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Biomedical subjects

I H Thomas

Publications and source records attributed to I H Thomas.

11 recordsLinked to original sources
PubMed1993

Audit of a bone bank.

The results are reported of an audit of allografts collected in the first 18 months of the Leicester Bone Bank. We retrieved 161 femoral heads at primary arthroplasty of which 103 were implanted into 59 patients. There were deep infections in two recipients and wound infections in five. In two of these cases, culture of the femoral head at implantation was positive but the organisms grown were not those which caused the clinical infection. We retrieved 22 large allografts from six cadavers. Four of these were contaminated at retrieval and required irradiation for sterilisation. There has been one clinical infection in the nine large allografts implanted so far. We recommend that all bone banks undertake prospective audit to ensure that high standards are maintained and wastage minimised.

Adolescent↗
PubMed1993

The reliability of ultrasonographic assessment of neonatal hips.

Ultrasound scans were made of the hips of 209 neonates born consecutively over a two-week period. Of the 418 scans, 62 images were selected at random and 25 of these were duplicated to give a total of 87 scans. These static images were then presented to five experienced observers who each made nine different assessments and measurements. Interobserver and intraboserver agreement was calculated and expressed as kappa values. Our results showed poor reliability on both counts.

Anthropometry↗
PubMed1991

PIS and DRGs: coding inaccuracies and their consequences for resource management.

Accurate information is important for the successful implementation of the Resource Management Initiative and the NHS White Paper. A review of 153 joint replacements performed in a three-month period in Leicester showed that 24 per cent of 139 procedures for which medical notes were available had been given incorrect Diagnosis-Related Groupings (DRGs). Of these, 64 per cent could be ascribed to errors in allocating OPCS-3 codes and 36 per cent to errors in converting OPCS-3 codes to DRGs by computer. It is of concern that inaccurate information may in future be used to allocate resources. The resource implications of assiduous quality control of recording, coding and computing is pointed out, and it is suggested that improved classification systems should be assessed for use in the NHS.

Diagnosis-Related Groups↗
PubMed1987

Function after partial pelvic resection for Ewing's sarcoma.

Seven patients with Ewing's sarcoma of the pelvis were treated by chemotherapy followed by wide resection of the primary tumour. Although good function after operation is possible, survival in this series reflects the poor prognosis associated with the disease; two patients died, two are alive with local recurrence and metastases and three patients are alive with no evidence of disease.

Adolescent↗
PubMed1987

The Gruca operation for congenital absence of the fibula.

An alternative to Syme's amputation for congenital absence of the fibula is described in this paper. Nine children have had the ankle reconstructed using the Gruca technique with a very satisfactory result in eight. This procedure is not suitable for every patient and in most unilateral cases the operation can only be regarded as an interim procedure because of progressive leg-length inequality. The decision to remove the foot may be delayed and it allows childhood to be spent without resort to prostheses. However, the procedure can be considered as the definitive operation in cases of bilateral deformity.

Amputation, Surgical↗
PubMed1985

A prospective trial of prophylactic povidone iodine in lacerations of the hand.

A series of 418 patients with lacerations of the hands were allocated randomly to a control group or to a group where the injury was treated with povidone iodine before suture. The incidence of infected and imperfectly healed wounds was determined seven days later. As well as the effect of povidone iodine on infection, thirteen other factors were also analysed. The overall infection rate of 5.0% and the 38.5% imperfect healing rate were not significantly affected by povidone iodine treatment, although both were reduced. The figures of four other trials were combined with this trial and this showed a significant effect of povidone iodine treatment. There were no adverse reactions to povidone iodine. It is therefore recommended that hand lacerations should be treated with povidone iodine prior to suture. Other factors found to be significantly important in wound infection or imperfect healing were the condition of the dressing, the part of the hand injured and pain. Patients should be strongly advised to keep their dressing clean and dry.

Adolescent↗
PubMed1982

Intra-osseous phlebography and intramedullary pressure in the rabbit femur.

Intra-osseous phlebography and the measurement of intramedullary pressure (IMP) have been used clinically and in experimental animals as qualitative methods of measuring blood flow in the bone. The normal phlebographic appearances in long bones are not clearly understood and the correlation between these appearances and the IMP is not known. The distal femora of 10 anaesthetised rabbits were cannulated percutaneously. The IMP was measured and phlebography performed by injecting a radio-opaque dye (Conray 280). The mean resting IMP was 33 millimetres of mercury with a range of 7 to 81 millimetres of mercury. The rate of elimination of dye from the marrow varied from less than 1 minute to 40 minutes. There was no correlation between the rate of elimination of dye and the IMP. Variation in the medullary phlebographic appearance and in the routes of drainage were noted. We concluded that the wide range of resting values for both techniques suggest that neither is a true measure of blood flow in the bone and that the results of research or clinical investigation using these techniques should be viewed with caution.

Animals↗
PubMedDate not supplied

Giant cell reparative granuloma of the humerus.

A 14-month-old girl presented with a fracture through a giant cell reparative granuloma of the distal humerus. This is the first report of such a lesion in a long bone in childhood. Following curettage, the lesion healed with full restoration of elbow function and normal growth.

Diagnosis, Differential↗
PubMedDate not supplied

Avascular necrosis after open reduction for congenital dislocation of the hip: analysis of causative factors and natural history.

We analysed the causative factors and natural history of avascular necrosis (AVN) after open reduction of 87 dislocated hips. AVN was observed in 37% of the hips, yet open reduction did not appear to contribute to the development of AVN and its prevalence was similar in hips treated by open or closed reduction in our institution. Only 45% of hips with AVN had a good late result. More containment procedures were required if AVN had occurred. Premature physeal closure was one late manifestation of this complication, which occurred following apparent partial AVN changes.

Acetabulum↗