Biomedical subjects
C J McCullough
Publications and source records attributed to C J McCullough.
Spindle-cell sarcoma of the hand may present as a benign recurrent nodule.
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Bilateral spontaneous scapho-lunate subluxation treated by limited carpal fusion.
The case of a 19 year-old-girl who developed spontaneous bilateral snapping scapho-lunate subluxation is described. Her symptoms were successfully treated by bilateral triscaphoid fusion.
Acute nerve injury as a complication of closed fractures or dislocations of the elbow.
Twenty-one patients with acute injury of either the median, ulnar, radial, anterior interosseous or posterior interosseous nerves associated with 1540 closed fractures or dislocations of the elbow have been reviewed. The mean time of follow-up was three years and nine months. Nine patients, 6 of whom had ulnar nerve lesions, had persistent evidence of nerve damage. Five patients sustained median nerve lesions complicating supracondylar fractures of the humerus. One patient, in whom there was no evidence of nerve recovery at five months, made a full recovery following neurolysis. Of the 9 patients who sustained ulnar nerve lesions, 2 required neurolysis and anterior transposition of the nerve, at two months and five months respectively, to facilitate recovery. Except for one patient with persistent radial paraesthesiae, full spontaneous recovery occurred in 7 patients who had sustained either anterior interosseous, posterior interosseous or radial nerve lesions.
The prognosis in congenital lower limb hypertrophy.
Twenty-eight patients with congenital total hypertrophy and ten patients with lower limb hypertrophy with congenital vascular abnormalities are reviewed. The pattern of increase in leg length discrepancy during growth and its influence on surgical management is discussed and the clinical features of the affected limbs are described. In congenital total hypertrophy the maximal increase in leg length discrepancy of more than 2.5 cm at age 4 years are likely to develop significant limb overgrowth that will require eventual surgical correction. In patients with congenital vascular abnormalities the change of leg length discrepancy was variable in degree and unpredictable in pattern, even in those with similar venous anomalies. The outcome for the limb was detergiography.
Osteochondritis dissecans of the talus: the natural history.
An assessment of 10 patients with osteochondral lesions of the medial or lateral articular surface of the talar dome was based, first on subjective symptoms and second, on an analysis of weight-bearing anteroposterior and lateral X-rays of both ankles. The mean period of follow-up was 15 years 11 months (range 7 to 28 years). In 5 of the 6 patients treated conservatively, radiologic assessment showed that the lesion had failed to heal, but nevertheless in each instance the ankle joint was relatively asymptomatic. Talocrural osteoarthrosis developed in only 2 ankles and was considered to be an uncommon complication in those joints treated either conservatively or by excision of the osteochondral fragment.
The influence of penicillin on experimental wound contamination with staphylococci: studies with chromic catgut and monofilament nylon closure.
This study examines the ability of penicillin to eradicate or modify the pattern of infection in experimental wounds contaminated with Staphylococcus pyrogenes in the presence of chromic catgut or monofilament nylon suture. Penicillin therapy initiated within 4 days of the onset of infection was successful in eradicating infection when compared with untreated controls (P less than 0-01). Infection was modified but not eradicated in penicillin was administered from the seventh day. The response of infection to penicillin was identical in wounds containing monofilament nylon or chromic catgut over a 21-day period. Antibiotics given before wound drainage permitted healing of all chronically infected wounds even in the presence of monofilament nylon. When antibiotics were begun at the time of drainage, wound healing occurred in 50 per cent (P less than 0-01).
Tuberculosis as a late complication of total hip replacement.
A case of tuberculosis developing in a hip joint which had undergone total prosthetic replacement arthroplasty 7 years previously is described. The patient had no manifestation of active systemic tuberculosis although calcified mesenteric nodes were noted on abdominal X-ray. It is assumed that hip joint infection occurred during a bacteraemia following activation of a latent tuberculous focus in the mesenteric lymph nodes.
Isolated mesenteric injury due to blunt abdominal trauma.
Isolated injuries of the small bowel mesentery or mesocolon with subsequent bowel infarction due to blunt abdominal trauma are rare. Two cases are described: 1 involving the mesentery to the terminal ileum and 1 involving the transverse mesocolon and middle colic artery, both with bowel infarction. The modes of clinical presentation and management of patients with injuries to the mesentery, mesocolon and mesenteric vessels following blunt trauma are described.