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Biomedical subjects

A H Simpson

Publications and source records attributed to A H Simpson.

11 recordsLinked to original sources

Prevention of bicycle accidents.

OBJECTIVE: To elucidate the way of reducing the number of bicycle accidents. A prospective study of all casualties from bicycle accidents attending an accident unit for a 29-month period was performed (1831 patients). A more detailed questionnaire on the causes of accidents was used for the last 12 months of the study (818 patients). RESULTS: In the 0-7 and 8-12 years age groups, 87.5 per cent and 66.2 per cent, respectively, were due to cyclist error. The 8-12-year-old cyclists were twice as likely to have caused the accident if they had not had formal training (risk ratio = 2.0). Over the age of 18 years, 41.4 per cent were due to another road user. A motor vehicle was involved in 633 of the 1831 accidents. CONCLUSIONS: Children under the age of 8 years should not be allowed on public roads. Older children should only be allowed on the roads after formal training. This should become part of the school curriculum. A campaign to increase the awareness of motorists would be expected to reduce the number of cycle accidents. It would be beneficial to dedicate more roads and tracks to cycle use. Cyclists should be encouraged to wear more protective gear.

Accidents, Traffic

A role for ultrasound in limb lengthening.

The distraction gap at eight sites in six patients undergoing limb lengthening was monitored by both standard radiographs and ultrasound. Using the measurements obtained we were able to assess the rate and quality of callus formation at the distraction site, something that radiographs alone do not enable one to do. We suggest that ultrasound has a valuable role to play in guaging the optimum rate of lengthening for a particular patient and commend it as a technique to complement radiographs in the follow-up of the increasing numbers of patients undergoing distraction osteogenesis.

Adolescent

Duodenal ulceration into the cystic artery.

We report two cases of massive gastrointestinal bleeding due to anterior duodenal ulceration into the cystic artery, with gallbladder infarction as a complication. These cases indicate the potential dangers of laser therapy or embolization in bleeding anterior duodenal ulcers penetrating the cystic artery, as such therapy will arrest blood flow through the cystic artery and may precipitate gallbladder infarction.

Aged

Thoracic spine translocation without cord injury.

We report three cases of thoracic spine translocation without neurological deficit. In each case bilateral pedicular fractures, demonstrated by computed tomography, produced 'floating arches' which account for the sparing of the cord. If computed tomography demonstrates adequate canal dimensions, these patients may be treated conservatively, but the treatment of choice at specialist spinal centres is operative stabilisation.

Adolescent

The modified Schollner costoplasty.

The modified Schollner costoplasty is a cosmetic procedure for the correction of rib prominence deformity in scoliosis. We present the results of the procedure in 21 patients who had previously undergone spinal fusion for scoliosis. We found the procedure to be well tolerated without major complications. Objective cosmetic improvement was achieved in all but one case. All but one patient considered the procedure to have been of cosmetic benefit.

Adolescent

Sliding hip screws: modes of failure.

The modes of failure of the sliding hip screw devices were investigated by reviewing 223 cases. There were 35 mechanical failures. Two of these occurred when the components separated in highly comminuted fractures. The use of the locking screw is recommended to prevent this. The other 33 occurred when the device had lost its sliding action. The reasons for this included jamming, insufficient slide being available and additional fixation. To reduce the complication rate it is recommended that any additional fixation (such as cerclage wires) should be used with care to ensure that they do not block the barrel. For patients with short femoral necks, a shorter barrelled version of the device should be used as it would have a greater sliding capacity. Guidelines for its use are given.

Bone Screws

Cystic degeneration of fibrous dysplasia masquerading as sarcoma.

An area of fibrous dysplasia of bone may undergo rapid enlargement which may be due to either cystic degeneration or malignant transformation. These complications may be clinically and radiologically indistinguishable and, unless both are borne in mind, incorrect management may follow. Magnetic resonance imaging was used in one of our cases and was the only imaging modality to demonstrate the true nature of the condition.

Adult