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Biomedical subjects

H H Steel

Publications and source records attributed to H H Steel.

At least 37 records · Page 2Linked to original sources
PubMed1980

Gluteus medius and minimus insertion advancement for correction of internal rotation gait in spastic cerebral palsy.

The gluteus medius and minimus muscles were transferred in twenty-six patients (forty-two hips) with spastic cerebral palsy. The transfer of the insertion of these muscles from the greater trochanter to the anterior part of the femur was done to change their function from that of inward rotators to that of outward rotators of the hip. In the follow-up period, ranging from three to eleven years, the transferred muscles functioned as outward rotators without sacrificing their abduction strength in 90 per cent of the patients. The failures were due primarily to lack of integrity of the transferred muscle insertion. No increase in valgus angulation of the femoral neck was recorded except when the integrity of the trochanteric apophysis had ben compromised. Additionally, in ten patients (thirteen hips) who were operated on when they were from five to eight years old and were followed to skeletal maturity, the angle of anteversion was reduced to at least 25 degrees (range, 18 to 36 degrees). This procedure is indicated in the patient with spastic cerebral palsy to correct an inward-rotation gait caused by hyperexcitable gluteus medius and minimus muscles. It has been useful in eliminating the problems of clumsiness on running and walking associated with tripping, falling, fatigability, and excessive shoe-wear without compromising the abduction power of the gluteus medius and minimus.

Adolescent↗
PubMed1978

Partial or complete resection of the hemipelvis. An alternative to hindquarter amputation for periacetabular chondrosarcoma of the pelvis.

After excision of the hemipelvis through a combined subnatal and anterior incision preserving the lower extremity, five patients with periacetabular chondrosarcoma, after a follow-up of three to six years, were able to walk with no support or with minimum lateral support and had resumed their preoperative occupations. None had either the instability that might have been anticipated or incapacitating discomfort from the neoarthrosis, and there was no evidence of spread or recurrence of tumor in any of the five patients. The procedure, which has the same basic indications as a hindquarter amputation, is a rewarding substitute for that mutilating operation, although the follow-up is too short and the series is too small to warrant conclusions as to the cure rate.

Acetabulum↗
PubMedDate not supplied

Protrusio acetabuli: its occurrence in the completely expressed Marfan syndrome and its musculoskeletal component and a procedure to arrest the course of protrusion in the growing pelvis.

Protrusio acetabuli [center-edge (C/E) angle > 60 degrees, teardrop collapsed, and pelvis invaded by acetabulum beyond ilioischial line (Köhler's)] was identified in 22 patients with classic Marfan syndrome. All had a preponderance of the syndrome's cardinal features (positive pedigree and musculoskeletal, ocular, and cardiovascular manifestations). Fifty-two immature patients with the syndrome's skeletal expressions predominating were studied for deep acetabuli. Half of these individuals (26 patients) had true protrusio acetabuli. Thirty-one percent (16 patients) had abnormal acetabular deepening (C/E angle > 50 degrees; teardrop partially collapsed without acetabular protrusion); 19% (10 patients) had normal pelves with C/E angle < 40 degrees and normal teardrop. To arrest the protrusio, the triradiate physis was closed surgically in 11 patients (21 hips), one unilaterally. In 19 operated-on hips followed-up to maturity by using teardrop, C/E angle, and acetabular relation to the ilioischial line as criteria, architecture was restored to normal in 12 hips and reduced from true protrusio to simply acetabular deepening in four. Three were unchanged. The youngest child operated on was 8; the oldest was 12 years. Laboratory examination of the physes was unrewarding.

Acetabulum↗
PubMedDate not supplied

Bifurcated femur with a normal tibia and fibula.

Bifurcation of the distal femur is not a common anomaly; there have been only 27 cases of bifurcated femur with tibial hemimelia reported in the literature. This is the first report of a bifurcated femur associated with a normal tibia, fibula, ankle, and foot.

Adolescent↗
PubMedDate not supplied

Relationship between acquired spastic talipes equinovarus and dystonia musculorum deformans.

Acquired spastic talipes equinovarus associated with dystonia musculorum deformans (DMD) presents orthopaedic surgeons with a difficult treatment problem. We reviewed the natural history, diagnostic evaluation, and treatment of this deformity in 12 patients. Two patients initially had the generalized form of dystonia, and 10 patients had the focal form (in which acquired spastic talipes equinovarus was the only manifestation). With time, five of these 10 developed the generalized form. A positive family history and age < 14 years at onset were prognostic of this progression.

Adolescent↗
PubMedDate not supplied

Scoliosis in pediatric spinal cord-injured patients.

One hundred thirty children who sustained spinal cord injuries between birth and age 21 years were reviewed to determine the progression rate of paralytic scoliosis and the effects of bracing and surgery. Patients were divided into two groups: those injured before and those injured after the adolescent growth spurt. Scoliosis developed in 97 and 52%, respectively. Bracing was effective in delaying progression in the preadolescent group. The progressive paralytic spinal deformity did not appear to be related to the level of injury. The older patient is at much less risk for paralytic scoliosis, but still requires routine examination.

Adolescent↗
PubMedDate not supplied

Congenital diastasis of the inferior tibiofibular joint: a review of the literature and report of two cases.

Congenital inferior tibiofibular diastasis is a rare condition of unknown etiology, possibly a form of tibial hypoplasia, marked by a clinical triad of talipes equinovarus, ankle diastasis, and limb length inequality. An analysis of 10 cases reported previously is given with two additional examples. Ankle mortise reconstitution and clubfoot correction by surgery have been the basis of treatment. We present two cases in which no ankle reconstruction was done with good results. Syme amputation is considered for cases with severe tibial shortening. Prognosis for a plantigrade foot is encouraging if limb length inequality is corrected operatively or non-operatively as indicated.

Ankle Joint↗