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Biomedical subjects

C L Stanitski

Publications and source records attributed to C L Stanitski.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1992

Fixation with a single screw for slipped capital femoral epiphysis.

The effectiveness of a single 6.5 or seven-millimeter-diameter screw for the promotion of premature physeal closure and the provision of stability of a slipped capital femoral epiphysis was investigated. Physeal fusion was demonstrated in forty-nine (92 per cent) of fifty-three hips after fixation with a single screw. Premature fusion of the involved physis, compared with the uninvolved, contralateral physis, was documented (p less than 0.001). Epiphyseal stability, as measured by the lateral head-shaft angle, was maintained in all except one hip. An analysis of twenty-nine hips for which there was a complete set of radiographs, that were in patients who had no endocrine problems, and that were the first hips entered into the study when the patient had bilateral involvement, revealed an average time to closure of the physeal line of thirteen months. A longer time to physeal fusion was correlated with increasingly eccentric placement of the screw (r = 0.44, p = 0.016) and increasing severity of the slip (r = -0.536, p = 0.003). There was no correlation between the age at the time of the operation, race, or sex and the time to physeal fusion. Only one patient had penetration by a screw, and no chondrolysis, avascular necrosis, or other serious problems developed. Fixation with a single 6.5 or seven-millimeter-diameter screw provided adequate epiphyseal stability and promoted premature physeal fusion in our patients, while decreasing the rate of complications compared with that reported to be associated with fixation with multiple screws or pins.

Adolescent↗
PubMed1989

Common injuries in preadolescent and adolescent athletes. Recommendations for prevention.

In general, children and youth sports are safe. The great majority of injuries which are sustained are minor and self-limiting. Fortunately, catastrophic acute injuries such as paraplegia, quadriplegia and major limb insults are rare. The 2 mechanisms of injuries at these age groups are acute traumatic insults and unresolved sequelae of repetitive microtrauma. The latter usually results from inappropriate training and coaching techniques. In the United States, adolescents and children are becoming involved in sport at earlier ages and with higher levels of intensity and competition. Factors which lead to injury include the athlete and his/her own psychobiology, inappropriate equipment, the sports environment (playing surfaces, temperature), training and coaching errors, and parental influences. Preparticipation assessment usually reveals extremely healthy children with rare factors which contribute to non-sports participation. Preventative efforts must be made to provide these children with the appropriate equipment and coaching to limit the number of overuse injuries. Management of acute sports problems and rehabilitation of significant injuries are as important in childhood and youth sports as in those of their older sibs in order to prevent lifelong sequelae of musculoskeletal injury. The appropriate goal of children and youth sports must remain one of enjoyment with acquisition of sport-specific skills.

Adolescent↗
PubMed1989

Diagnostic arthroscopy of the knee in children and adolescents.

There is a definite role for arthroscopy in the diagnosis and treatment of problem knees in children and adolescents. In this series, the largest reported to date, significant intraarticular pathology frequently existed in both preadolescent and adolescent groups. Three hundred ten knee arthroscopies in 285 children were reviewed. Preoperative clinical diagnoses were correlated with arthroscopic findings. In preadolescents (12 years old and younger), only 55% of preoperative clinical diagnoses were confirmed at surgery. Thirty-five percent of this group were found to have additional pathology not anticipated preoperatively. In adolescents (13 to 18 years old), 70% of clinical diagnoses were confirmed arthroscopically. Additional pathology was also found on arthroscopic examination in 25% of this group.

Adolescent↗
PubMed1989

Arthroscopy in acute septic knees. Management in pediatric patients.

Arthroscopic evacuation, debridement, and irrigation of acute septic knees in children were effective adjuncts in the treatment of this joint infection. Sixteen knees in 16 pediatric patients were treated with arthroscopic management. Ninety-four percent of the knees had sepsis secondary to Staphylococcus aureus. Two immune-suppressed patients (postrenal transplants) had combined S. aureus and Pseudomonas aeruginosa infections. Twenty-five percent of the patients had a foreign body in the joint that was removed arthroscopically. No postoperative irrigation or drainage systems were used. At an average follow-up period of three years, no evidence of persistent or recurrent infection was noted. Roentgenograms showed no evidence of joint or epiphyseal destruction. Because of the low morbidity associated with the procedure, rapid restoration of joint motion and patient mobility was seen in all patients. Arthroscopic debridement of acute septic knees may be carried out in pediatric patients, given appropriate equipment and arthroscopic skills.

