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Biomedical subjects

L Muir

Publications and source records attributed to L Muir.

12 recordsLinked to original sources
PubMed2004

Management of intra-articular fractures of the proximal interphalangeal joint by internal fixation and bone grafting.

INTRODUCTION: Intra-articular fractures of the proximal interphalangeal joint are usually treated by one of many methods of external fixation, but this does not restore the articular surface. We describe a procedure where bone grafting and internal fixation are used to restore the articular surface. PATIENTS AND METHODS: A prospective study was conducted in which three patients underwent surgical treatment for this fracture. We describe a surgical procedure where bone graft harvested from the distal radius is packed through a diaphyseal window to restore the articular surface. This is followed by internal fixation with mini-screws. RESULTS: The average follow-up was 61 months. At last follow-up the average arc of movement of the proximal interphalangeal joint was 100 deg and the average Disability of the Arm, Shoulder and Hand (DASH) Score was 2. Postoperative radiographs showed restoration of the articular contour in all three patients. CONCLUSION: The surgical technique described addresses the issues of restoration of the articular surface and permits early mobilisation. The results for our group are excellent and compare favourably with those achieved using external fixators described in the literature.

Adult↗
PubMed1997

Disease management ... drug data debate.

Desperately seeking a new way to generate profits, pharmacy benefit managers are trying to sell employers and HMOs on the notion of using their mountains of drug-claim information to manage chronic diseases. But skeptics point out that prescription data tell only part of the treatment story.

Aged↗
PubMed1997

Ax injuries of the hand.

OBJECTIVE: To review a series of ax injuries of the hand. DESIGN: Retrospective epidemiological review of 125 cases. MATERIALS: Assessment from the notes of all injuries, with more detailed follow-up of 26 cases. MEASUREMENTS: Levels of injury, surgery required, complications, results, patient satisfaction, methods of prevention. CONCLUSIONS: Ax injuries are rare. They usually affect the thumb and index finger of the nondominant hand. As with all hand injuries, expertise in dealing with bone, tendon, nerve, and skin cover is essential. Even "minor" injuries may give rise to considerable morbidity. Our complication rate in replantation was 50%. Care should be taken here not to compromise the result by attempting to maintain the length of the bony skeleton. The long-term results (at 11 months to 12 years) were generally satisfactory, but cold intolerance may persist for many years. As with all accidents, prevention would be better than cure. Neither we nor the patients could think of any way of significantly reducing the incidence of these accidents. However, holding the ax by the neck seemed a common way of sustaining injury.

Adolescent↗
PubMed1996

The epidemiology of pelvic fractures in the Mersey Region.

The Mersey Region Trauma Survey was performed over 12 months in 1989 and 1990 to study the epidemiology of trauma in a population of 3,200,000. All deaths from injuries, and all survivors with an injury severity score of 15 or over were included, giving a total of 1088 cases. This paper, primarily epidemiological, considers those victims with a pelvic fracture (153 patients), and especially those who reached hospital alive (111 patients). The epidemiology, hospital care and mortality are considered, but the specific management of individual fractures is not.

Abdominal Injuries↗
PubMed1995

Absence of the dorsalis pedis pulse in the parents of children with club foot.

There is some evidence that the anterior tibial vascular tree is poorly developed in children with club foot. We have found a significantly greater prevalence of absence of the dorsalis pedis pulse in the parents of such children. We also found significantly more tobacco smokers among the club-foot parents than in the control group.

Adolescent↗
PubMed1995

Blood transfusion requirements in femoral neck fractures.

Fractures of the femoral neck are common, and their incidence seems likely to increase. A prospective study in 1991 of 80 patients with such fractures suggested that not all need to be cross-matched preoperatively, a finding supported by the existing literature. At the same time, a survey of transfusion protocols in hospitals throughout the country suggested that much blood was being wasted daily in unnecessary cross-matching. This survey was repeated in 1995, and little appears to have changed. The implications of this are discussed.

Aged↗
PubMed1993

Ladder injuries.

A series of 66 patients injured in falls from ladders was studied prospectively to assess the mode of fall, whether or not the fall was preventable, and the range of injuries sustained. Of the patients, 47 (71 per cent) fell because their ladder fell, and up to 90 per cent of these injuries were preventable. A wide spectrum of injuries was noted, and the importance of a thorough examination of such patients is emphasized. The need for a public education programme to prevent such injuries has also been highlighted.

Accidental Falls↗
PubMed1988

Antibody-dependent cell-mediated cytotoxicity: comparison between HTLV-I and HIV-1 assays.

This study confirms the presence of detectable antibody-dependent cell-mediated cytotoxicity (ADCC) towards both HTLV-I- and HIV-1-infected cell lines, mediated by normal donor peripheral blood mononuclear cells and either by antibody from adult T-cell lymphoma and tropical spastic paraparesis patients (HTLV-I) or by antibody from sera of patients with persistent generalized lymphadenopathy, AIDS-related complex, AIDS and asymptomatic patients seropositive for HIV-1 infection. A comparison of ADCC towards these two retroviruses, under carefully controlled laboratory conditions, indicates major differences between the capacity of HTLV-I-seropositive sera and HIV-1-seropositive sera to mediate ADCC. In all cases, HIV sera showed low-titre ADCC, in contrast to the high titre (greater than 1:800,000) ADCC mediated by HTLV-I-positive sera. Both sets of sera showed the prozone phenomenon, and heat inactivation may abolish ADCC towards HIV-1-infected cells. Quantitation of surface antigen expression on HTLV-I- and HIV-1-infected cell lines indicated the presence of easily detectable amounts of virus-specific antigen. We conclude that, in contrast to some previous reports, ADCC mediated by HIV-1-specific immunoglobulin G (IgG) antibody is rather weak and of low titre when compared with HTLV-I ADCC. This is true for all cell lines and HIV-1 virus isolate combinations tested.

Antibodies, Monoclonal↗