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Biomedical subjects

F D Burke

Publications and source records attributed to F D Burke.

64 records · Page 4Linked to original sources
PubMed1985

The hand complications of Colles' fractures.

Two hundred and thirty-five patients with displaced Colles' fractures were followed to union, and 209 patients to six months, specifically searching for hand pathology. The incidence of carpal tunnel syndrome was seventeen per cent at three months and twelve per cent at six months. The patients with the syndrome were significantly older and their fractures showed significantly greater residual dorsal angulation. Sixteen patients developed Dupuytren's disease between three and six months, when the incidence was eleven per cent. These patients were significantly older and had average fractures and anatomical results. All cases were mild, with only two contractures. Twenty-one patients were reviewed at a mean of 20.7 months post-fracture, when no case had significantly progressed.

Adolescent↗
PubMed1985

The proximal interphalangeal joint in Dupuytren's disease.

In one hundred patients with Dupuytren's disease, one hundred and fifty-four operations were performed. The average pre-operative proximal interphalangeal joint contracture was 42 degrees and the average percentage improvement in proximal interphalangeal joint extension at post-operative review was 41%. Fourteen amputations were performed (9.1%). The primary deformity is caused by disease involvement of the palmar fascial structures. Secondary changes may prevent correction of the deformity despite excision of the contracted fascia. The anatomy of the joint is reviewed together with the primary and secondary mechanisms of joint contracture in Dupuytren's disease. Arthrodesis, osteotomy of the proximal phalanx and joint replacement are considered as alternatives to amputation when a systematic surgical approach fails to correct the flexion contracture.

Adult↗
PubMed1984

Functional cast-bracing for Colles' fractures. A comparison between cast-bracing and conventional plaster casts.

The use of Orthoplast cast-bracing to allow early hand function in the treatment of displaced Colles' fractures was investigated in 243 patients. They were randomly allocated into three groups: in the first a conventional Colles' type plaster was used; in the second an above-elbow cast-brace with the forearm in supination; and in the third a below-elbow cast-brace. Radiographic measurements were made at each stage of treatment, and the final anatomical result was scored using Sarmiento's (1975) criteria. Function was assessed at three months and at six months. The anatomical result was not influenced by the method of immobilisation but was related to the efficacy of reduction. Loss of position in the braces was no greater than in plaster. The functional result at three months also was uninfluenced by the method of immobilisation; it was, however, related to the severity of the initial displacement, and (to a lesser degree) to the anatomical result, an effect which was lost at six months. Early hand function and the supinated position advocated by Sarmiento were found to confer no anatomical or functional advantage; we could see no reason to change from the use of conventional plaster casts in the treatment of uncomplicated Colles' fractures.

Adolescent↗
PubMed1984

Dupuytren's contracture: a comparative study of fasciectomy and dermofasciectomy in one hundred patients.

This study reviews one hundred patients with Dupuytren's disease treated surgically by the Derby Hand Unit between January 1975 and September 1981. One hundred and twenty-eight operations were assessed with a follow-up period from nine months to ninety months, average thirty-eight months. In thirty-five patients the overlying skin was excised and replaced by a full-thickness skin graft (dermofasciectomy). The remaining patients were treated by fasciectomy without skin excision. The overall recurrence rate after surgery was found to be 46.5%. However skin excision and replacement following fasciectomy prevented any appreciable, if not all recurrence of Dupuytren's tissue. The function of the hand was assessed with regard to the improvement in flexion contracture; ability to flex the finger to the distal palmar crease; sensibility of the replaced skin; time to return to work and full activity. It was concluded that skin replacement did not jeopardize hand function.

Aged↗
PubMed1984

Vibration disease of the capitate.

There are four previous cases of isolated avascular necrosis of the capitate in the literature. This report describes a fifth, and the first to be associated with vibration. A paint sprayer presented with wrist pain, tenderness over the capitate and radiological changes of avascular necrosis of the capitate. Following mid-carpal arthrodesis, he returned to work. The role of trauma and a pre-existing ligamentous abnormality of the wrist in the aetiology of this condition is discussed.

Adult↗
PubMed1980

A prospective controlled trial of valgus osteotomy in the fixation of unstable pertrochanteric fractures of the femur.

A total of 62 patients with unstable pertrochanteric fractures of the neck of the femur was subjected to either nail plating with 130 degrees neck-shaft angle or valgus osteotomy using a neck-shaft angle of at least 140 degrees. The patients were assessed in terms of ability to walk and stability of fracture fixation. A clear superiority of valgus osteotomy over the controls was demonstrated in terms of fracture fixation, but the difference in terms of ability to walk was less remarkable.

Adult↗
PubMed1975

Emergency and elective surgical treatment of portal hypertension. A review of 23 years' experience.

A retrospective review of surgical treatment for portal hypertension during a 23-year period in a regional unit is reported and the immediate and subsequent management of patients with bleeding oesophageal varices is discussed. Fifty-four patients with recurrent varix haemorrhage uncontrolled by conservative methods have been treated by oesophageal transection with a mortality of 22.2% (26.6% for cirrhotic patients). Thirty-two per cent of the cirrhotics were alive after 2 years. Only a minority (12%) of the survivors were considered suitable for a subsequent shunt procedure. Therapeutic portacaval anastomosis has been performed on 65 patients with a 51.2% 5-year survival (43-5% for cirrhotic patients). Further haemorrhage due to shunt thrombosis occurred in 5-3% of cases. The frequent occurrence of portal-systemic encephalopathy, increasing with duration of time following a shunt, is emphasized. The high morbidity and mortality in the poor-risk cirrhotic indicated that this type of patient is unsuitable for a portal-systemic shunt and is better treated by medical means.

Adult↗