Paralymics offer athletes--and DOs--new challenges.
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Biomedical subjects
Publications and source records attributed to K J Richter.
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The rigid removable dressing technique for below-knee amputees has many advantages over other conventional systems. There is some reluctance to use this system in the presence of an open lesion. We present a patient with severe wound dehiscence who had success with this system. The advantages of the rigid removable dressing are protection of the stump and better shrinkage, combined with the ability to remove the dressing and look at the wound. This makes the technique ideal for a stump with poor wound healing.
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The attachment of a pylon and prosthetic foot to a postoperative rigid dressing can be beneficial in the management of a below-the-knee amputation. Recently, a rigid, removable dressing has been used to allow easy inspection of the stump during healing. The removal of the pylon and prosthetic foot at night, preventing unsupervised ambulation, is accomplished by a disconnecting mechanism, which is permanently attached to the end of the rigid removable dressing. This disconnecting mechanism adds to the bulk and weight of the rigid dressing, increasing the shear force on the stump. We are introducing the detachable cast pylon technique, in which a fabricated sleeve attached to the pylon is easily and completely attached and detached from a rigid dressing. It is lightweight, less bulky, easily fabricated, and inexpensive. It offers a quick disconnect system for either the Otto-Bock attachment plate or uniquely with PVC tubing. In addition, this technique affords consistency in shaping the stump, as the same rigid dressing can be used for both rest and training. Its intent is for in-hospital use or when ambulation is restricted to supervised situations.
Hyperhidrosis is a condition affecting the spinal cord injured (SCI) patient that often does not respond well to medical management. While the aetiology of hyperhidrosis in SCI patients is not completely understood, the standard form of treatment is aimed at interrupting the sympathetic cholinergic eccrine sweat glands. It has been our experience in treating this condition that many patients will have a significant decrease in hyperhidrosis using propoxyphene hydrochloride (Darvon) 65 mg once or twice per day. Two of these patients are presented. While the mechanism of action is purely speculative, there is evidence to support the concept that opioids may act as a weak ganglionic blocking agent. We have found that a trial of this medication for SCI patients suffering from hyperhidrosis may produce very gratifying results. Further investigation into the treatment of this condition with propoxyphene hydrochloride is indicated.
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Explore the source record for details and available documents.
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