Biomedical subjects

M L Ecker

Publications and source records attributed to M L Ecker.

40 records · Page 3Linked to original sources

PubMedDate not supplied

Posterior spinal fusion for scoliosis in patients with cerebral palsy: a comparison of Luque rod and Unit Rod instrumentation.

The development of the U-shaped Unit Rod for posterior spinal arthrodesis is a recent advance in the treatment of spinal deformity in patients with cerebral palsy. The results of 15 patients who underwent arthrodesis with dual Luque rod instrumentation (group I) are compared with the results of 15 patients in whom Unit Rod instrumentation was used (group II). The two treatment groups were similar with respect to age, gender, major spinal curve, and degree of pelvic obliquity. The Unit Rod instrumentation allowed significantly greater correction of both the major curve and pelvic obliquity, as assessed on postoperative radiographs. The mean postoperative major curve in group I was 44.1 degrees, compared with 31.7 degrees in group II (mean corrections of 48.6 and 61.7%, respectively). The mean angle of postoperative pelvic obliquity in group I was 12.6 degrees, compared with 5.2 degrees in group II, corrections of 49.5 and 79.3%, respectively. Sagittal-plane alignment was improved to a similar degree in both groups in those patients with preoperative imbalance and maintained in the remainder of patients.

Adolescent↗

PubMedDate not supplied

Supracondylar fractures of the humerus in children treated by closed reduction and percutaneous pinning.

During the period from 1973 to 1978, 38 children with displaced supracondylar fractures of the humerus were treated at The Children's Hospital of Philadelphia by closed reduction and percutaneous pin fixation. The technical details of the procedure include (1) reduction under general anesthesia with adequate relaxation; (2) insertion of crossed pins from the medial and lateral side with the elbow in acute flexion; (3) and intraoperative clinical and roentgenographic examination of the pinned fracture with the elbow in extension to determine the adequacy of the reduction, with particular attention to the carrying angle. By Flynn's criteria acceptable results were obtained in 19 of the 25 patients studied. Three results were unacceptable due to cubitus varus of 2 degrees, 5 degrees, and 10 degrees, respectively, and three to loss of flexion. Although rotational malalignment occurred in 19 patients, as manifested by a change in shoulder rotation, in no patient was it clinically significant, either cosmetically or functionally. There were no neurologic or vascular complications from the treatment. This is a safe and reliable technique for obtaining and maintaining an excellent reduction in this difficult fracture while preserving vascular function.

Bone Nails↗

PubMedDate not supplied

The treatment of osteonecrosis of the medial femoral condyle.

Osteonecrosis of the medial femoral condyle presents as a sudden onset of pain on the medial side of the knee. This is associated with a positive bone scan and, frequently, a radiolucent lesion in the subchondral zone. In a review of 79 patients with this disease, performed to establish guidelines for treatment, the patients are divided into three groups according to clinical course and size of the lesion. Group I patients have typical clinical presentation and positive bone scans, but lack radiologic evidence of the lesion. Group II patients have small lesions, with an average diameter of 32% of that of the medial femoral condyle. Group III patients have large lesions, all with diameters greater than 50% of the diameter of the condyle. Patients in Groups I and II obtained relief of pain with conservative treatment; the lesion stabilizes; surgery should be avoided until late degenerative changes become symptomatic. The joints of Group III patients will all collapse rapidly; surgical treatment prior to the development of fixed deformity is advisable.

Aged↗

PubMedDate not supplied

Transverse fractures of the patella.

A technique termed longitudinal anterior band with or without cerclage (LAB/C) is recommended for internal fixation of transverse patellar fractures. The fixation is secure even with the existence of considerable comminution in one fragment. The security of this fixation allows early mobilization and the prevention of knee stiffness. The technique involves longitudinal drill holes through which a wire is pulled and looped over the anterior surface of the patella. When folded and tied over the patella, it allows excellent anterior compression and firm fixation. A cerclage wire is applied primarily for marked comminution. Sixteen patients have been treated in this manner with excellent results. To date there have been no complications from wire breakage or fragment distraction, and early motion has been achieved.

Adolescent↗