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Biomedical subjects

E S Stauffer

Publications and source records attributed to E S Stauffer.

At least 37 records · Page 2Linked to original sources
PubMed1988

Wiring techniques of the posterior cervical spine for the treatment of trauma.

Surgical stabilization of the cervical spine for maintaining reduction and facilitating fusion following trauma may be accomplished by wiring the dorsal elements together. Twenty gauge (0.8 mm) 316L stainless steel surgical wire is the most convenient size to use. Meticulous atraumatic technique is necessary to reduce and fix the unstable spine in order to prevent damage to the spinal cord. Multiple wiring techniques of the upper and lower cervical spine are described and demonstrated, noting the advantages and disadvantages of each.

Bone Wires↗
PubMed1988

Intramedullary stabilization of neoplastic destructive disease involving the subtrochanteric region of the femur.

Neoplastic destructive disease involving the subtrochanteric region of the femur is a difficult condition to treat. This is a retrospective study of 11 femurs in 10 patients with subtrochanteric destructive lesions or pathologic fractures that were stabilized with the Zickel intramedullary device. The study investigated underlying disease process, ambulatory status, operative parameters, time to death, and associated metastasis. The average survival time of the patients who died was 4.7 months. All of the patients involved in this study could be mobilized, but only 3 out of 10 were ambulatory. This study concludes that the intramedullary fixation of pathologic fractures or lesions of the subtrochanteric region does not necessarily allow ambulation, but does allow mobilization of debilitated patients.

Aged↗
PubMed1988

Traumatic division of the spinal cord demonstrated by magnetic resonance imaging. Report of two cases.

Magnetic resonance imaging (MRI) of the spine is a new imaging technique that allows greater visualization of the spinal cord than other imaging modalities. This article reports on two cases of traumatic division of the spinal cord demonstrated by MRI. Both patients had complete transection of the spinal cord and did not have neurologic functional recovery distal to the spinal cord transection. MRI is applicable to diagnosis in acute conditions and to reveal division of the spinal cord, allowing prediction of an unlikely chance of neurologic recovery.

Adult↗
PubMed1988

Neurologic injury and recovery patterns in burst fractures at the T12 or L1 motion segment.

Fourteen consecutive patients with burst fractures at T12 or L1, partial paralysis, and more than 30% canal compromise were prospectively evaluated pretreatment and posttreatment with roentgenograms to determine the initial fracture pattern, CT scans to determine the percent canal compromise and subsequent improvement, and a quantitative motor trauma index scale and bladder sphincter evaluation to determine neurologic recovery. The follow-up period averaged 32 months (range, 12-50 months). Treatment was as follows: nonoperative (three patients), Harrington rods and fusion (seven patients), and Harrington rods and fusion followed by anterior decompression and fusion (four patients). The initial severity of paralysis did not correlate with the initial fracture roentgenographic pattern or the amount of initial CT canal compromise. Neurologic recovery did not correlate with the treatment method or amount of canal decompression. Subsequent recovery did correlate with the initial fracture pattern. If the patient had a Type I or Type II fracture (both greater than 15 degrees kyphosis), greater than 90% neurologic recovery occurred, regardless of treatment. If the patient had a Type III fracture (less than 15 degrees kyphosis and the maximal canal compromise where bone encircles the canal) less than 50% neurologic recovery occurred. If the patient had a Type IV fracture (less than or equal to 15 degrees kyphosis and the maximal canal compromise at the level of the ligamentum flavum), the neurologic recovery was variable. Prognosis for neurologic recovery can be made based on initial roentgenograms. If greater than 15 degrees kyphosis is present, there is a good prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Non-union of fractures of the atlas.

Eighteen patients who had a fracture of the atlas were evaluated clinically and by computed axial tomography an average of forty-six months (range, two to 164 months) after injury. The purpose of the evaluation was to determine the effect of the pattern of the fracture, the quality of osseous healing, and the method of primary immobilization on the long-term outcome. Three (17 per cent) of the patients had a non-union, and two of them had a poor clinical result. These two patients had had a unilateral comminuted fracture--that is, one fracture that was anterior and one that was posterior to the lateral mass, with an associated osteoperiosteal avulsion of the transverse ligament on the same side of the ring of the atlas. Six (33 per cent) of the eighteen patients had an osteoperiosteal avulsion of the transverse ligament. The avulsions usually progressed to osseous union. Rupture of the mid-substance of the transverse ligament was uncommon. No patient had a neurological deficit or late neurological sequelae that were directly attributable to the fracture of the atlas.

Adolescent↗
PubMed1987

Orthopaedic teaching: the practicing family doctor's perspective.

Two hundred and two family doctors in practice responded to a survey that identified orthopaedics as a surgical specialty in which they would have benefited from more training. Forty percent felt unprepared to apply casts or manage fractures. Learning objectives were either not used or used ineffectively, according to the majority of respondents. Fifty percent reported that indicating a career interest in family medicine resulted in a negative bias toward them during surgery clerkship. The results indicate the need for an increased allocation of curricular time to orthopaedics and an augmented emphasis on outpatient experiences.

