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Biomedical subjects

G Bentley

Publications and source records attributed to G Bentley.

At least 109 records · Page 6Linked to original sources
PubMed1983

The effect of age and sex of normal volunteers upon the transcutaneous oxygen tension in the lower limb.

The transcutaneous oxygen monitor, developed as a non-invasive method of measuring arterial oxygen tension in neonates, has recently been applied to measurement of skin ischaemia in peripheral vascular disease. Since peripheral vascular disease occurs in older age groups and more commonly in men than women, the effects of age and sex on the transcutaneous oxygen tension in the lower limb have been investigated. Two hundred and five normal volunteers of both sexes with a wide age range had measurements taken at a fixed point in the lower limb under similar conditions. The results showed no significant correlation between either the age or sex of the individual when compared to the transcutaneous oxygen tension.

Adolescent↗
PubMed1983

Measurement of transcutaneous oxygen pressure in normal and ischaemic skin.

The transcutaneous oxygen pressure (tcPO2) was measured by a polarographic technique in the legs of 161 volunteers and compared with the levels found in 62 patients with ischaemic skin due to peripheral vascular disease. The results show that the tcPO2 was related to the degree of ischaemia and, in many cases, was a more accurate guide to the viability of the skin than clinical assessment. Measurement of the transcutaneous oxygen pressure in the leg at the site of amputation in 24 patients with peripheral vascular disease showed that a preoperative level greater than 40 millimetres of mercury at an electrode temperature of 44 degrees Celsius was necessary for the skin of the stump to heal. The technique is simple, non-invasive and reliable. The tcPO2 accurately reflects the physiological and pathological changes in the circulation of the skin. It has potential in many fields of surgery where careful assessment of the viability of the skin is necessary.

Adolescent↗
PubMed1983

Costodesis and contralateral rib release in the management of progressive scoliosis.

This paper reports on 41 immature patients whose scoliosis was treated by fixation of ribs on the convexity. All had progressive scoliosis, the curve deteriorating at more than 10 degrees p.a., or the rib-vertebra angle difference being greater than 20 degrees. Of the 24 with infantile idiopathic scoliosis examined 5 years after operation, 10 maintained the improvement obtained at operation and in a further 19 the rate of deterioration had been slowed. Factors leading to a favourable outcome included: 1) An initial rib-vertebra angle difference of less than 30 degrees. 2) Success in achieving convex rib fusion. 3) The use of the operation in patients with infantile idiopathic scoliosis. There was a less favourable outcome in congenital and adolescent scoliosis. Spirometric volumes were diminished immediately after operation. Costodesis is therefore contraindicated in patients with precarious respiratory function.

Child↗
PubMed1981

Effect of aspirin treatment on chondromalacia patellae.

Twenty-nine patients (21 females and 8 males) with chondromalacia patellae diagnosed by arthroscopy were randomly allocated to receive aspirin or placebo for 3 months. Clinical and arthroscopic examination after 3 months showed no significant change in symptoms, signs, or macroscopic appearances in either group. Surgical treatment was performed in 14 patients for deteriorating symptoms.

Adolescent↗
PubMed1981

A prospective study of deep vein thrombosis of the leg in children on halo-femoral traction.

This prospective study was performed to determine the true incidence of deep vein thrombosis of the lower limb in children who had undergone halo-femoral traction to correct scoliosis before operation. Bilateral ascending phlebography of the lower limbs was performed on 54 children two days before spinal fusion and Harrington rod instrumentation. Two patients developed clinical evidence of thrombosis whilst on traction. This diagnosis was confirmed by phlebography. The other 52 children had no clinical evidence of thrombosis and their venograms were normal. The incidence of thrombosis was 3.7 per cent and clinically silent thrombosis did not occur.

Adolescent↗
PubMed1981

Radionuclide scanning in the early diagnosis of Perthes' disease.

A prospective survey was carried out on all cases of irritable hip presenting at the Royal Liverpool Children's Hospital over a period of one year. All children had a radioisotope scan of the hips and were then followed for one year by serial radiography. Five of the 50 children seen during the one year had areas of ischaemia in the capital femoral epiphysis demonstrated on the scan. all five developed radiological signs of Perthes' disease within sic months. The remaining 45 had radiographically normal hips at one year.

Child↗
PubMed1980

Intra-operative awakening during scoliosis surgery.

A method of intra-operative awakening which allows assessment of spinal cord function during Harrington rod spinal fusion for scoliosis is described. The anaesthetic technique is based on a standard muscle relaxant, N2O anaesthetic sequence supplemented with intravenous morphine 0.1 mg/kg at the commencement of surgery and 0.2 mg/kg intramuscular premedication. This relatively large total dose of morphine may reduce intra-operative awareness, and may also provide substantial pain relief during the initial 24 h postoperative period. It has been used successfully in 20 patients aged between 6 and 16 yr. Five patients remembered being woken, but did not regard it as unpleasant. In one patient, this technique allowed intra-operative detection and correction of impaired motor function of the legs.

Adolescent↗
PubMed1980

Prognosis in infantile idiopathic scoliosis.

