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Biomedical subjects

D C Paterson

Publications and source records attributed to D C Paterson.

At least 37 records · Page 2Linked to original sources
PubMed1985

Electrical stimulation in the treatment of congenital pseudarthrosis of the tibia.

A treatment regime using electrical stimulation in association with a variety of surgical procedures has improved the prognosis in congenital pseudarthrosis of the tibia--one of the most challenging of all orthopaedic disorders. The technique consists of correction of the tibial deformity, intramedullary fixation and cancellous bone grafting, augmented by electrical stimulation using an implanted bone-growth stimulator. Experience with 27 pseudarthroses in 25 patients is presented; of those, 20 have joined. The cases have been reviewed and the causes of failure analysed. These results offer encouragement to the orthopaedic surgeon treating this difficult condition.

Child↗
PubMed1985

Long-term results of early surgical release in club feet.

One-hundred and seventy patients with 252 club feet treated by early posterior release were reviewed after a follow-up averaging 15 years 10 months. The feet were assessed both functionally and clinically and the results related to any bony deformity found radiographically; a satisfactory result was obtained in 81%. Lateral tibial torsion was examined and found to be less than in a normal population. The relationship between primary bone deformity and eventual functional result was examined, and a classification of talar dome deformity introduced. The range of ankle movement was a major factor in determining the functional result, and this in turn was influenced by the degree of talar dome flattening. It is suggested that the primary bone deformity present at birth dictates the eventual result of treatment.

Clubfoot↗
PubMed1982

The effects of varying current levels of electrical stimulation.

An effort has been made to find an experimental delayed union of a long bone that could be used to evaluate the osteogenic effect of different current strengths. It is important that the optimum current strength be determined. Any such model should be able to produce a difference in new bone formation with an active and an inactive stimulator, particularly one using a 20 microA direct current. Attempts to produce a nonunion model in dogs were unsatisfactory, possibly because the defect was too small and surrounded by normal bone, and excessive movement occurred at the cathode plate. The optimum range of electrical stimulation using a titanium cathode has not been established by this work. The changes in serum alkaline phosphatase, serum calcium and serum phosphorus concentrations in response to trauma have been shown to be the same in the bone formation induced by electrical current.

Animals↗
PubMed1982

A comparison between innominate osteotomy and hip spica in the treatment of Legg-Perthes' disease.

Thirty-eight cases of Legg-Perthes' disease treated by innominate osteotomy have been reviewed and compared with 33 cases, matched for age and severity, treated in recumbency in plaster hip spicas. The results were similar in the two groups, the radiologic results in the innominate osteotomy group being marginally worse. There was a high incidence of poor results in both groups in those over the age of eight years at the onset of symptoms, especially if femoral "head at risk" signs were present. Other methods of treatment need to be provided for these older children.

Adolescent↗
PubMed1981

Can serial scintigraphic studies detect delayed fracture union in man?

The uptake of the bone-seeking tracer technetium-99m-methylenediphosphonate increases following bone fracture as bone healing occurs. To investigate the pattern of change in normal healing and compare it with delayed union and nonunion, an analysis of automated computer profiles was carried out on serial scan data for 22 patients. The type of fracture (simple, comminuted, etc.) influenced the appearance of the activity profile; however, no significant differences in the patterns of change were noted between normal healing and delayed or non-union.

Adolescent↗
PubMed1980

Tendon injuries about the foot and ankle in children.

Sixty-four children with tendon injuries about the foot and ankle have been reviewed in order to present a plan of management when such injuries occur. One-third involved the tendo Achillis; the others were equally distributed between the dorsum and sole of the foot, and in only 12% was more than one tendon involved. Sensory nerves were frequently severed, but nearly all recovered completely after early repair. The results of immediate repair of tendons were good. When repair was delayed the results were less satisfactory, as severe deformities developed in the growing feet. Early exploration and surgical repair of selected tendons are recommended to avoid future disability.

Achilles Tendon↗
PubMed1980

The nuclide bone-scan in the diagnosis and management of Perthes' disease.

The nuclide bone-scan will reliably diagnose Perthes' disease with a sensitivity of 0.98 and a specificity of 0.95. The comparable figures for radiographic sensitivity and specificity are respectively 0.92 and 0.78. In addition, it is possible on the scan to recognise the onset of revascularisation of the femoral capital epiphysis some months before there are radiographic signs of new bone formation. Scintigraphy also suggests that in some cases of transient synovitis there may bae a period of reversible ischaemia of the capital epiphysis, which may have relevance to the pathogenesis of Perthes' disease.

Adolescent↗
PubMed1980

Treatment of congenital pseudarthrosis of the tibia with direct current stimulation.

