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Biomedical subjects

L Root

Publications and source records attributed to L Root.

At least 37 records · Page 2Linked to original sources
PubMed1986

Hip changes in spastic cerebral palsy.

Radiographs of the hips of 69 patients with cerebral palsy were evaluated for the angle of Wiberg, acetabular angle, degree of subluxation, shape of the femoral head, and, when the appropriate studies had been performed, anteversion and neck-shaft angles. Abnormalities included various degrees of superior lateral subluxation or dislocation, dysplasia of the acetabulum associated with femoral head displacement, flattening of the medial and/or lateral portions of the femoral head, an increase in the anteversion angle, functional increase in the neck-shaft angle, and, in long-standing cases, secondary degenerative joint disease and pseudoarticulation. Neuromuscular imbalances and abnormal ambulation caused by cerebral palsy change the biomechanical forces on the hip and result in characteristic osseous changes. Recognition and proper treatment of these changes can significantly alter the clinical course of the disease.

Adolescent↗
PubMed1986

The treatment of the painful hip in cerebral palsy by total hip replacement or hip arthrodesis.

The painful dislocated or subluxated hip in the patient with cerebral palsy presents a difficult problem in management. Twenty-three patients with cerebral palsy who had a painful subluxated or dislocated hip with degenerative changes were operated on at The Hospital for Special Surgery. Eight patients had a unilateral hip arthrodesis. Six had a successful arthrodesis initially, resulting in relief of pain and return to the preoperative functional level. A pseudarthrosis developed in two patients, but both had successful revision surgery, one by a second arthrodesis and the other by a total hip replacement. Thirteen of the fifteen patients with a total hip replacement were pain-free and functioning at a level consistent with their over-all involvement. One patient had migration of the greater trochanter and slight bending of the femoral component, with persistent pain. A second patient had progressive loosening of the femoral component over a period of seven years, but continued to walk with minimum pain. Two patients had a recurrent dislocation, one requiring revision of the femoral component and the other, of the acetabular component. We think that the presence of cerebral palsy, even in the patient with severe involvement, is not a contraindication for either a hip arthrodesis or a total hip replacement for a painful deformed or degenerated hip. These patients should be treated for the pain in the hip, and the presence of the underlying neuromuscular disorder should not deter the appropriate treatment. For unilateral hip disease in patients who are unable to walk and in young, active patients, we recommend hip fusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

The prevalence of tardive dyskinesia in geropsychiatric outpatients.

The prevalence of tardive dyskinesia was studied in a geropsychiatric outpatient clinic. All currently active patients were examined using the Abnormal Involuntary Movement Scale (AIMS) and a standardized procedure. Data were collected on a number of previously reported risk factors. A higher prevalence was noted in both tardive dyskinesia and spontaneous involuntary movement disorders in this patient population. Only sex and duration of exposure to antipsychotic drugs were noted to be significant risk factors.

Aged↗
PubMed1984

The treatment of osteogenesis imperfecta.

In this article, the author discusses the classification, genetic patterns, histologic and radiographic features, and treatment of osteogenesis imperfecta. Four types of treatment are available: (1) drugs or medications to increase the strength of bone and decrease fractures, (2) physical therapy, (3) bracing and splinting, and (4) surgery, with the most effective treatment being an operation consisting of multiple osteotomies and intramedullary rod fixations.

Bone Nails↗
PubMed1983

Biomechanical measurement of spastic plantarflexors.

A study was conducted to determine the feasibility of quantifying spasticity in plantarflexors by measuring the resistance to passive dorsiflexion of the ankle joint at several constant angular speeds. Repeated testing was conducted on normal subjects and spastic patients. Good repeatability was found for both groups and both groups were found to differ significantly from each other with respect to the measurement variable. The method will provide a useful tool for quantifying alterations in plantarflexor spasticity which result from various surgical and non-surgical treatments.

Adolescent↗
PubMed1983

ECT and tardive dyskinesia: two cases and a review.

A brief review of the literature on electroconvulsive therapy in the management of tardive dyskinesia is presented and two patients are described who were treated for major functional disorders with ECT and showed dramatic remissions in tardive dyskinesia. This response was noted during the course of ECT and has been sustained at 1-year follow-up.

Antipsychotic Agents↗
PubMed1981

Hip adductor transfer compared with adductor tenotomy in cerebral palsy.

In a ten-year study in patients with cerebral palsy, fifty patients had ninety-eight adductor transfers and fifty-two patients had 102 adductor tenotomies with or without obturator neurectomy. The groups were similar with regard to severity of their disease, age, and associated concomitant surgery. Results were evaluated in three ways: functional change, change in passive motion of the hip, and change in stability of the hip. Our data support the view that although the adductor transfer operation takes longer and is associated with a higher incidence of postoperative drainage, the over-all improvement is greater and is maintained better than that after adductor tenotomy with or without neurectomy. The transferred muscle provides greater pelvic stability, decreases hip-flexion contractures, and reduces instability of the hip.

Adolescent↗
PubMed1981

Upper limb surgery in osteogenesis imperfecta.

Although 90% of the surgical procedures performed on patients with OI are on the lower limbs, intramedullary fixation of the humerus may at times be indicated also in the upper limb for the correction of deformity and improvement of function. Upper limb deformities are generally present only in patients with severe disease (osteogenesis imperfecta congenita or osteogenesis imperfecta tarda I). The recommendations expressed in this paper are based on experience with 36 intramedullary rod fixation procedures on the upper limb in 12 patients with osteogenesis imperfecta, including 24 on the humerus, five on the radius and seven on the ulna. A Rush pin provided satisfactory fixation for the humerus, when inserted from its proximal end. Intramedullary rods were extremely difficult to insert in the forearm bones, and the author considers the operation to be rarely indicated. Two interesting and unusual problems in the upper extremities have been encountered in patients with osteogenesis imperfecta: deformity of the clavicle severe enough to cause pain and limited motion, and unicameral bone cysts in the upper humerus.

Adolescent↗
PubMed1980

Osteotomy of the hip in children: posterior approach.

The posterior approach for varus rotational osteotomy of the hip with the patient prone is relatively bloodless, provides excellent visualization of the osteotomy site, and facilitates insertion of internal fixation devices. We performed this operation on 100 hips in fifty-nine patients. All but one of the osteotomies healed within eight weeks and there was one infection.

Adolescent↗
PubMed1977

Hypoplasia of the fibula.

Fibular hypoplasia occurs in differing degrees of severity with fibular hemimelia as its most severe form. Normally the distal epiphyseal plate of the fibula is at the same level as the distal end of the distal tibial epiphysis, whereas the tip of the proximal fibular epiphysis is level with the proximal tibial epiphyseal plate. Varying degrees of shortening of the fibula in relation to the tibia were found in 14 children, 6 of them boys. Shortening at the distal end of the tibia leads to instability of the ankle. Shortening at the proximal end of the fibula leads to hypoplasia of the lateral tibial plateau and valgus deformity of the knee. Syme type ankle disarticulation became necessary in five cases of fibular hemimelia because of leg length discrepancies or ankle instability.

Ankle Joint↗