A review was performed of 86 cases of infantile idiopathic scoliosis treated between 1962 and 1979. The single primary curves were classified as resolving, stable, progressive with a low rib--vertebra angle difference (RVAD) and progressive with a high RVAD. Two single primary curves subsequently developed a second curve and 17 were double when first diagnosed. Prognosis was difficult to establish before the age of five years. Only 18 per cent of curves showing progression beyond 50 degrees reached that point before the age of four. Conversely, if a scoliosis of 50 degrees or more was present before the age of four it always progressed. A more favourable outcome was indicated by male sex, a left-sided curve, a low initial curve measurement, an RVAD of less than 20 degrees in the initial radiograph, and the onset of scoliosis in the first year of life.

Adolescent↗
PubMed1980

Treatment of nondisplaced fractures of the femoral neck.

In all the reported series of impacted femoral neck fractures treated conservatively the incidence of disimpaction is between 8% and 15%. It is impossible at the time the patient presents to predict which fractures will undergo disimpaction. Disimpaction requires a secondary operation to prevent nonunion and subsequent disability. Internal fixation is, therefore, considered the most satisfactory treatment of an impacted fracture in every case. This will add certainty to an already stable situation and allow immediate weight-bearing without concern for stability of the fracture. If elementary precautions are taken during operation, disimpaction will not occur. No attempt should be made to improve the position of a markedly valgus fracture in an attempt to prevent subsequent avascular necrosis since this can result in conversion of the fracture to an unstable one. The internal fixation of impacted fractures may be by use of a Smith-Petersen nail, by Moore pins or preferably by a screw of the Garden type. This has the advantage of not separating the fracture during insertion and secures firm fixation of the fragments. The operation is short and simple, particularly when an image intensifier is employed, and the patient may begin weight-bearing on the day following operation and return home after a few days. There is no higher risk of avascular necrosis after internal fixation than after conservative treatment, provided the nail or screw is placed in the center of the femoral head. Conservative treatment is indicated only for those patients who present with an impacted femoral neck fracture several weeks after their injury and are walking without pain.

Age Factors↗
PubMed1978

Isolated epiphyseal chondrocyte allografts into joint surfaces. An experimental study in rabbits.

Isolated epiphyseal chondrocytes from 5 week old female New Zealand white rabbits were transplanted as allografts into drill holes in the tibial articular surface of adult male New Zealand white rabbits. The grafts were examined after 8 weeks. Fresh chondrocytes which were partially separated from their matrix were more successful (47%) than completely separated cells (20%) and were significantly more successful (P greater than 0.05) in skeletally mature (58%) as opposed to immature recipients (20%). Storage of the cells at -79 degrees C for 2 to 9 days or at -196 degrees C for 36 to 58 weeks gave successful results of 23% and 33%, respectively. Control defects showed fibrocartilage filling the defect in 25%. The factors affecting survival of chondrocyte allografts require further study before clinical application of the method.

Animals↗
PubMed1978

Arthroscopy in the diagnosis of chondromalacia patellae.

Chondromalacia patellae is difficult to diagnosis clinically with accuracy. In order to clarify the relevant symptoms and signs, 78 patients presenting with a clinical diagnosis of chondromalacia were examined by arthroscopy. In 49% of the knees no abnormalities were found. Presenting symptoms were similar in the normal and abnormal groups. Physical signs were more helpful in diagnosis and it is considered that the presence of an effusion, quadriceps wasting, and patello-femoral crepitus are the most important clinical findings in the diagnosis of chondromalacia patellae. The arthroscope is valuable instrument in establishing the diagnosis of chondromalacia patellae especially in the teenage female.

Adolescent↗
PubMed1978

Patella alta and chondromalacia.

The Insall-Salvati method of determining the position of the patella by radiography was employed in fifty-one patients with chondromalacia patellae that had been proved at arthrotomy. There was no definite relationship between chondromalacia patellae and patella alta. There was, however, a highly significant statistical difference between the ratio of the length of the patella to that of the patellar tendon in normal men and women.

Adolescent↗
PubMed1978

The surgical treatment of chondromalacia patellae.

Four methods of surgical treatment of chondromalacia patellae have been evaluated after periods ranging from two to thirty years (average seven years), to discover the success rate, complications and indications for each. A total of 140 operations had been performed in 98 patients. Overall, satisfactory results were achieved in 25 per cent after forty shavings of the patellar cartilage, 35 per cent after twenty cartilage excisions and drilling of the subchondral bone, 60 per cent after twenty medial transfers of the patellar tendon and 77 per cent after sixty patellectomies. Thirty-four primary patellectomies gave 82 per cent satisfactory results compared with 62 per cent after twenty-six patellectomies performed after a previously unsuccessful operation. The results were worst in patients below twenty years of age especially women and in those with Grade IV changes in the patellar cartilage. Weakness of the quadriceps after any procedure predisposed to an unsatisfactory result. Extensive late radiological degenerative changes in the knee were not seen. On the basis of the results in this report, patellar tendon transfer is recommended in adolescents and athletes with Grade I, II or III changes in the patellar cartilage. In adults over twenty years of age with Grade I and II changes cartilage excision and drilling is satisfactory. In adults with Grade III and adults or adolescents with Grade IV changes patellectomy is the treatment of choice.

Adolescent↗