Biomedical subjects

A Kalamchi

Publications and source records attributed to A Kalamchi.

27 records · Page 2Linked to original sources

PubMed1976

Halo-pelvic distraction apparatus. An analysis of one hundred and fifty consecutive patients.

One hundred and fifty consecutive patients on whom the halo-pelvic apparatus was used were analyzed. Sixty-six per cent had tuberculous kyphosis or paralytic scoliosis. The apparatus was of great value in holding and correcting spines with tuberculous kyphosis and the results were gratifying, even though the average correction of the kyphos was only 20 per cent. In paralytic scoliosis a 46 per cent correction was obtained, but presently Dwyer and Harrington instrumentation are used for the majority of such cases. The halo-pelvic apparatus was effective in holding and correcting severe congenital curves and kyphoscoliosis secondary to neurofibromatosis, especially when there were signs of cord compression. The complication rate was high early in the series, but has been lowered by strict patient selection and close adherence to specific guidelines in the application of the apparatus. The apparatus should be reserved for severe deformities when other means of correction or stabilization are inadequate.

Adolescent↗

PubMed1976

Use of the thermography for the early diagnosis of deep vein thrombosis following hip operations.

Up to 50% of patients suffer from deep vein thrombosis (DVT) after major hip surgery. Frequently DVT cannot be diagnosed clinically. To the present, venography alone has been used in these patients, but it is time consuming, necessitates an intravenous dye injection and is not without complications. Now, however, the technique of thermography is available as an additional diagnostic aid. The results of thermography were assessed in 24 patients who had recently undergone major hip operations and compared with those obtained by venography. Thermography did identify DVT in the lower leg veins of patients with no clinical symptoms, but higher obstructions were only diagnosed by venography. Thermography gave one false-positive result later disproven by venography. Thermography has the advantage of being noninvasive and economical; it will become more useful when smaller portable systems are developed.

Aged↗

PubMedDate not supplied

Efficacy and safety of sequential treatment with parenteral sulbactam/ampicillin and oral sultamicillin for skeletal infections in children.

Nine children with osteomyelitis and/or septic arthritis were treated sequentially with parenteral sulbactam/ampicillin and oral sultamicillin. Causative pathogens were identified in six cases; all were susceptible to the combination of ampicillin and sulbactam. The mean duration of parenteral therapy was 7.1 days (6-11 days), and the average hospital stay was 10.3 days (6-18 days). Peak serum bactericidal titers of greater than or equal to 1:8 were achieved in all patients during parenteral therapy; only one child receiving oral therapy did not achieve a titer of greater than or equal to 1:4. At follow-up, all of the children were cured clinically and there was no evidence of relapse. Adverse reactions to oral therapy were minimal. The regimen of parenteral sulbactam/ampicillin and oral sultamicillin used sequentially is effective and safe for the treatment of skeletal infections in children. The use of this approach significantly reduced the duration of hospitalization.

Administration, Oral↗

PubMedDate not supplied

Acetabular epiphysis-labrum entrapment following traumatic anterior dislocation of the hip in children.

Traumatic anterior dislocations of the hip during childhood are rare injuries. Although a concentric reduction can usually be achieved with closed techniques, open reduction is occasionally required. We recently treated two children, 10 and 13 years of age, with nonconcentric closed reductions following traumatic anterior dislocation sustained 6 weeks and 6 months previously, respectively. Preoperative evaluation revealed intraarticular entrapment of the acetabular epiphysis and its contiguous labrum as the cause of the nonconcentric reduction. This was confirmed at surgery. Although displacement of the acetabular epiphysis has not been previously described, it is probably a common source for cartilaginous and osteocartilaginous fragments that have been recognized at open reduction following both traumatic anterior and posterior hip dislocations in children. Damage to this secondary center of ossification does not appear to affect adversely further growth and development of the acetabulum.

Acetabulum↗

PubMedDate not supplied

Arthrodesis for paralytic shoulder: review of ten patients.

Ten patients who had arthrodesis of their flail shoulders secondary to poliomyelitis were reviewed. The average age at the time of surgery was 15 years, 3 months, and follow-up range from one year eight months to seven years. Union occurred in each case, and no reoperations were required. Internal fixation was used for each patient, and this maintained the position of arthrodesis. All patients were significantly improved. Optimal position of fusion seems to be in 30 degrees of abduction, 30 degrees of forward flexion, and 45 degrees of internal rotation.

Adolescent↗

PubMedDate not supplied

Late-onset tibia vara: a histopathologic analysis. A comparative evaluation with infantile tibia vara and slipped capital femoral epiphysis.

Histopathologic and histochemical studies were performed on the entire physes and contiguous structures of five knees (three patients) with late-onset tibia vara (Blount's disease). A constellation of abnormalities of both medial and lateral physeal components resulted in disorganization and misalignment of the physeal zones. The changes were remarkably similar to those observed in both infantile tibia vara and slipped capital femoral epiphysis, suggesting a common etiology. Our evaluation indicates that asymmetric compressive and shear forces acting across the proximal tibial physis effect its disruption and causes suppression and deviation of normal endochondral ossification, thereby resulting in tibia vara.

Adolescent↗

PubMedDate not supplied

Congenital deficiency of the femur.

A classification system for congenital deficiency of the femur is introduced, based on initial radiographic appearance of the hip joint in 60 patients (70 affected limbs). Follow-up records ranging from 1 to 30 years demonstrated a relatively constant percentage of shortening in each patient with further growth (2.4% average change). Treatment programs have been established for each of the following groups: I, short femur with good hip joint (19 limbs); II, short femur and coxa vara (17 limbs); III, short femur with proximal deficiency, a well-developed hip joint, and broad angulated and sclerosed diaphysis (15 limbs); IV, dysplastic distal femoral segment with no hip joint (16 limbs); and V, total absence of the femur (3 limbs).

Acetabulum↗

PubMedDate not supplied

Sacral agenesis: a clinical evaluation of its management, heredity, and associated anomalies.

In the child born with sacral agenesis, the management of arthrogrypotic-like deformities, spinal and multisystem abnormalities poses several problems to the orthopedist. A clinical evaluation was undertaken on 17 patients and available parents in an effort to define better the heredity and proper management of this disorder. Flexion contractures of the hips and knees adversely affect ambulation potential and are rather resistant to standard treatment. The presence of protective sensation and proprioception, though, warrants aggressive attempts at correction, Subtrochanteric amputations are not necessary to achieve a functional ambulator. Spinal-pelvic instability does not preclude functional ambulation. In fact, there may be some benefit in maintaining motion in this region. Abolishment of spinal-pelvic motion by surgical fusion in the presence of hip contractures could impair sitting ability and the ability to walk upright. Congenital vertebral anomalies in the remainder of the spine, including the neck, occurred in 12 patients. Four patients had idiopathic-like curves. Only one patient had a normal spin above the level of agenesis. From an analysis of families, there was no obvious genetic association. Finally, the high frequency of multisystem associated congential abnormalities will necessitate a team approach to these patients.

Adolescent↗

PubMedDate not supplied

Osteocartilaginous lesion of the acetabulum resembling osteoid osteoma.

An unusual acetabular lesion radiographically resembling osteoid osteoma appeared in a 10-year-old girl recovering from trauma of the hip joint. Abnormal growth of cells of triradiate cartilage displaced by injury is a possibility that is supported by observations at open operation and biopsy.

Acetabulum↗