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Biomedical subjects

M Swann

Publications and source records attributed to M Swann.

At least 19 recordsLinked to original sources
PubMed1991

A comparison of postoperative analgesia provided by wound infiltration or caudal analgesia.

A prospective randomised study was performed to compare postoperative analgesia produced by caudal block with that of local wound infiltration in 54 children following unilateral inguinal herniotomy. There was no statistically significant difference in the analgesia produced by these two methods. The requirement for additional postoperative analgesia and the incidence of side-effects was similar in the two groups.

Analgesia, Epidural↗
PubMed1991

Metal wear and tissue response in failed titanium alloy total hip replacements.

Thirteen total hip replacements with titanium alloy femoral components required revision for loosening at an average of two years after implantation. At revision the soft tissues around the implant were darkly stained and a proliferative membrane had invaded the cement-bone interface. The femoral components showed polishing of parts of their shot-blasted surfaces. Histology showed a fibroblastic reaction with abundant titanium lying free and within histiocytes, and a scanty foreign-body giant-cell reaction. Surface analysis of the removed femoral components and chemical analysis of the excised tissues is described. Tissue reaction in response to the metal-wear debris may have contributed to the early failure of these implants.

Adult↗
PubMed1991

Total hip replacement for juvenile chronic arthritis.

We review the results of 96 primary total hip replacements in 54 patients with juvenile chronic arthritis at five years or longer after surgery. The mean age at operation was 16.7 years (range 11.25 to 26.6); the follow-up period averaged 11.5 years. The clinical results in terms of pain, range of movement, mobility and function are presented. A revision procedure was required in 24 hips (25%) in 18 patients at an average of 9.5 years after the primary operation. A further 17 hips had radiographic signs of loosening. The factors thought to contribute to this relatively high failure rate in patients with juvenile chronic arthritis are discussed.

Adolescent↗
PubMed1990

The surgery of juvenile chronic arthritis. An overview.

Surgery now has a well-established place in the management of childhood arthritis. However, satisfactory results can only be achieved by a team of medical experts composed of a pediatric rheumatologist, an orthopedic surgeon, an anesthetist, a physiotherapist, and others who are knowledgeable about the particular problems of juvenile chronic arthritis. An aggressive team approach offers the best available help.

Arthritis, Juvenile↗
PubMed1987

Scoliosis in juvenile chronic arthritis.

Structural scoliosis occurs more commonly in patients with juvenile chronic arthritis than in the normal population. We have reviewed 32 patients with both juvenile arthritis and a scoliosis and suggest that structural curves may arise from postural curves associated with asymmetrical involvement of lower limb joints.

Adolescent↗
PubMed1987

Juvenile chronic arthritis.

Juvenile chronic arthritis is a heterogenous group of diseases in which the common denominator is a persistent arthritis in one or more joints commencing before the age of 16 and lasting three months or more. The care of these patients by a pediatric rheumatologist, an orthopedic surgeon, and a full rehabilitation team must be combined to afford the best treatment. Medication, splintage, and physiotherapy are useful in helping to suppress and reduce the effects of the disease, but in some patients arthritis attacks in acute episodes, while in others arthritis chronically and relentlessly pursues its destructive course. Surgical treatment, particularly of the soft parts, has a considerable part to play in correcting deformity, maintaining movement, and relieving pain. Timely surgical treatment may also serve to prevent deformity and to maintain function as well as muscle strength so that by the time the child becomes an adult he can lead a normal life. The plan of treatment is thus long range.

Arthritis, Juvenile↗
PubMed1986

Total hip replacement in children with juvenile chronic arthritis.

The results of 75 total hip replacements in 42 children with juvenile chronic arthritis are reported after a mean follow-up of 5.4 years. Their ages ranged from 11 to nearly 17 years at operation and many had active disease. Severe pain and marked stiffness of the hips were limiting their independence. At least half of the children were still growing and continued to grow after operation. The patients were carefully selected and gratifying results were obtained, but pre-operative assessment and overall supervision by a rheumatologist are important. Technical difficulties related to the size and maldevelopment of the hip are discussed. There was no infection and the single case of loosening of a femoral component after nine years has been successfully revised.

Adolescent↗
PubMed1986

Soft-tissue release of the hips in children with juvenile chronic arthritis.

In juvenile chronic arthritis the hips are commonly affected and this becomes the most important reason for losing independence and mobility: the joint develops a painful flexion contracture with marked loss of movement. Soft-tissue release operations consisting of psoas and adductor tenotomies have proved a safe and effective method of relieving pain and improving function. We report 89 such operations in 52 patients. More extensive soft-tissue release operations or synovectomy of the hips offer no advantage and recovery is often more painful and prolonged.

Adolescent↗
PubMed1983

Isolated paralysis of the serratus anterior. A report of 20 cases.

A description is given of 20 patients with winging of the scapula. The majority had suffered spontaneous severe pain in the region of the shoulder followed about two weeks later by the deformity and associated loss of function. Only in three patients was there a clear history of trauma. Some patients may have strained the arm, but in the majority no single factor heralded the problem. Most of the patients were followed up for more than two years and it became clear that functional recovery could take up to this time to be complete. However, careful examination revealed that often a slight degree of winging remained. No specific treatment apart from gentle physiotherapy was prescribed and certainly no operative procedures. It is considered that a number of these cases were examples of neuralgic amyotrophy.

Adolescent↗
PubMed1983

Surgical treatment of the cervical spine in rheumatoid arthritis.

Rheumatoid arthritis can affect any of the synovial joints in the vertebral column. However, the cervical spine, which is the most commonly involved, is the region where segmental instability can lead to neurological sequelae. Severe pain may also be a feature demanding relief. The natural history of the disease as it affects the cervical spine must be a yardstick of management, because quite severe subluxation can occur without neurological embarrassment, whilst a small segmental shift may have profound neurological implications. It is with this knowledge that surgical fusion is offered to a few selected patients. Our own cases are derived from the Medical Research Council Rheumatism Unit at Taplow and the paper will also include experience of Juvenile Chronic Arthritis and ankylosing Spondylitis.

Adolescent↗
PubMed1979

Spontaneous dislocation of the sterno-clavicular joint.

A description is given of 22 patients, with a spontaneous forward subluxation of the sternal end of the clavicle, seen over a 5-year period. The majority were middle-aged women presenting with a lump at the root of the neck, which was usually associated with little or no discomfort. There was no history of injury and no interference with shoulder function. The diagnosis was obvious on clinical examination and no treatment was required other than explanation, reassurance and simple analgesia. In no case was the correct diagnosis made by the referring physician and many of the patients were unduly concerned by the nature of the swelling. The sterno-clavicular joint is a synovial articulation and consequently it may be involved in rheumati arthropathy. A condition of non-infective subacute arthritis of the sterno-clavicular joint has been described and is similar to that reported here but in contrast to the previous report we believe that the changes which occur in the joint are secondary to its subluxation.

Adult↗
PubMed1977

The results of early operation in talipes quino-varus. A preliminary report.

The results of operation performed within the first six months of life upon seventy-seven resistant club feet are presented. The indications for and the rationale of early operation are discussed. Particular attention has been paid to the relationship between the age at operation and the outcome more than four years later; the results were greatly superior when operation was undertaken early. Two surgical techniques are compared, the postero-medial release proving better than a simple posterior release. The relationship between clinical and radiological assessment is discussed, and also the influence of the results reported upon future practice.

Age Factors↗