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Biomedical subjects

J D Heckman

Publications and source records attributed to J D Heckman.

At least 55 records · Page 3Linked to original sources
PubMed1986

Comparison of skeletal traction forces in patients treated in conventional and oscillating hospital beds.

This study compares the forces in two types of skeletal traction systems: a standard hospital bed with balanced suspension traction and an oscillating hospital bed using a flexion cable system. In line traction, forces were continuously measured, using a specially designed transducer. Changes in the magnitude of traction forces of up to two times the applied force were caused by patient movement, nursing procedures, and changes in bed configuration. The oscillating hospital bed was found additionally to impart a moderate (20-50%) rhythmic, sinusoidal variation in applied traction forces. The traction forces applied with the flexion cable system on the oscillating hospital bed were well tolerated and equivalent to those applied in conventional balanced suspension on a standard hospital bed. Although different in design, standard balanced suspension traction on a conventional hospital bed and traction using the flexion cable system on the oscillating hospital bed appear to be equally effective in stabilizing fracture sites.

Acetabulum↗
PubMed1986

Chronic non-hematogenous osteomyelitis treated with adjuvant hyperbaric oxygen.

Between 1979 and 1982, thirty-eight patients with chronic non-hematogenous osteomyelitis were treated by local débridements of the wound, prolonged parenteral administration of antibiotics, and an average of forty-eight once-a-day treatments with hyperbaric oxygen. Of these thirty-eight patients, thirty-four remained free of clinical signs of osteomyelitis for an average of thirty-four months (range, twenty-four to fifty-nine months) after this regimen of treatment. Only four of the thirty-eight patients had been free of clinical signs of osteomyelitis for as long as three months during the two years preceding this treatment. Three of the four failures of treatment were evident within one month after treatment. This method of treatment appears to prolong the infection-free interval of patients with chronic non-hematogenous osteomyelitis.

Adult↗
PubMed1985

Fractures of the lateral process of the talus.

A retrospective review of nine patients with fractures of the lateral process of the talus indicates that a substantial portion of patients will have persistent symptoms if the fracture is not diagnosed and appropriately treated soon after the injury. When a patient is evaluated for the symptoms of a "sprained ankle," these fractures are often overlooked on the initial roentgenograms. If untreated, these fractures often fail to heal, and persistent pain over the lateral aspect of the ankle following an inversion injury should be investigated for the possibility of this diagnosis. Prompt treatment of acute fractures appears to lead to the best result. Nondisplaced fractures heal well in a short-leg cast, with six weeks of immobilization. Large displaced fracture fragments require surgical treatment: single large fragments should be reduced and internally fixed, and large comminuted fragments should be excised.

Adolescent↗
PubMed1984

Principles and techniques of splinting musculocutaneous injuries.

Splinting should be used as soon after a musculoskeletal injury as possible, and the splint should be maintained (in some form) until the injury is healed to the extent that protected limb function can be resumed without pain. This principle is the overriding guide to the appropriate pre-hospital management of these injuries. In the emergency department, the physician performs a careful physical examination, without removing the splint if possible, and takes the patient's history in order to arrive at an accurate diagnosis before the splinted patient is sent for x-ray evaluation.

Adult↗
PubMed1984

Emergency department evaluation of the swollen joint.

Pain, swelling, and limited range of motion of a joint are extremely common complaints in the emergency department. In assessing joint complaints it is helpful for the emergency physician to keep in mind the major categories of diagnostic possibilities; it is also useful to distinguish between chronic and acute problems and between monoarticular and polyarticular problems. The emergency physician does not need to make a precise diagnosis of every joint complaint, but it is essential that infectious arthritis not be missed.

Acute Disease↗
PubMed1984

Traumatic plastic deformation of the radius and ulna. A closed method of correction of deformity.

More than 50 cases of plastic deformation of the forearm in children have been reported in the literature, but no method of reduction other than osteoclasis has been described. Fourteen patients with plastic deformation of one or both bones of the forearm were observed over a period of five years. Of these 14, nine were cared for acutely, and a closed reduction was performed by placing the apex of the plastically deformed bone over a fulcrum and applying significant pressure for several minutes. The average correction was 85% of the angulation present prior to reduction. The clinical findings in these patients treated by closed reduction were compared with those observed in untreated cases seen by the authors and those in the literature. Early reduction of the plastic deformation decreased the clinical deformity, allowed treatment of adjacent fractures, and led to earlier return of full pronation and supination of the forearm.

Adolescent↗
PubMed1983

Eikenella corrodens in human bite infections of the hand.

