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Biomedical subjects

J P Schwab

Publications and source records attributed to J P Schwab.

12 recordsLinked to original sources
PubMed2001

Traumatic unilateral avulsion of the anterior superior and inferior iliac spines with anterior dislocation of the hip: a case report.

A sixteen-year-old boy involved in a high-speed motor vehicle accident sustained an anterior hip dislocation and avulsion of the anterior ilium extending from the anterior superior iliac spine to the anterior inferior iliac spine. The hip was emergently reduced, and further imaging was obtained to evaluate the bony injury. Computed tomography confirmed the presence of a large displaced bony fragment representing avulsion of the anterior superior and inferior iliac spines and a smaller fragment from the reflected head of the rectus femoris. The patient underwent open reduction and internal fixation of the ilium two days after the initial injury. Postoperatively, he was allowed to bear weight as tolerated with crutches but to avoid active hip flexion. He went on to an uneventful recovery, and at last report (approximately six months after injury), he had returned to full activity. An extensive review of the literature failed to show a similar injury of ipsilateral avulsion of the anterior superior and inferior iliac spines and reflected head of the rectus femoris.

Accidents, Traffic↗
PubMed1997

The necessity of acute bone grafting in diaphyseal forearm fractures: a retrospective review.

OBJECTIVE: To determine the union rate of forearm fractures where acute bone grafting was recommended but not performed. DESIGN: Retrospective review. SETTING: Regional level one trauma center. PATIENTS: The criteria for inclusion in the study were patients with closed growth plates and a diaphyseal fracture of the radius, ulna, or both (including Monteggia and Galeazzi fracture-dislocations) that were treated with plate fixation. Patients were excluded from the study if they were lost to follow-up before radiographic documentation of bone union. The review identified 198 fractures that were eligible for inclusion. Fifteen fractures were excluded. INTERVENTION: The method of treatment of each fracture was open reduction and plate fixation with or without bone grafting. MAIN OUTCOME MEASUREMENT: Fracture union. RESULTS: The overall union rate in comminuted, nongrafted forearm fractures (open and closed) was 98% (99/101; 95% confidence interval: 93-100%). The union rate in closed, comminuted, nongrafted forearm fractures was 97% (74/76; 95% confidence interval; 91-100%). CONCLUSIONS: Open reduction and internal fixation of comminuted diaphyseal forearm fractures without bone grafting in this study produced union rates comparable to those reported for open reduction and internal fixation of comminuted forearm fractures with acute bone grafting. This study suggests that routine use of bone grafting in comminuted forearm fractures is not indicated.

Adolescent↗
PubMed1995

Polytrauma care. The effect of head injuries and timing of skeletal fixation.

There is a substantial body of literature supporting early ( < 48 hours) fixation of long bone fractures in the patient with polytrauma. Early fixation reduces the complications of traction and recumbency, reduces pain, decreases the stimulus for a systemic inflammatory response, makes nursing care easier, makes the fracture outcome more predictable, and decreases health care costs. If hypotension and hypoxia are avoided, early fixation of long bone fractures does not increase the incidence of adverse cerebral events. The benefits (short and long term), if any, of early fixation of long bone fractures on the recovery from closed head injury remain poorly defined.

Fractures, Bone↗
PubMed1987

Septic spondylodiscitis in ankylosing spondylitis.

A patient with ankylosing spondylitis (AS) for 10 years suddenly developed localized midback pain after minimal activity. Although he sought immediate medical assistance, recognition of a septic spondylodiscitis was delayed 3 weeks. One day after admission, he developed fever and admitted to intravenous drug use. Staphylococcus aureus empyema and spondylodiscitis were subsequently diagnosed. Clinical differentiation of aseptic from septic spondylodiscitis cannot be ignored in patients with AS.

Adult↗
PubMed1986

Olecranon fractures treated with AO screw and tension bands.

Twenty-eight patients averaging 36.4 years of age underwent open reduction and internal fixation of olecranon fractures. The AO cancellous screw was used alone in 16 and with tension banding in 12. Banding was used when the bone was soft or severely comminuted. The fractures were clinically healed at an average of nine weeks and roentgenographic healing with obliteration of the fracture line occurred at 13 weeks. Sixty-seven percent acquired full motion by the ninth postoperative week. All but two patients regained full supination and pronation. No patient lost greater than 30 degrees of extension and only two lost greater than 30 degrees of flexion. There were few operative difficulties or postoperative complications. We found the AO cancellous screw alone and in severely comminuted cases in combination with tension band wiring to be an excellent fixation device for olecranon fractures. It allows for early range of motion in young patients with excellent healing prospects by 16 weeks.

Adolescent↗
PubMed1985

Painful spondylolysis or spondylolisthesis studied by radiography and single-photon emission computed tomography.

Planar bone scintigraphy (PBS) and single-photon emission computed tomography (SPECT) were compared in 19 adults with radiographic evidence of spondylolysis and/or spondylolisthesis. SPECT was more sensitive than PBS when used to identify symptomatic patients and sites of "painful" defects in the pars interarticularis. In addition, SPECT allowed more accurate localization than PBS. In 6 patients, spondylolysis or spondylolisthesis was unrelated to low back pain, and SPECT images of the posterior neural arch were normal. The authors conclude that when spondylolysis or spondylolisthesis is the cause of low back pain, pars defects are frequently heralded by increased scintigraphic activity which is best detected and localized by SPECT.

Adolescent↗
PubMed1985

The use of Ender nails in fractures of the tibial shaft.

Between November 1979 and January 1983, we treated fifty-one severe fractures of the tibial shaft with multiple intramedullary Ender nails. Thirty-six fractures were treated within two weeks after injury. Forty-one fractures united in less than four months and eight, in four to eight months. Only two were not united after eight months. An anatomical reduction was maintained in all but three of the fractures, in which the tibia shortened. Two tibiae united with an angulation of 7 degrees and one with 6 degrees, as measured in two planes. There were two infections, both after an open fracture. It has been our experience that Ender nails provide excellent rotational stability, allow early full weight-bearing, and markedly decrease the duration of need for immobilization. Ender nailing was of value both for the acute management of complicated high-energy fractures of the tibial shaft with extensive soft-tissue damage and as a salvage procedure to maintain reduction of a fracture when other techniques had failed.

Adolescent↗
PubMed1985

Subtrochanteric fracture as a complication of proximal femoral pinning.

The circumstances of subtrochanteric fractures following the use of multiple pins for fixation of femoral neck fractures were reviewed in four women (age range, 67-94 years). Internal fixation by use of multiple pins in the proximal femur is a common orthopedic procedure. The pins, however, create a significant stress riser in the lateral subtrochanteric cortex. Subtrochanteric fracture has been reported after internal fixation of slipped capital femoral epiphysis with multiple conventional pins and, recently, after internal fixation of femoral neck fractures with large Garden screws.

Aged↗
PubMed1982

Suprapatellar plica synovialis: a common arthrographic finding.

The suprapatellar structures are often overlooked during double contrast knee arthrography. A plica synovialis suprapatellaris representing a remnant structure from the embryonic septum between knee joint and suprapatellar bursa was identified in 40 of 53 double contrast knee arthrograms. Symptoms including knee pain and clicking have been described in association with the presence of a plica synovialis. Only one of 40 patients in this series, however, was treated for the diagnosis of plica syndrome. Plica synovialis suprapatellaris is a common, usually incidental finding at knee arthrography and should not be mistaken for an adhesion or other capsular abnormality if the clinical findings of plica syndrome are absent.

Humans↗
PubMed1979

Lumbar fusion.

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Humans↗