Congenital pseudarthrosis of the tibia presents surgeons with one of the most challenging of all orthopedic problems. The results of various forms of surgical treatment are rarely successful. This is a preliminary report on an implanted direct current bone growth stimulator (DCBGS) for treatment of congential pseudarthrosis of the tibia. The implanted stimulator achieved encouraging results in 6 patients when it was used in conjunction with cancellous bone grafting and efficient immobilization of the tibia. The leg requires long-term protection of the fracture site until skeletal maturity is complete.

Child↗
PubMed1980

Treatment of delayed union and nonunion with an implanted direct current stimulator.

A multicentered research program on direct electrical current for stimulation of bone healing was performed by 30 Australian orthopedic surgeons. The program was designed to test an implanted device named direct current bone growth stimulation (DCBGS). The DCBGS achieved union in 72 of 84 (86%) cases of ununited fractures of long bones. These results are comparable to those obtained with other devices. The time to achieve sound union however, appears to be significantly less than by conventional bone grafting techniques. The procedure is safe and simple, with a short hospital stay and low rate of complications. Certain technical details have been stressed. The presence of previous infection is not a contraindication to this procedure. The procedure has advantages over Phemister or Charnley bone graft operations in that it produces less pain, generally avoids the need for a cancellous bone graft and allows an anterior approach to the shaft of the tibia when this might otherwise not be possible. The results for the various techniques of applying electric stimulation to bone are generally comparable although the clinical indications favoring one technique over another have yet to be determined. Electric stimulation used as described is an effective method of treatment for ununited fractures of long bones.

Adult↗
PubMed1978

Bone scintigraphy in discitis and related disorders in children.

Thirty-nine children with suspected pathology involving the vertebral column were investigated haematologically, radiographically, and by bone scintigraphy using technetium 99M pyrophosphate. Fifteen children were shown to have inflammatory disease of the vertebrae. A further six suffered from Scheuermann's disease, two from benign tumours, and the remainder from miscellaneous diseases not specifically involving bony pathology. The nuclide scan was abnormal in all cases of discitis and osteomyelitis, and in the two tumours. All of the other conditions were associated with a normal bone scan. This finding is of considerable diagnostic importance, and leads support to the theory that discitis is due to bacterial infection.

Adolescent↗
PubMed1977

Electrical bone-growth stimulation in an experimental model of delayed union.

An experimental model has been devised for the consistent production of delayed bone healing of the tibia in adult dogs. A double-blind trial, with bias eliminated, was used to evaluate the use of a commercially available direct-current bone-growth stimulator with this model. The stimulator produced a statistically significant acceleration of bone healing at four weeks in the experimental model. Osteogenesis was normal, and no dysplastic, inflammatory, or neoplastic changes were found. This research has shown that electrical stimulation of bone is safe and augments bone formation. The bone-growth stimulator unit remains on trial, but in future it may alter the management of many difficult orthopaedic problems.

Animals↗
PubMed1977

Orthopaedic aspects of spinal tumors in children.

A retrospective survey has been made of forty children with spinal tumours. Difficulties in establishing the correct diagnosis are mentioned and the value of radiological and cerebrospinal fluid investigations discussed. The major orthopaedic disabilities are spinal deformity or instability, and paraplegia. The main factor in the development of the former is the site of laminectomy: the higher the level the greater is the likelihood of deformity or instability developing. Measures to prevent this distressing complication are discussed. The role of the orthopaedic surgeon in the management of these children is emphasised.

Adolescent↗
PubMed1977

Experimental delayed union of the dog tibia and its use in assessing the effect of an electrical bone growth stimulator.

A technique has been described for the consistent production of delayed bone healing of the tibia in an animal model. A controlled double blind trial, where independent observors did not know the coding of the stimulators and did not collaborate with each other, has evaluated the use of a direct current bone growth stimulator in such an animal model. The conclusion of the experiment is that this commercially available direct current stimulator does produce a significant acceleration of bone healing at 4 weeks in the experimental model used. There is no evidence of inflammatory or neoplastic changes. The eventual clinical role of electrical bone stimulation remains uncertain and many questions remain unanswered, but are promising enough to encourage a controlled clinical trial in situations of disturbed bone healing. Electrical stimulation is apparently safe and appears to significantly augment bone formation. A controlled clinical trial is now being carried out in major medical centers in Australia.

Animals↗
PubMed1973

Creatine phosphokinase elevation in a case of tick paralysis.

The results of studies on a case of tick paralysis in a female child are described. The patient was paralysed by a single female specimen of Dermacentor andersoni Stiles attached to the left temporal area of the scalp. Paralysis of the lower limbs, incoordinate respiration and weakness of the arms were evident.The findings on physical examination and the results of diagnostic laboratory procedures are reported and the possible significance of the results is discussed. The only abnormal laboratory finding was an elevated level of plasma creatine phosphokinase (CPK) activity occurring during the paralytic phase and persisting for 10 days.

Action Potentials↗