younger the age at which reduction was achieved, the less the residual subluxation of the hip at follow-up. The age at which the late osteotomy was performed did not appear to affect the residual hip subluxation or the acetabular development. We could not find any radiologic parameter that would predict the need for an osteotomy.

Child, Preschool↗
PubMedDate not supplied

Practical applications in idiopathic clubfoot: a retrospective multicentric study in EPOS.

We report a European study of idiopathic clubfoot that was compiled with the aid of a detailed questionnaire. The retrospective study was presented at the seventh meeting of the European Paediatric Orthopaedic Society (EPOS). Most EPOS members treat idiopathic clubfoot at birth with plaster cast, but a few use physiotherapy and splints. The results of this conservative treatment vary. Operation is usually indicated at an age ranging from 4 to 15 months. Some physicians perform extensive procedures, and others limit operation to the medial and posterior parts of the foot. We propose a classification system for idiopathic clubfoot in an attempt to standardize procedures.

Casts, Surgical↗