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Biomedical subjects

C L Stanitski

Publications and source records attributed to C L Stanitski.

At least 19 recordsLinked to original sources
PubMed2000

Acute knee injuries.

Skeletally immature athletes do get major knee injuries. Hemarthrosis is associated with peripheral meniscal tears, anterior cruciate ligament ruptures, tibial tubercle avulsion injuries, and patellar/femoral osteochondral fractures and cannot be ignored. The primary diagnostic tool for patients with a knee injury is a clinical examination by a physician well trained in knee evaluation. MR imaging has significant limitations in this age group. The algorithm for anterior cruciate ligament injury treatment must take into account the patient's physiologic maturity, not chronological age.

Acute Disease↗
PubMed2000

Neurovascular injuries in type III humeral supracondylar fractures in children.

Clinical and radiographic records of 210 consecutive children treated for Type III extension humeral supracondylar fractures during a 66-month period were reviewed retrospectively to determine (1) the incidence of neural and vascular injuries associated with this fracture; (2) the frequency of the type of nerve injured; and (3) the relationship of fracture displacement to neural and vascular compromise. Forty patients (19.1%) had neural compromise, vascular compromise, or both. Nerve injuries occurred in 13.3% of patients, combined nerve and vascular compromise occurred in 2.9%, and vascular compromise occurred in 2.9% of patients. Median nerve injuries accounted for 58.9% of nerve injuries followed by radial (26.4%) and ulnar (14.7%) lesions. Eighty percent of the median nerve injuries involved the anterior interosseous nerve. Posterolateral fracture displacement was correlated with median nerve and vascular compromise. Posteromedial fracture displacement strongly correlated with radial nerve injury. Recognition of fracture displacement pattern provides a guide to clinical examination to assess associated neural injury, in particular, the anterior interosseous nerve, which may be difficult to evaluate in a child who is uncooperative.

Blood Vessels↗
PubMed2000

Orthopaedic manifestations of Ehlers-Danlos syndrome.

Ehlers-Danlos syndrome is the most prevalent heritable disorder of connective tissue. Musculoskeletal problems include joint pain, swelling and instability, and spinal deformity. This study was undertaken to assess functional orthopaedic problems of patients with Ehlers-Danlos syndrome. Sixty patients with genetically verified Ehlers-Danlos syndrome (range, 8-60 years; mean, 34 years) who attended a National Ehlers-Danlos Syndrome Foundation learning conference were evaluated by questionnaire, clinical examination, and when indicated, radiographs. A database of 250 items per patient was constructed and statistically assessed using analysis of variance. Because of rarity of Types VII and VIII, these two patients were dropped from the analysis. Fifty-eight patients had Ehlers-Danlos syndrome Types I, II, III, or IV and form the study cohort. Among these four types, there were no significant differences in history of joint dislocation, swelling, or types of orthopaedic surgical procedures experienced. Thirty patients with Type III Ehlers-Danlos syndrome reported joint pain more frequently than did patients with Types I, II, or IV. Ambulation was impaired significantly in patients with Type III disorder as a whole, as was functional hand strength and upper extremity function. Back or neck pain was a common (67.2%) report among patients with all types of disease but did not correlate with the presence or absence of spinal deformity. Contrary to most previous reports, the patients in this study showed that Type III Ehlers-Danlos syndrome was the most debilitating form with respect to musculoskeletal function.

Adolescent↗
PubMed1999

Syndrome of inappropriate antidiuretic hormone secretion in children following spinal fusion.

