Fat embolism: vascular damage to bone due to blunt trauma: intraosseous phlebography study.
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Biomedical subjects
A Finsterbush
Publications and source records attributed to A Finsterbush.
Fat pad adhesion to partially torn anterior cruciate ligament: a cause of knee locking.
Isolated damage to the ACL was found on arthroscopic examination of 51 patients who had symptomatic knees. There were 47 male and 4 female patients. The average age of the patients was 26.5 years, ranging from 13 to 43 years. Twenty-four of the patients had isolated partial tears of the ACL, and 27 had isolated complete tears. The purpose of this study was to examine the clinical patterns and arthroscopic findings in these two groups. On examination, 12 patients were found to have locked knees. An additional six patients gave a history of knee locking. All 18 of these patients were clinically suspected of having meniscal damage; however, only partial and complete ACL tears were found at arthroscopy. Of these 18 patients who had locking knees, 15 had a partial tear of the ACL and 3 had a complete tear. Locking was involved primarily in the group with partial ACL tears (15 of 24); only 3 of the 27 patients who had complete tears described locking. Of the 12 patients who had locked knees on examination, all were found to have fibrosis and adhesions of the fat pad and the synovium adjacent to the ACL stump. All 12 of these patients had a partial tear of the ACL. The fibrosis and adhesions were histologically documented in 10 of those 12 patients. The three patients who had partial ACL tears and histories of locking were not observed to have adhesions of synovium to the fat pad, but did have an entrapped remnant of ACL between the tibial plateau and femoral condyle.(ABSTRACT TRUNCATED AT 250 WORDS)
Adipose Tissue↗
Secondary damage to the knee after isolated injury of the anterior cruciate ligament.
Between 1978 and 1984, we examined and performed arthroscopy on 1000 consecutive patients. Ninety-eight of the 1000 had isolated ACL damage. These cases do not include patients with initial ACL injuries combined with other intraarticular damage. Diagnosis was by physical and arthroscopic examination. Examination took place an average 13.6 months after injury. Of the 98 isolated ACL injuries, 56 were complete ruptures and 42 were partial ruptures. In most cases of partial rupture, the clinical diagnosis was wrong. "Meniscal damage" was the usual diagnosis in these cases; the true diagnosis was made only by arthroscopic examination. Thirty-four of the 98 patients with isolated ACL injuries (30 men and 4 women) developed further intraarticular damage. Of these 34, 20 had complete ACL rupture and 14 had partial ACL rupture. Treatment after primary injury included physiotherapy in all patients and bracing in those whose knee was unstable during daily activities. Reconstructive surgical procedures were not performed in those patients. The time lapse from the primary to the secondary injury varied from 1 month to 20 years, with an average of 28 months. The secondary damage was caused by a secondary injury that was mild (22 cases) or developed insidiously (12 cases). Five types of secondary damage were observed: partial ACL tears that became complete--11 cases; meniscal tear--8 cases; loosening and subluxation of the anterior horn of the medial meniscus--14 cases; and fracture or damage to the articular condylar cartilage, with or without bone involvement--11 cases. It should be emphasized that the secondary damages were at times combined.
Adolescent↗
The role of the knee brace in the prevention of anterior knee pain syndrome.
Our prospective study evaluates the use of a knee brace with a silicon patellar support ring as a method of preventing anterior knee pain from developing in young persons undergoing strenuous physical exercise. We studied 60 young athletes, who qualified for a strenuous physical training course and who had not suffered from anterior knee pain previously. Twenty-seven subjects were in the brace group and 33 were in the nonbrace control group. The incidence of anterior knee pain syndrome increased with the intensity of exertion as the study progressed; i.e., subjects ran 6 km in the 1st week, gradually increasing each week up to 42 km/week at the 8th week. Yet, there was a significant reduction in the incidence of the syndrome at the end of the study in male athletes who had applied the braces before exercise sessions and in the brace group as a whole, compared with the control group. Prophylactic use of the brace, as described, did not reduce the ability of the athletes who wore braces to improve their physical fitness parameters in response to exercise. These data indicate that the use of a brace may be an effective way to prevent the development of anterior knee pain syndromes in persons participating in strenuous and intensive physical exercise.
Braces↗
Fracture patterns in thalassemia.
Of 61 patients with homozygous beta-thalassemia, 30 had fractures; the majority were single fractures. In three thalassemic families, multiple fractures were observed. Although fractures occurred mostly during the growth period, no epiphyseal fractures were found among the patients in the present study. Roentgenograms showed either horizontal or oblique fractures, frequently with compression, or linear fractures without displacement. No delay in fracture healing or residual gross bone deformities were noted, with the exception of fractures of the femoral neck. On the basis of clinical and scintigraphic examinations, four additional adolescent patients, excluded from this study, were suspected of having microfractures around their ankles and knees. In the future, with improvements in diagnostic methods, microfractures may be found often and recognized as a common source of acute pain about the knees and ankles of thalassemic patients.
Adolescent↗
Prevention of peripheral nerve entrapment following extensive soft tissue injury, using silicone cuffing: an experimental study.
A semirigid silicone cuff was investigated in rats to prevent scar entrapment of the sciatic nerve. Scar was induced by crushing or burning the surrounding muscles. On one side, the nerve was covered by a longitudinally split semirigid silicone tube. On the other side, the same procedure was done without silicone coverage of the nerve. At different time periods the animals were sacrificed and the nerve with surrounding tissues examined. The protected nerve was found gliding freely during mobilization of the limb. The blood supply to the nerve was maintained through the split in the silastic cuff by formation of new mesoneurium. On the control side, the nerve was surrounded by a fibrous tissue in various stages of maturation depending upon the time postinjury. The nerve structure showed reduced vascularity and progressive degenerative changes of the axons. Clinical tests on the silicone cuff method are proposed fo selected patients with extensive soft tissue injury around nerves.
Animals↗