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Biomedical subjects

G Njus

Publications and source records attributed to G Njus.

7 recordsLinked to original sources

Analysis of cryotherapy penetration: a comparison of the plaster cast, synthetic cast, Ace wrap dressing, and Robert-Jones dressing.

Four groups were studied to determine the cooling effect at skin level of ice application over common ankle bandages and casts. The plaster cast, synthetic cast, and Ace wrap dressing groups had 18 participants and the Robert-Jones dressing group had four participants. In a standardized fashion, ice bags were applied over each bandage or cast and skin temperatures were measured with a thermocouple over a 90-min period. The average final skin temperature was 16.5 degrees in the plaster cast, 18.8 degrees in the synthetic cast, 21.2 degrees in the Ace wrap dressing, and 28.7 degrees in the Robert-Jones dressing. The temperature curves showed that ice application effectively decreased skin temperatures through the plaster cast, synthetic cast, and Ace wrap dressing. The cooler temperature did not adequately penetrate the Robert-Jones dressing.

Adult

Alkyl cyanoacrylates as space filling bone adhesives.

Higher chained alkyl cyanoacrylates have potential to function efficiently as space filling, hydrophobic, viscoelastic, biocompatible, and rapidly polymerizing bone adhesives. Hence they may be useful in applications where a void has to be filled, such as replacement of the intervertebral disc. To assess their applicability as space filling material in such an application, three alkyl cyanoacrylates; methoxyethyl cyanoacrylate, isobutyl cyanoacrylate, and isoamyl cyanoacrylate have been evaluated in this study. The bonding strength of these cyanoacrylates to bone in a space filling situation have been measured. The results indicate the bond strength of isoamyl cyanoacrylate (0.13 MPa) to be significantly (p less than 0.05) lower compared with methoxyethyl cyanoacrylate (0.33 MPa) and isobutyl cyanoacrylate (0.37 MPa). There was no significant difference in the bond strengths of isobutyl cyanoacrylate and methoxyethyl cyanoacrylate.

Animals

Ligament strain and ankle joint opening during ankle distraction.

To determine the efficacy of ankle distraction and to investigate possible complications of the procedure, the strain on four ankle ligaments and the tibiotalar joint opening resulting from distraction force and various foot positions were studied. We mounted strain gauges on the deltoid, calcaneofibular, tibiofibular, and anterior talofibular ligaments of six fresh human cadaver ankles. An Acufex ankle distractor was used to apply forces of 45, 90, 135, and 180 N at 20 degrees dorsiflexion, neutral, and 10 degrees plantar flexion. The ankle distractor proved to be effective in opening the joint space for better visualization, but complications of pin bending, excessive ligament strain, and bony destruction did occur within the clinically recommended range. Based on the observed results, the safest method of distraction was to use forces < 135 N in the neutral position.

Ankle Joint

Basilar crescentic osteotomy. A three-dimensional computer simulation.

A three-dimensional computer simulation of the basilar crescentic osteotomy has been presented. The bunion deformity consists of hallux valgus, an increased first and second intermetatarsal angle, pronation of the great toe, and elevation of the first metatarsal head. Every foot is different and some may have more or less of each of the above noted components. Because the deformity is multiplanar, at least two roentgenograms are needed to evaluate the deformity. The weight-bearing, anterior-posterior roentgenogram is the principle radiograph used in preoperative planning. The use of a weight-bearing, sesamoid roentgenogram is recommended to quantify the anterior-posterior deflection and rotation of the first metatarsal head. A computer model (based on a cylinder) of the first metatarsal has been formulated. The osteotomy then was performed in a variety of scenarios in order to simulate the surgical correction. A great deal of flexibility is afforded by this osteotomy. The surgeon needs to be aware of the coupled motions that occur. That is, closure of the intermetatarsal angle may also cause head rotation, depression, or elevation. If the osteotomy is performed in an oblique multiplanar direction, then it is possible for the metatarsal head to elevate, pronate, and significantly shorten as the intermetatarsal angle is closed. If this scenario should occur, a poor surgical outcome will result. Excision of the medial eminence is recommended after the osteotomy has been completed and secured with stable fixation because of these rotational changes. The basilar crescentic osteotomy is an excellent method for correction of a marked metatarsus primus varus. It is important to pay close attention to a variety of anatomic considerations. The osteotomy must not be made in the diaphysis because of potential nonunion. There should be little dissection of the periosteum because of possible delayed union. As in any bunion surgery, it is essential to perform an adequate, distal, soft-tissue repair. Three dimensional preoperative planning is essential in obtaining correction of all components of a bunion. Specific guidelines, based on a three-dimensional computer model, are now available. An interactive computer program also is available to aid the surgeon in preoperative planning. We hope there will be better understanding of this technically difficult but highly versatile osteotomy.

Hallux Valgus

Tin ear syndrome: rotational acceleration in pediatric head injuries.

An array of signs pathognomonic of child abuse is described for three young children. The eponym "tin ear syndrome" describes distinct unilateral ear bruising, radiographic evidence of ipisilateral cerebral edema with obliteration of the basilar cisterns, and hemorrhagic retinopathy. Rotational acceleration produced by blunt trauma to the ear is shown to be a necessary and sufficient cause for the production of this syndrome. An approximate value of 4,670 radians/s2 produced by a force of 309 to 347 N (70 to 80 lb) results in shear stress and tearing of the subdural veins, loss of cortical vasomotor tone, cerebral hyperemia, herniation, and death. Past history and environmental circumstances implicated child abuse in every case.

Battered Child Syndrome

Torsional fatigue of the lumbar intervertebral joints.

The effect of cyclic torsional loads on the behavior of intact lumbar intervertebral joints was investigated. A total of 24 specimens, divided in two groups, were tested. In the first group, a specimen was subjected to a specified constant cyclic torque, and the resulting change in angular displacement with time was recorded. The specimens in the second group were subjected to a specified constant angular displacement and the resultant torque recorded. The results of the constant torque tests showed that fatigue failure was primarily a function of the averaged initial angular displacement and secondarily of the applied torque. The critical threshold values appear to be an initial angular displacement of +/- 1.5 degrees. All specimens, displaying an averaged initial angular displacement of less than +/- 1.5 degrees, did not fail in fatigue, while the others did. However, the specimens with angular displacements of less than +/- 1.5 degrees had lower applied torques (11.3 and 22.6 Nm), while specimens with higher applied torques (33.9 and 45.2 Nm) all exceeded the +/- 1.5 degrees threshold and failed in fatigue. Failure locations occurred in such diverse regions as end-plates, facets, laminae, capsular ligaments, etc. All specimens exhibited a synovial fluid discharge from the apophyseal joint capsule sometime during testing. Post-test examinations of all the cartilage surfaces showed fibrillation, whether or not the intervertebral joint failed.

Adult

Fatigue response of lumbar intervertebral joints under axial cyclic loading.

A low-cycle fatigue of 11 lumbar intervertebral joints under axial compression is reported. The magnitude of the maximum compressive load ranged from 37 to 80% of the failure load. The maximum deformation, as a function of the number of cycles, showed two distinct results: one group showed a gradual, stable increase, and the other an abrupt, unstable increase. The before- and after-test radiographs showed a one-to-one correspondence between unstable specimens and generalized bony failure. The radiographs of 5-mm thick transverse endplate slices show crack propagation from the periphery of the subchondral bone inward. Removal of the organic matrix from the cracked specimens produced its physical disintegration into small particles, while normal controls and stable specimens retained their size and shape.

Adolescent