OBJECTIVES: a) To determine if antidiuretic hormone (ADH) is elevated in patients undergoing spinal fusion, especially in those who have clinical evidence of syndrome of inappropriate antidiuretic hormone (SIADH); b) to evaluate the relationship between ADH secretion and the secretion of atrial natriuretic peptide (ANP). SETTING: Tertiary care pediatric intensive care unit (ICU) in a university hospital. DESIGN: A prospective cross-sectional, observational study with factorial design. PATIENTS: Thirty patients > or = 10 yrs of age undergoing spinal fusion admitted to the ICU for postoperative care. INTERVENTIONS: Patients underwent anterior, posterior, or both anterior/posterior spinal fusion. Blood was collected for serial measurements of ADH, ANP and serum electrolyte levels. Heart rate, blood pressure and central venous pressure were measured. MEASUREMENTS AND MAIN RESULTS: Thirty children were studied. Nineteen had idiopathic scoliosis, nine had neuromuscular scoliosis, one had Marfan's disease, and one had congenital scoliosis. Ten (33%) children met clinical criteria of SIADH. There was no difference in duration of surgery, blood loss, volume of iv fluid administration pre- and intraoperatively, or type of scoliosis between those who developed SIADH and those who did not. Hemodynamic variables were similar in both groups. ADH levels increased in both groups immediately postoperatively and at 6 hrs after surgery, but were much more elevated in those patients with SIADH. Patients with SIADH also had significantly higher ADH levels preoperatively. In relation to serum osmolality, ADH was considerably higher in those with SIADH compared with those who did not. Although ANP values tended to be higher in the group with SIADH, this did not reach statistical significance. CONCLUSION: SIADH occurs in a subset of children who undergo spinal fusion. The diagnosis of SIADH can be made easily using clinical parameters which are well-defined. In the face of SIADH, continued volume expansion may be harmful, and should therefore be avoided.

Adolescent↗
PubMed1998

Clotting parameters in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion and instrumentation.

Thirty-six patients, 9 males and 27 females, average age 13.2 years, undergoing posterior fusion and segmental instrumentation surgery for idiopathic adolescent scoliosis were studied for abnormalities of platelet count (PC), prothrombin time (PT) and partial thromboplastin time (PTT). Intraoperative and immediate postoperative values were obtained at 2, 4, 6, 12, 24, and 48 hours. All patients showed diminution of platelet counts during the study period, but mean values were reduced below normals only at 4 hours after operation. The PT was significantly elevated in all patients intraoperatively and for the first 24 hours postoperatively, with return to normal by 48 hours. The PTT levels were essentially unaffected at any time.

Adolescent↗
PubMed1998

Conditions of the spine.

Sequelae of congenital, developmental, infectious, degenerative, and neoplastic processes present themselves throughout adolescence, a time of rapid growth and spinal development. The author outlines the elements of an accurate diagnostic physical examination, the signs and symptoms of various spinal deformities, and their diagnosis and treatment. The potential causes of back pain in children and adolescents are explored. The author cautions against dismissing complaints of back pain in the skeletally immature population as mere "growing pains."

Adolescent↗
PubMed1997

Pediatric and adolescent sports injuries.

Scholastic-age sports are generally safe, and major musculoskeletal injuries are uncommon. Injuries are proportional to the athlete's age, size, and type of sport. Significant knee injuries do occur, especially during adolescence, and they require prompt, accurate diagnosis and specific treatment. The team physician plays a major role in injury prevention and management.

Adolescent↗
PubMed1996

Femoral version in acute slipped capital femoral epiphysis.

Seven patients with seven acute slipped capital femoral epiphyses (SCFE) had computed tomography (CT) scan determination of femoral version. Version value differences were compared between the involved and uninvolved sides, and each was compared with a standard value for age. Comparison was also made with chronic slipped femoral version values. As compared to the standard of 20 degrees, the acute, involved side femoral version was 9.3 degrees (p = 0.057). Comparisons of involved and uninvolved sides showed no significant difference (p = 0.25). Analysis of differences of bilateral femoral version of patients with acute SCFE with that of patients with chronic SCFE version showed a significant difference (p = 0.009). Version in patients with acute SCFE more closely resembles the normal value than does that of patients with chronic SCFE, further emphasizing the uniqueness of the acute type of SCFE.

Acute Disease↗
PubMed1996

Acetabular version in slipped capital femoral epiphysis: a prospective study.

To determine if acetabular orientation is abnormal in patients with slipped capital femoral epiphysis (SCFE), we measured acetabular version in 60 patients with stable and unstable SCFE by computed tomography (CT) scan. Comparison of the involved sides of the two groups with the standard values for age, with the opposite uninvolved hip, or between stable and unstable hips showed no significant differences.

Acetabulum↗
PubMed1992

Noninvasive vascular monitoring during limb lengthening.

Transcutaneous wires and pins in wire-tension Ilizarov external fixators provide frame stability, transfix and transport bone segments, produce distraction, and stimulate transosseous osteogenesis. Vascular compromise by the transfixing pins and wires is nevertheless an ongoing possibility. Based on earlier studies of a two-phase method of measuring vascular blood blow, noninvasive vascular monitoring was performed on three patients undergoing Ilizarov method limb lengthening.

Bone Lengthening↗