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Biomedical subjects

B P Boden

Publications and source records attributed to B P Boden.

6 recordsLinked to original sources

Management of traumatic cutaneous defects by using a skin-stretching device.

We report on nine orthopedic patients who underwent skin stretching to close 10 acute soft-tissue defects. The skin surrounding all wounds was stretched sufficiently to enable a primary closure. At an average of 9 weeks postoperatively, 9 of the 10 wounds healed without any complications. One wound dehisced postoperatively, but subsequently healed by secondary intention. The skin-stretching device eliminated the need for local or distant flap reconstruction in five skin defects and skin grafting in five wounds. Donor morbidity was avoided, the cosmetic appearance of the skin was maintained, and the in-hospital course of these patients was shortened.

Adult

Wrist arthroscopy.

Miniaturization of arthroscopic equipment has allowed wrist arthroscopy to emerge as a powerful surgical tool in orthopedic surgery. The magnified view of the arthroscope has provided a new understanding of carpal anatomy and disease. Arthroscopy improves surgeons' ability to diagnose wrist disorders and enables them to perform operative procedures with less morbidity than would occur in open procedures.

Arthroscopy

Analgesic effect of intraarticular morphine, bupivacaine, and morphine/bupivacaine after arthroscopic knee surgery.

In a double-blind randomized fashion, 38 patients were divided into four groups according to the intraarticular injection received after arthroscopic surgery. Patients in group I (n = 7) received saline, group II (n = 10) morphine, group III bupivacaine, and group IV (n = 11) morphine and bupivacaine. Before surgery and at 0.5, 1, 1.5, 2, 6, and 24 h postoperatively, pain levels were recorded. In addition, postoperative supplemental i.v. morphine requested by the patient was tabulated. Results showed that the mean consumption of supplemental analgesia was lowest in the morphine/bupivacaine group. Although there was a statistically significant difference in pain scores between the saline group and the other three groups during the early postoperative period, there was no significant difference in pain scores between the morphine, bupivacaine, and morphine/bupivacaine groups. We conclude that postoperative, intraarticular injection of analgesics is beneficial in reducing pain levels. The combination of morphine/bupivacaine appears to be the most beneficial analgesic due to its low supplemental analgesic requirements postoperatively.

Adult

Wrist flexor muscles of elite rowers measured with magnetic resonance spectroscopy.

We used phosphorus magnetic resonance spectroscopy to study skeletal muscle metabolism of trained vs. untrained humans. The forearms of highly trained rowers (n = 10) and age-matched controls were placed in a 1.9-T magnet so that the wrist flexor muscles were placed over a 4-cm transmitting and receiving coil. The subjects performed work by depressing a handle attached to an isokinetic ergometer. Relative concentrations of Pi, phosphocreatine (PCr), and ATP were measured along with intracellular pH. Measurements were made at rest, during steady-state and ramp exercise protocols, and during recovery from exercise. At rest the rowers had Pi/PCr that were not different from control. During steady-state exercise rowers (n = 4) had lower Pi/PCr at the same relative power levels, and the slope of the power vs. Pi-PCr curve was significantly greater than for controls. Rowers (n = 4) also had faster rates of PCr recovery after exercise than controls (T1/2 of 24 +/- 2.0 s for rowers and 47 +/- 8.4 s for controls) when power level was adjusted so that all subjects recovered from the same level of Pi/PCr. During a ramp exercise protocol, the initial slope of the power vs. Pi-PCr curve was greater in three of six rowers compared with controls and at the highest power level rowers had lower Pi/PCr values with less drop in pH. At the end of the ramp test, the same degree of muscle fatigue was associated with much lower levels of H2PO-4 (5.7 +/- 0.70 mM) in rowers compared with controls (13.0 +/- 1.8 mM).(ABSTRACT TRUNCATED AT 250 WORDS)

Female

Detection of muscle injury in humans with 31-P magnetic resonance spectroscopy.

Strenuous exercise can result in muscle injury that may persist for 2 weeks. Our purpose was to determine if muscle injury can be detected with 31-P magnetic resonance spectroscopy. Normal subjects performed repeated lengthening contractions with either arms or legs designed to result in mild muscle injury. One hour after the arm exercise, there was a significant increase in the inorganic phosphate to phosphocreatine ratio (Pi/PCr), with the maximum increase in Pi/PCr occurring 1 day postexercise (0.12 +/- 0.01 to 0.21 +/- 0.05). Pi/PCr remained elevated for 3-10 days. Similar results were seen following the leg exercise protocol. ATP/(Pi + PCr) decreased in all the arm exercised subjects. Exercise protocols that did not contain lengthening contractions did not result in changes of Pi/PCr or ATP/(Pi + PCr). Patients with various neuromuscular diseases with evidence of muscle damage (elevated CK, muscle soreness, and histopathological findings) also showed increased Pi/PCr at rest. We conclude that elevated Pi/PCr at rest can reflect nonspecific muscle damage in normal and diseased subjects.

Adult

Acute compartment syndrome of the lower extremity secondary to noncontact injury.

We retrospectively reviewed the cases of three patients with injuries similar to the mechanism of an ankle sprain which resulted in compartment syndrome of the lower extremity. All three patients presented with sharp, proximal, anterolateral pain in the leg after an indirect, twisting injury. None of the injuries involved direct contact. Two of the three athletes initially presented to local hospitals, where the injury was misdiagnosed as an ankle sprain. The mechanism appears to be a muscle strain or tear with resultant hemorrhage in the compartment. All three patients returned to high-level athletics after prolonged recovery periods.

Adolescent