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Biomedical subjects

B K Bay

Publications and source records attributed to B K Bay.

23 records · Page 2Linked to original sources

Biomechanical consequences of fracture and repair of the posterior wall of the acetabulum.

We measured the distribution of contact area and pressure between the acetabulum and the femoral head of cadaveric pelves in three different conditions: intact, with an operatively created fracture of the posterior wall, and after anatomical reduction and fixation of the fracture with a buttress plate and interfragmentary screws. The study involved eight cadaveric hip joints from five pelves loaded to 2000 newtons in simulated single-limb stance. Measurements were made with pressure-sensitive film. The acetabulum was divided into three areas--the anterior wall, the superior aspect, and the posterior wall--for the analysis of the data. Creation of a fracture of the posterior wall was followed by an increase in contact area, maximum pressure, and contact force in the superior aspect of the acetabulum. A concomitant decrease in these parameters was observed in the anterior and posterior walls. Anatomical reduction and fixation of the fracture with a plate and screws did not restore the pattern of loading to pre-injury levels.

Acetabulum↗

Median nerve displacement through the carpal canal.

We determined the direct relationships between wrist position and displacement of the median nerve during active contraction of the flexor tendons at the wrist with an intact, transected transverse carpal ligament (TCL). Nine fresh cadavers were mounted in an apparatus to allow variable wrist position. Excursions of the tendons and displacement of the median nerve were measured by tracking markers with a video camera. Each limb was tested at 0 degree, 30 degrees, and 60 degrees of wrist extension before and after release of the TCL. Excursion of the flexor tendons required for full finger flexion ranged from 2.3 to 3.1 cm (mean, 3 cm). Median nerve displacement ranged from 0.9 to 1.4 cm (mean, 1 cm). The relationship between median nerve and flexor tendon excursion was consistently linear. Finger motion alone allows for median nerve displacement after surgery in the carpal tunnel.

Analysis of Variance↗

Evaluation of an intraosseous infusion device for the resuscitation of hypovolemic shock.

An intraosseous infusion device designed for the prehospital administration of hypertonic saline-dextran solutions was evaluated by resuscitating hemorrhaged conscious sheep. Eight animals underwent 2 hours of hemorrhagic hypotension (50 mm Hg, bled volume = 43 +/- 7 ml/kg). This was followed by the intraosseous infusion of 200 ml (4-5 ml/kg) of 7.5% NaCl-6% dextran 70 into the bone marrow of the sternum. Results were compared to seven control animals (bled volume = 31 +/- 6 ml/kg) resuscitated through a central venous catheter. Despite the small volumes infused, mean arterial blood pressure and cardiac output were rapidly normalized in both groups by 10 minutes post resuscitation (p less than 0.01). Plasma sodium concentration increased an average of 12 mEq/L and plasma volume was rapidly expanded regardless of route. The metabolic acidosis of hemorrhagic shock was rapidly corrected, pulmonary pressures remained normal, and hypoxemia did not occur after intraosseous resuscitation. The device provided safe and rapid vascular access via the sternal bone marrow space. The use of intraosseous infusion of hypertonic saline dextran solutions via the sternal bone marrow may allow prehospital rescuers to consistently incorporate fluid replacement therapy into 'scoop and run' policies by avoiding the time delays associated with failures in IV access.

Animals↗

Biomechanical consequences of anterior column fracture of the acetabulum.

OBJECTIVES: To measure biomechanical consequences of a high anterior column acetabular fracture. DESIGN: A benchtop biomechanical model using quasi-static loading of the hip joint in a simulated single-leg stance. Pressure-sensitive prescale (Fuji) film was used to determine hip joint loading parameters. PARTICIPANTS: Six cadaveric hemipelvi with one hip tested in each specimen. Three right and three left hips were tested. INTERVENTION: Creation of an anterior column fracture with anatomic reduction and fixation, followed by gap malreduction/fixation, and subsequently step malreduction/fixation. MAIN OUTCOME MEASUREMENTS: Contact pressure, contact area, and load distribution throughout the hip joint in each experimental condition. RESULTS: There were significant increases in load (p<0.01) and peak pressures (p<0.01) in the superior acetabular region after gap malreduction and in peak contact pressures after step malreduction (p<0.01) as compared with the intact acetabulum. Anatomic reduction was not associated with increased mean or peak contact pressures (in any region). CONCLUSIONS: Both step and gap malreductions of a high anterior column fracture resulted in significantly increased peak contact pressures in the superior acetabular region. These biomechanical data cannot be directly extrapolated to clinical applications, but these data suggest that anatomic reduction of anterior column fracture affords the best opportunity to restore contact pressures, contact area, and load distribution within the hip to levels similar to those seen in the intact acetabulum.

Acetabulum↗