Acute Disease↗
PubMed1988

Management of sports injuries in children and adolescents.

In general, child and youth sports are safe. The vast multitude of injuries sustained are mild contusions, sprains, and strains. Major catastrophic injuries are rare. Overuse injuries secondary to repetitive, unrepaired microtrauma are becoming a more common source of injury. Children must not be thought of as simply small adults. Physiologically and emotionally, children, youth, and adolescents all vary in rate and magnitude of maturation in these spheres. The vast majority of sports-related injuries in children and adolescents require neither hospitalization nor surgery but lend themselves to out-patient treatment. The practice of preventive medicine is encouraged, and orthopedists should take an active part in advising patients about equipment and training programs to prevent coach and parental abuses that may lead to musculoskeletal long-term disabilities.

Adolescent↗
PubMed1985

Rehabilitation following knee injury.

Over the past decade, there has been a resurgence of interest in techniques of rehabilitation of the injured knee. Technologic advances have provided instruments that yield objective measurements so that appropriate staging can be done as part of the rehabilitation plan. Research in multidisciplinary fields has provided data that currently allow a rational physiologic approach to progressive care of the injured lower extremity. No longer is the adage "work it out and let's see how it goes" appropriate care for the injured knee. Starting with the proper diagnosis, rehabilitation begins at the time of injury and is specific for both the patient and the injury. A time frame is established for the rehabilitation, with progressive monitoring to allow gradual return to activity and the goals of both the patient and the surgeon taken into consideration. The management of knee injuries, whether from an overuse stress syndrome or following severe trauma with major ligament disruption, deal with the management of the inflammatory response. Since we do not know the exact time period for full mechanical competence following ligament healing, gradual assessment of objective data is necessary before return to full vigorous activity. Improved methods of rehabilitation allow patients to feel a sense of an active, dynamic process during which they are made to realize that much of their total improvement is up to them, under the guidance of the physician and therapist. The maintenance of function and fitness in uninjured extremities also allows for a feeling of well-being. Techniques now available make this often-forgotten phase of treatment a more pleasurable one and one that must be considered as much a part of knee injury management as is the knee immobilizer or the surgeon's scalpel.

Adolescent↗
PubMed1985

Environmental problems of runners.

By its very nature, running allows for a freedom that many athletic endeavors lack. The ability to run anytime and anywhere may be detrimental in itself, in that it may allow runners to place themselves in environmental circumstances that are unhealthy. Acclimatization to heat, altitude, and air pollution conditions can occur. Rapid changes in environment brought about by travel may lead to lack of recognition of appropriate clothing or running routes. Usual workout intensities and durations may not be appropriate for the specific environment at hand. Runners are advised to recognize the potential for such problems and make adjustments accordingly.

Air Pollution↗
PubMed1983

The correction of spinal deformity in idiopathic torsional dystonias.

The torsional dystonias constitute a group of motion disorders of unknown etiology with variable onset, progression, and severity that frequently result in spinal curvature. Four patients with this uncommon disorder, with curves averaging 70 degrees (range, 55 to 95 degrees), underwent surgical correction for progressive spinal deformity. All of them had improvement in function postoperatively, but there was a high rate of postoperative complications.

Adolescent↗
PubMed1982

Ferrographic analysis of wear in human joints. Evaluation by comparison with arthroscopic examination of symptomatic knees.

Ferrography is a technique for analysing wear by means of the magnetic separation of wear particles. To evaluate its application in human joints, the results of the ferrographic analysis of saline washings of symptomatic human knees were compared with the results of the arthroscopic examination of the same knees. Ferrography was found to be an extremely sensitive monitor of articular erosion, with a resolution far greater than that of arthroscopy. This was particularly apparent with knees suffering from a torn anterior cruciate ligament: arthroscopy detected no damage to the cartilaginous surfaces whereas ferrography detected a substantial level of "microdamage". The spectrum of wear particles showed qualitative and quantitative alterations depending upon the condition of the knee. Ferrography thus holds much promise as a potential differential diagnostic technique of great sensitivity, with particular relevance to the very early changes which precede clinical symptoms. Study of wear particles is also justified by evidence indicating an active role in the pathophysiological progression of arthritis.

Adolescent↗
PubMed1981

Immune function in marathon runners.

