Sonographic underestimation of the size of a foreign body.
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Child↗
Biomedical subjects
M Nyska
Publications and source records attributed to M Nyska.
Surgical treatment of lumbar spinal stenosis in patients aged 65 years and older.
Spinal stenosis syndrome affects mainly patients at their 5th-6th decades of life. The main goals of surgical treatment in the elderly are to allow the individual to walk longer distances, maintain the activities of daily living (ADL) and social life. Our aim was to evaluate the results of surgical treatment for lumbar spinal stenosis in elderly patients. All patients over 65 years of age who underwent surgery due to spinal stenosis syndrome between 1990 and 1998 were evaluated. There were 29 males and 17 females aged between 65 and 90 years. The clinical presentation included low back pain (89%), intermittent claudication (100%) and neurological involvement (87%). The radiological examination showed a frequent narrowing at the level L4-L5 in 93.5% of the patients. The results of the surgery in a mean follow-up of 22 months were good to excellent in 80% of the patients, fair in 11%, and poor in 9%. An improvement in the intensity of pain and in walking distances was noted in 89 and 85% of the patients, respectively. Improvement was achieved in the level of daily activity and in social lives in 57 and 61%, respectively. Major and minor complication rates were 6.5 and 19.5%, respectively. No mortality was noted in this series. Eighty-seven percent of the patients were satisfied with the results of the surgery. We conclude that Surgery for spinal stenosis is a successful and relatively safe procedure, also for patients aged over 65, and should be considered as a treatment option for these patients.
Journal Article↗
Concomitant medial facet and dome fractures of the talus.
Osteochondral fracture of the dome of the talus is a well known complication of an inversion injury of the ankle. Recently the authors encountered a patient having a talar dome fracture associated with intra-articular fracture of the medial facet after inversion injury of the ankle. The authors have been unable to find a medial facet intra-articular fracture reported in the English literature. The talar dome fragment was removed arthroscopically and the medial facet fragment was removed using an open surgical approach. The mechanism of injury and the operative approach are discussed.
Accidental Falls↗
Assessment of bony bridge by computed tomography: experimental model in the rabbit and clinical application.
A bony bridge was created in the growth plates of young rabbits. Weekly computed tomography (CT) scanning was done in the axial (transverse) plane for 3 weeks. Transverse histological sections from the plate area were examined after 3 weeks. The CT image showed the exact location and extent of the sclerotic bony bridge. The area of the bony bridge as a percentage of the plate was measured from the CT image. Good correlation was found between the CT image and the histological section. This technique has been applied to children, and three such examples show accurate assessment of the growth plate.
Animals↗
Using bone's adaptation ability to lower the incidence of stress fractures.
In three prospective epidemiologic studies of the effect of pre-military-induction sport activities on the incidence of lower extremity stress fractures during infantry basic training, recruits who played ball sports (principally basketball) regularly for at least 2 years before basic training had a significantly lower incidence of stress fractures (13.2%, 16.7%, and 3.6% in the three studies, respectively) than recruits who did not play ball sports (28.9%, 27%, and 18.8%, respectively). Preinduction running was not related to the incidence of stress fracture. To assess the tibial strain environment during these sport activities, we made in vivo strain measurements on three male volunteers from the research team. Peak tibial compression and tension strain and strain rates during basketball reached levels 2 to 5.5 times higher than during walking and about 10% to 50% higher than during running. The high bone strain and strain rates that occurred in recruits while playing basketball in the years before military induction may have increased their bone stiffness, according to Wolff's Law. The stiffer bone could tolerate higher stresses better, resulting in lower strains for a given activity and a lower incidence of stress fractures during basic training.
Adaptation, Physiological↗
Avulsion fracture of the medial epicondyle caused by arm wrestling.
Fractures occurring in teenagers during arm wrestling usually involve the distal humerus and appear as a fracture of the medial epicondyle. We studied eight male patients, aged 13 to 15 years, with such fractures. All fractures involved the right hand and occurred while the patients were in the final stages of winning a match in a formal competition. Three fractures occurred during an official competition and the other five occurred during a match between friends. One patient suffered from ulnar nerve paresis that eventually recovered spontaneously. All of the patients were immobilized for 10 to 21 days, and progressed gradually to motion of the elbow. At 1-year followup, clinical and functional results were satisfying. Therefore, we recommend conservative management for fractures of the medial epicondyle sustained during arm wrestling.
Adolescent↗
The use of ultrasound in children with pain around the hip and thigh.
The use of ultrasound in the evaluation of effusion of the hip is well established. We performed ultrasound examinations on 87 children who presented with a limp and with pain in the hip region. We confirm the diagnostic value of ultrasound in detecting an effusion in the hip. Furthermore, ultrasound examination revealed effusion in two cases (psoas myositis), an unexpected effusion in the contralateral hip in two cases, and the cause of the pain in eight cases without effusion.
Bone Diseases↗