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Biomedical subjects

D F Bell

Publications and source records attributed to D F Bell.

9 recordsLinked to original sources
PubMed1992

Pediatric applications of the Ilizarov method.

Since mid-1987, more than 250 applications of the Ilizarov technique have been successful in treating a variety of pediatric orthopedic problems. The principles of the method are the same in adults and children. Careful preoperative planning and close follow-up evaluation during distraction are important to success. Complication rates are high but improving as experience is gained with the technique. Most complications can be managed such that the ultimate success is not jeopardized. The Ilizarov technique has wide application in the treatment of difficult deformities. The method is useful for treatment of limb-length discrepancy projected to be greater than 5 cm and in limb-length discrepancy combined with angular deformity. The method is applicable to angular deformities such as in adolescent Blount's disease and congenital tibial pseudarthrosis, especially conditions where bone transport may be needed to gain length. In resistant or recurrent clubfeet, the Ilizarov technique is useful as an alternative to osteotomy of the mid- and hindfoot or both. The method may even be indicated for lengthening limbs in selected patients with short stature.

Adolescent↗
PubMed1991

Problems with substantial limb lengthening.

Limb lengthening takes careful planning and meticulous outpatient care and still is burdened by minor complications. Experience may lessen major complications, but pin tract problems, swelling, and pain will plague these patients. A large group of patients can benefit from lengthening procedures, and new techniques are improving the risk-benefit balance. A thoughtful approach is needed by the surgeon, especially taking time to fully inform the patient about the time, effort, and problems involved in substantial limb lengthening.

Bone Lengthening↗
PubMed1991

Posterolateral rotatory instability of the elbow.

Recurrent posterolateral rotatory instability of the elbow is an apparently undescribed clinical condition that is difficult to diagnose. We treated five patients, ranging in age from five to forty years, who had such a lesion and in whom the instability could be demonstrated only by what we call the posterolateral rotatory-instability test. This test involves supination of the forearm and application of a valgus moment and an axial compression force to the elbow while it is flexed from full extension. The elbow is reduced in full extension and must be subluxated as it is flexed in order to obtain a positive test result (a sudden reduction of the subluxation). Flexion of more than about 40 degrees produces a sudden palpable and visible reduction of the radiohumeral joint. The elbow does not subluxate without provocation. The cause for this condition, we think, is laxity of the ulnar part of the lateral collateral ligament, which allows a transient rotatory subluxation of the ulnohumeral joint and a secondary dislocation of the radiohumeral joint. The annular ligament remains intact, so the radio-ulnar joint does not dislocate. Operative repair of the lax ulnar part of the lateral collateral ligament eliminated the posterolateral rotatory instability, as revealed intraoperatively in our five patients.

Adult↗
PubMed1979

Effective evaluations.

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Education, Nursing, Continuing↗
PubMedDate not supplied

The use of the Ilizarov technique in the correction of limb deformities associated with skeletal dysplasia.

The skeletal dysplasias are a unique and heterogeneous group of disorders with skeletal manifestations including deformity, disproportion, and short stature. The purpose of this article is to describe the use of the Ilizarov technique in the management of these orthopedic problems in 15 patients with skeletal dysplasias. The technique is particularly appropriate in those patients requiring correction of angular deformity and limb lengthening. The greatest number of complications were encountered in those patients undergoing extended limb lengthening. Nevertheless, all patients achieved their preoperative goals.

Adolescent↗
PubMedDate not supplied

Management of congenital fibular deficiency by Ilizarov technique.

Between April 1987 and January 1990, 11 patients with congenital fibular deficiency underwent tibial lengthening of 12 involved limbs by the Ilizarov technique. The average follow-up was 23.2 months. The mean lengthening was 8.3 cm, representing an average lengthening of 31%. No knee or ankle subluxation occurred despite preoperative cruciate ligament laxity and ankle abnormalities in all patients. The most significant complications included regenerate bone deformation and delayed consolidation. With the Ilizarov technique, the limb length discrepancy, angular and rotational deformities, and foot and ankle deformities frequently associated with congenital fibular deficiency can be addressed simultaneously.

Adolescent↗
PubMedDate not supplied

Measuring CE outcomes.

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Clinical Competence↗