Attitude of Health Personnel↗
PubMed1986

Management of spine fractures C3 to C7.

The goals of management of spine fractures from C3 to C7 are to provide stability for maximum pain-free function and to prevent further or future injury to the spinal cord and nerve roots. Surgical fusion may be necessary to provide immediate and long-term stability. Posterior instability should be treated by posterior fusion, and anterior instability should be treated with anterior stabilization.

Braces↗
PubMed1983

Unrecognized spinal instability associated with seemingly "simple" cervical compression fractures.

This paper described 27 patients who had seemingly stable compression cervical vertebral fractures. All were treated in cervicothoracic orthoses. None was initially treated in a Halo device or with surgery. Twenty patients were stable and healed without progressive displacement, angulation, or pain. One patient demonstrated an angular deformity, which spontaneously stabilized within six months with anterior bony ankylosis in a kyphotic position. Six patients demonstrated persistent progressive post-injury instability related to posterior ligament rupture. As muscle spasm diminished, the patients could be given a more reliable flexion-extension radiographic examination, unmasking the hidden posterior instability. Five of the six who demonstrated this instability were disabled because of pain. Two of the six patients were treated with a two-segment fusion. The other four have had fusion recommended and are currently being followed clinically. This paper emphasizes the need for better initial criteria of potential instability and close follow-up of patients with simple compression fractures of the cervical spine.

Adolescent↗
PubMed1981

Evaluation and treatment of bone tumors.

The family physician will rarely see patients with bone tumors; however, when bone tumors do arise, they can be devastating as they unfortunately occur in young patients and are among the most malignant of lesions. The diagnosis of a bone tumor should be suspected if there is deep aching pain, a mass, or a pathological fracture. X-ray films usually lead to the diagnosis and help distinguish malignant from benign lesions. benign tumors are relatively small, do not break out of the bone, and leave the cortex intact and the soft tissue uninvolved. Malignant tumors are large, break out of the bone, and involve the soft tissues. In general, benign tumors are treated with biopsy, local excision, or curettage with bone grafting. Malignant tumors require much more extensive surgery including wide radical excision (probably amputation), chemotherapy, and/or radiation therapy as indicated.

Biopsy↗
PubMed1980

Surgical manpower and practice patterns in a nonmetropolitan area. Nonmetropolitan surgical manpower.

Surgical practice in a nonmetropolitan area was studied with a field survey of 33 general surgeons and family practitioners. Instruments included a physician interview and questionnaire, a nurse-receptionist questionnaire, a sample of 3,733 office patient records, and a sample of hospital operating room logbooks. The general surgeons reported spending an average of 22 hours a week seeing an average of 74 patients in their office practices. Twenty-six percent of the presenting problems and 32% of the principal diagnoses identified in the sample of general surgeons' office patient records were defined as primary care problems. Twenty-two percent of the problems and diagnoses were defined as specialty surgical problems, such as urological problems. An indication of patient referral was found in 2% of the records. In hospital practice the surgeons estimated spending an average of 14 hours a week in the operating room, and performed an average of seven to eight procedures a week. The mean California relative value (CRV) for each procedure was 10.0 CRV. The family physicians managed patients with a broad range of problems, including surgical, in their office practices, and performed an average of three operative procedures each week in the hospital.

Family Practice↗
PubMed1979

Gunshot wounds of the spine: the effects of laminectomy.

In a review of 185 patients with gunshot wounds of the spine from low-velocity missiles, 106 were found to have a complete lesion and seventy-nine, an incomplete lesion. Fifty-six patients with complete lesions underwent laminectomy and only one had a partial (sensory) return of function. The fifty patients with complete lesions who had no laminectomy also had no spontaneous improvement. There were forty-five patients with incomplete lesions who had laminectomy and thirty-two (71 per cent) of them showed measurable improvement. For comparison, thirty-four patients with incomplete lesions had no operative treatment and in twenty-six (76.5 per cent) there was some spontaneous return of neural function. Four wound infections and six spinal fistulae developed in the operative group (a complication rate of 10 per cent). Spinal instability developed in six patients because of the laminectomies.

Adolescent↗
PubMed1977

Fracture-dislocations of the cervical spine. Instability and recurrent deformity following treatment by anterior interbody fusion.

Anterior intervertebral-body fusion has been advocated by various authors for management of several varieties of fracture and fracture-dislocation of the cervical spine. This report is a retrospective study of sixteen patients, all of whom had a fracture-dislocation of the cervical spine, who were treated with an anterior dowel interbody fusion. All had postoperative instability with recurrence of angular deformity, and all sixteen were shown to have disruption of the posterior ligaments. Three patients had a progressive neurological deficit postoperatively. Thirteen patients required two or more operative attempts at stabilization. Anterior fusion should not be performed as primary surgical treatment for fractures of the cervical spine when there is either evidence of disruption of the posterior ligaments or a strong presumption that such disruption exists.

Adolescent↗