Quantitative immunoglobulins (IgG, IgA, IgM) and leukocyte phagocytosis and killing were studied in 20 male marathon runners to determine if rigorous physical conditioning affects immune function. C3, C4, Properdin Factor B, T and B cells, and phytohemagglutinin and pokeweed mitogen stimulation of lymphocytes were determined in selected runners. Complete blood counts, including platelets, were obtained for the group. Mean immunoglobulin values for IgG, IgA and IgM were within normal limits. Ten runners (50%) had slightly low total lymphocyte counts (less than 1500/mm3). Leukocyte phagocytosis and killing was consistently normal. Nine marathoners felt that running had increased, and one felt that it had decreased their resistance to respiratory infections. This could not, however, be correlated with significant changes in immune parameters. We conclude that long distance running has no effect on immune function.

Adult↗
PubMed1980

Epiphyseal fractures of the elbow in children.

Fractures about the elbow are common in children. In addition to the more frequent humeral supracondylar type, fractures of the lateral humeral condyle, the medial humeral epicondyle and the proximal radius often occur. Fortunately, these latter types are rarely associated with neurovascular compromise, as seen with the supracondylar type. However, accurate anatomic reduction is required to permit appropriate growth at these epiphyseal sites and to prevent complications.

Child↗
PubMedDate not supplied

Depression of the medial tibial plateau in early-onset Blount disease: myth or reality?

Patients with severe early-onset Blount disease (Langenskiold III or greater) often have the radiographic appearance of depression of the medial tibial plateau and delayed ossification of the epiphysis, adjacent physis, and metaphysis. Schoenecker and other authors recommended elevation of the medial plateau of the tibia for correction of this deformity. The purpose of this study was to assess the nature of the medial proximal tibia in these severe cases. Eight girls and two boys (17 tibiae) with severe early-onset Blount disease had standing radiographs and magnetic resonance imaging (MRI) evaluation. Average patient age was 5.8 years (range, 3-8 years). Eleven knees in eight patients underwent arthrography at the time of surgical correction of deformity. No tibia had MRI or arthrographic evidence of medial tibial joint "depression." The "empty" radiographic space was occupied by cartilage-density material. A smooth dye contour without pooling parallel to the femoral condyles was noted arthrographically in all instances. These findings do not support the concept of routine joint elevation in the correction of severe deformity associated with early-onset Blount disease.

Age of Onset↗
PubMedDate not supplied

The effect of pediatric orthopaedic experience on interobserver and intraobserver reliability of the herring lateral pillar classification of Perthes disease.

An analysis was done of the effect of surgeons' pediatric orthopaedic experience on the classification of Perthes disease according to the lateral pillar classification described by Herring. Five observers with varied pediatric orthopaedic experience reviewed anteroposterior (AP) pelvis radiographs of 33 patients in the fragmentation phase of Perthes disease and classified each case on three separate occasions at least 24 hours apart. Frog-leg lateral-view radiographs taken at the same time were also classified using the same criteria based on the femoral head anterior column. Kappa statistics showed good agreement for intra- and interobserver reliability of classification for both AP and frog lateral radiographs. There were no statistically significant variations among the reviewers. Twenty-four percent of the cases had a classification one grade worse on the lateral radiograph compared to the AP view. The lateral pillar classification provides a reproducible radiographic technique for Perthes disease characterization independent of pediatric orthopaedic experience.

Adolescent↗
PubMedDate not supplied

Relationship of factors affecting age of onset of independent ambulation.

Despite the standard available pediatric developmental scales and popular lore that girls walk at an earlier age than boys, no large-scale evaluation of the age of onset of independent ambulation has been previously published. The purpose of this study was the prospective epidemiologic evaluation of a large heterogeneous group of normal children to determine the effect of gender, race, birth order, and socioeconomic status on the age of onset of independent ambulation. The study cohort consisted of 986 children (575 male, 471 female). A multivariable analysis of covariance model was used to examine the effects of race, gender, income, and birth order on age at ambulation. After controlling for the other variables in the model, race was the only statistically significant predictor of age at ambulation (p < 0.0001), with black children walking at a younger age (10.9 +/- 2.1 months) than white children (11.6 +/- 2.3 months). Overall, the independent variables included in the model were only able to explain 2.5% of the variance of age at ambulation.

Black or African American↗