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Biomedical subjects

B K Foster

Publications and source records attributed to B K Foster.

45 records · Page 3Linked to original sources
PubMedDate not supplied

Spinal fusion in Duchenne's muscular dystrophy.

The Women's and Children's Hospital experience with Luque spinal fusion in Duchenne's muscular dystrophy was reviewed from its commencement in 1983 to the present with a view to assessing the clinical and radiologic outcome and safety of the procedure. Seventeen boys have undergone spinal fusion. L-rod instrumentation was used in 10, six of whom had significant problems with sitting imbalance or progression of the scoliosis or both. In seven cases, distal instrumentation was taken to the pelvis with a Galveston construct and rigid crosslinking. Apart from some progression and sitting imbalance in the L-rod group, there were few complications. In the Galveston group, pelvic obliquity was corrected by a mean of 63%, and there was better maintenance of correction. There were no pseudoarthroses or instrument failures in the Galveston group. Of the total group, four patients had forced vital capacity (FVC) values < 25% predicted, and two required ventilation postoperative (< 48 h). There were no other respiratory complications. The effect of surgery on respiratory function remains uncertain. Spinal fusion with the Luque rod construct and pelvic fixation is a safe procedure. It provided a mean correction of 60% and control of pelvic obliquity without significant postoperative deterioration. In our experience, surgery can be safely performed with FVC value down to 20% predicted. On the basis of these data, one current practice is to instrument to the pelvis with a Galveston construct and Texas Scottish Rite Hospital cross-linking.

Adolescent↗
PubMedDate not supplied

Three-dimensional reformation of skeletal abnormalities using computed tomography.

A new technique for evaluation of skeletal pathology is described. The use of three-dimensional reformations based on conventional computed tomographic imaging is a technique that has been used by craniofacial surgeons since 1982 and more recently by orthopedic surgeons at the Adelaide (Australia) Children's Hospital for evaluation of pediatric skeletal pathology. Four cases are presented that demonstrate our early experience with the technique. Three-dimensional reformation is an effective method of translating conventional computed tomographic scans into a readily understood three-dimensional image. We believe that the method will be of increasing value in the evaluation of pediatric skeletal pathology.

Adolescent↗
PubMedDate not supplied

Statistical analysis of the incidence of physeal injuries.

The incidence of physeal injuries in nearly 2,000 bony injuries was 18%. They were commoner in adolescents and specifically more frequent in the upper limbs. The incidence of growth arrest was just over 1%, whereas the incidence of serious complication was less than 1%. The prognosis depends more on the site than the Salter-Harris classification. The proximal tibia is a common site for growth disturbance.

Adolescent↗
PubMedDate not supplied

The value of a new ultrasound stress test in assessment and treatment of clinically detected hip instability.

Fifty patients with clinical suspicion of hip dislocation were investigated prospectively with a dynamic ultrasound stress test. A posterior force was applied to hips in flexion and any movement between the femoral head and the acetabulum was measured. The results of this test showed that posterior movement ranged from 0 to 13.0 mm. Hips that were clinically normal had a mean movement of 1.4 mm, hips with minor clinical instability had a mean movement of 0.6 mm, hips with moderate instability had a mean movement of 4.5 mm, and those with major instability had a mean movement of 5.1 mm. This was statistically significant to a 1% confidence interval. We propose two groups of ultrasound-detected movement: group A less than 5.0 mm representing physiologic laxity, and group B greater than or equal to 5.0 mm being pathological and requiring treatment.

Evaluation Studies as Topic↗
PubMedDate not supplied

Technetium phosphate bone scan in the diagnosis of septic arthritis in childhood.

The technetium phosphate bone scans of 106 children with suspected septic arthritis were reviewed to determine whether the bone scan can accurately differentiate septic from nonseptic arthropathy. Only 13% of children with proved septic arthritis had correct "blind" scan interpretation. The clinically adjusted interpretation did not identify septic arthritis in 30%. Septic arthritis was incorrectly identified in 32% of children with no evidence of septic arthritis. No statistically significant differences were noted between the scan findings in the septic and nonseptic groups and no scan findings correlated specifically with the presence or absence of joint sepsis.

Adolescent↗
PubMedDate not supplied

Remodeling in slipped capital femoral epiphysis: sonographic assessment after pinning.

Twenty-one children and 26 hips with recent slipped capital femoral epiphysis (SCFE) underwent serial sonographic examination after operative fixation. The initial sonographic step at the anterior outline of physis decreased as a result of metaphyseal resorption. The first signs of resorption were evident 3 weeks after onset of symptoms; thereafter, the rate of resorption was 2 mm for each 3 weeks of follow-up. Finally, the physeal step was smooth and the anterior aspect of the femoral neck was straight. Sonography is accurate and free of projectional errors in assessment and classification of remodeling in SCFE.

Bone Remodeling↗
PubMedDate not supplied

Premature femoral neck physeal closure in Perthes' disease.

One hundred premature femoral neck physeal closures in 430 hips with Perthes' disease have occurred in two patterns central and lateral. Abnormal physeal growth can be demonstrated early by a narrowed physeal plate with overlying avascular epiphysis and marked metaphyseal reaction below. Subsequently, a bony bridge forms between the metaphysis and epiphysis. If the physeal closure is central, the mature hip will have a short femoral neck, a relatively round femoral head, a trochanter that has overgrown the femoral head, a short leg, and a mildly deformed acetabulum. If the physeal closure is lateral, the mature hip will have a femoral head that is externally tilted as the medial neck lengthens and the lateral neck remains short, a trochanter that has overgrown the femoral head, an oval femoral head, a short leg, and a deformed acetabulum. A physeal arrest is a contraindication for a varus osteotomy because it accentuates the deformity, especially in the greater trochanter. The leg-length discrepancy may be treated by epiphysiodesis of the contralateral femur, when necessary, and the abductor muscle insufficiency may be treated by an exercise program or distal and lateral transfer of the greater trochanter.

Adolescent↗
PubMedDate not supplied

Prenatal ultrasound diagnosis of clubfoot.

Prenatal ultrasound diagnosis of clubfoot is increasing. Of 103 patients with clubfoot diagnosed at birth, 26 (25.2%) positive prenatal scans were identified with the earliest diagnosis being made at 15 weeks. A questionnaire assessment indicated that 17 (65.4%) deemed that the explanation of the baby's condition was clear. With an increasing incidence of antenatal detection, it is suggested that parents require adequate antenatal counseling by a specialist in the area of clubfoot to improve the understanding of the natural history and treatment of this condition.

Clubfoot↗