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Biomedical subjects

J Ivory

Publications and source records attributed to J Ivory.

6 recordsLinked to original sources
PubMed2001

A retrieval study of capital hip prostheses with titanium alloy femoral stems.

We have examined 26 retrieved, failed titanium-alloy femoral stems. The clinical details, radiological appearances and the histology of the surrounding soft tissues in each patient were also investigated. The stems were predominantly of the flanged design and had a characteristic pattern of wear. A review of the radiographs showed a series of changes, progressive with time. The first was lateral debonding with subsidence of the stem. This was followed by calcar resorption and fragmentation or fracture of the cement. Finally, osteolysis was seen, starting with a radiolucency at the cement-bone interface and progressing to endosteal cavitation. Three histological appearances were noted: granulomatous, necrobiotic and necrotic. We suggest that an unknown factor, possibly related to the design of the stem, caused it to move early. After this, micromovement at the cement-stem interface led to the generation of particulate debris and fracture of the cement. A soft-tissue reaction to the debris resulted in osteolysis and failure of fixation of the prostheses.

Aged↗
PubMed1994

Failure of the sliding hip screw in the treatment of femoral neck fractures: 'left-handed surgeons for left-sided hips'.

The pre-operative radiographs of 265 patients consecutively treated with sliding hip screws were reviewed. In 244 cases the fixation was for a basicervical or intertrochanteric fracture. The post-operative radiographs of these 244 patients were examined for technical failure of the device. Of the 15 failures analysed, one had occurred where insufficient sliding length had been available to the screw within the barrel, and one was due to jamming of the screw within the barrel. Of the remaining 13 fixations, 12 had occurred where the screw had been poorly positioned within the femoral head, and one device had failed for no obvious reason. Malpositioning of the failures occurred significantly more frequently on the left than on the right, in a Unit where all the surgeons were right-handed. We conclude that the majority of technical failures of the sliding hip screw occur because of poor positioning of the screw. This occurs more commonly on the left side when the surgeon is right-handed.

Bone Screws↗
PubMed1983

Working with non-dental groups to influence adoption of self-applied fluoride programs in schools: one approach.

Although the use of self-applied fluorides in schools has been proven safe and effective, thousands of children are not benefiting from these procedures. This paper describes a dual promotional approach designed to increase the awareness of the need for school-based self-applied fluoride programs. A manned exhibit providing consultation and educational materials was displayed during the entire meeting of a state PTA and was supplemented by a presentation scheduled on the formal program. The workshop participants were parents of school-age children; most held decision-making positions in their local PTAs. Results of the workshop to date include: one participant prevented the demise of an established fluoride mouthrinsing program in her community; and the workshop leaders presented the merits of school-based self-applied fluoride programs to a local PTA and a county school health council. The same programs were described in a county PTA newsletter. These actions suggest that, given the appropriate information and assistance, parents of school children through their PTA can influence adoption of school-based fluoride programs. Furthermore, strategies directed toward members of other groups with an interest and decision-making role in children's health may be effective methods of influencing adoption of school-based self-applied fluoride programs and ultimately promoting children's oral health.

Child↗
PubMed1980

Health centres: does small mean success?

On May 16 this year the Journal published a special issue entitled 'Sixty years after the Dawson Report' in which Dr J. Gerald Beale wrote that a study of health centres proved that in many respects they had done more harm than good. Here Dr J. Ivory, GP; Mr F. H. Kirton, area works officer; and Mr. C. A. Clark, planning administrator, Northumberland AHA put an alternative view.

Community Health Centers↗