Over a 51/2-year period 30 patients were found with Eikenella corrodens infections of the hand following closed fist injury. Twenty-four had mixed infections; six grew pure cultures of Eikenella. Twenty-one of the 30 patients had positive cultures from an injured metacarpophalangeal joint. A delay in presentation or an inaccurate initial diagnosis appeared to be the most significant factors leading to the complications of osteomyelitis (in five patients) and significant loss of joint function (in eight other patients). Clinicians must have a high index of suspicion when evaluating any hand injury and clenched fist injuries of the hand should be treated by early adequate surgical debridement followed by IV penicillin given until operative cultures confirm or deny contamination with Eikenella corrodens.

Adolescent↗
PubMed1982

Supracondylar-intercondylar fractures of the femur treated with a supracondylar plate and lag screw.

Twenty-six patients ranging from nineteen to ninety-two years old underwent rigid internal fixation of supracondylar-intercondylar fractures of the distal end of the femur, using a supracondylar plate and lag screw to achieve two-plane fixation. The congruity of the articular surface of the knee was anatomically restored, as were the mechanical and anatomical axes of the lower extremity. The time to clinical and roentgenographic union averaged four months. There were no non-unions or postoperative infections. The average postoperative range of motion of the knee was 120 degrees. The average length of follow-up was twenty-one months. This series demonstrates the advantages of stable internal fixation using a supracondylar plate and lag screw over other types of fixation.

Adult↗
PubMed1981

Partial fibulectomy for ununited fractures of the tibia.

Despite the improved rate of union reported with early weight-bearing in tibial shaft fractures, there continues to be a small number of patients with delayed union and non-union who present a dilemma to the surgeons. Partial fibular ostectomy (fibulectomy) is one means of promoting union in ununited fractures of the tibia. Fifty-one patients at our hospital underwent that treatment between December 1, 1971 and June 30, 1979, at twenty to fifty-nine weeks after the date of injury. Following the partial fibulectomy, 77 per cent of the tibial fractures healed. Failure of union after fibulectomy was associated with either failure of the patient to bear weight postoperatively, the presence of a true pseudarthrosis at the fracture site, or previous prolonged treatment of the initial fracture with external fixation. Partial fibulectomy proved to be a relatively effective and simple method for the treatment of ununited fractures of the tibial shaft.

Adult↗
PubMed1978

Traumatic closed transection of the biceps brachii in the military parachutist.

Static line injury to the military paratrooper's arm occasionally produces an unusual muscle injury: closed transection of the belly of the biceps brachii. A review of twenty-eight untreated paratroopers so injured demonstrated significant residual weakness and deformity. Attempts at late repair resulted in only minimum improvement. The results of twenty fresh injuries treated by either surgical repair or aspiration followed by closed reduction and splinting are presented.

Arm Injuries↗
PubMed1976

Case finding of unrelated disease in the orthopedic clinic.

Protocols for detecting hypertension and pelvic disease were established in the orthopedic outpatient department. A significant percentage (hypertension, 20%; pelvic disease, 10%) of the patients were found to have undiagnosed pathologic conditions. The cost to the orthopedist of such case finding was minimal in terms of time and money. Methods of securing adequate follow-up are discussed.

Adult↗
PubMedDate not supplied

Non-union of the clavicle in a child. A case report.

A case of symptomatic non-union of the clavicle occurred in a 12-year-old boy. Differential diagnosis roentgenographic and histologic observations, including the results of resection of the non-union site and stablization of the proximal clavicle using the coraco-acromial ligament demonstrated that this rare condition can be restored to full asymptomatic function without any internal metallic fixation devices.

Child↗
PubMedDate not supplied

Distal patellar pole fractures. A proposed common mechanism of injury.

A variety of names has been given to disorders of the inferior pole of the patella occurring in young athletic individuals and several different causes have been proposed for these disorders. Occasionally a direct blow will cause fracture of the inferior pole of the patella, but the only other mechanism which seems to be responsible is subluxation or dislocation. Ten cases of distal patellar pole fracture secondary to dislocation or subluxation of the patella are reported. From these cases and an extensive review of the literature it is concluded that patellar subluxation or dislocation is the usual common mechanism of distal patellar pole fractures in young, active individuals and that adequate treatment of this problem must address the patellar instability as well as the fracture.

Adolescent↗
PubMedDate not supplied

Tendon lacerations in the foot.

An extensive search of the English and foreign language literature yields clinical reports on only 87 patients with open injuries of various tendons about the foot and ankle. This retrospective review is presented to document case histories in 80 additional patients, to present the results of 46 patients, and to assess the treatment recommendations outlined in the literature.

Adolescent↗