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Biomedical subjects

O N Nagi

Publications and source records attributed to O N Nagi.

At least 37 records · Page 2Linked to original sources
PubMed1994

The versatility of the contoured AO plate as a mode of fixation for proximal femoral fractures.

Proximal femoral fractures, especially in young adults, usually are high-energy injuries associated with severe comminution. Presently available fixation devices such as the blade plate and DHS are difficult to apply in comminuted cases, their application requires the use of an image intensifier, and their versatility is limited. This report describes the use of the AO plate molded according to the proximal femoral anatomy in 21 cases (seven subtrochanteric and 14 trochanteric fractures) in which high-energy injuries were sustained. Eleven cases were primarily bone grafted. Postoperative mobilization was started by an average of 5.4 weeks. All cases united by an average of 3.2 months. There were six excellent, ten good, three fair, and one poor result (one patient died). This method was found to be superior to conventional devices as it offers more versatility in placement of screws and plate contouring. The inventory of implants is also reduced, and there is no need for specialized instruments, a significant factor in Third World countries.

Adolescent↗
PubMed1994

Ewing's sarcoma of the foot bones: an analysis of seven cases.

Seven cases of Ewing's sarcoma presenting with primary lesions of the foot bones are described. Difficulty and delay in making the initial diagnosis are the hallmarks of the problems encountered at this site. Although radiation therapy plays an important role for control of disease in Ewing's sarcoma, surgery along with chemotherapy appears to give better results. Lesions of the forefoot are amenable to surgery; however, no guidelines are available in the literature for hindfoot lesions. Chemotherapy has revolutionized the outcome, and its use along with surgical intervention is recommended in all cases of Ewing's sarcoma of foot bones.

Adolescent↗
PubMed1993

Comparison of fresh autogenous with formalin preserved allogeneic bone grafts in rabbits. An experimental study.

A complete circumferential gap was produced in the diaphysis of the ulna in rabbits and the radius was left intact. The gap on the right side was filled with formalin preserved allogeneic (FPA) bone graft, and fresh autogenous bone taken from the right ulna was put into the gap on the left side. The gap was left untouched in a control group. Up to 8 weeks, the rate of union was slower in the FPA grafts compared with the autogenous grafts. Maximum fluorescence was seen at 10 to 16 weeks and was the same in both groups. These results indicate that osteoinduction occurs with normal bony repair in 80% of both groups, although the onset of healing is delayed in the FPA grafts.

Animals↗
PubMed1993

Management of giant cell tumor of the tarsal bones: a report of nine cases and a review of the literature.

Giant cell tumor of the tarsal bones is uncommon and therapeutic options are ill defined. We report on nine cases of giant cell tumors of the tarsal bones treated by excision of the complete bone in 6 cases, partial excision in 1 case, and curettage and bone grafting in two cases. There was no recurrence at an average 25.8-month follow-up. Function after calcanectomy was satisfactory. Excision of the talus may or may not be followed by arthrodesis, but arthrodesis is essential after excision of all the other tarsal bones except the calcaneus. We advocate aggressive surgical measures in these cases; amputation should be reserved for recurrences only. Satisfactory function may be expected after excision of tarsal bones.

Adolescent↗
PubMed1993

Primary bone malignancies in pregnancy. A report of four cases.

Primary malignant bone tumors are rarely associated with pregnancy. Because of the rare nature of the condition, the relevant literature available is scant, providing limited information to the clinician about its management. Common management problems stem from delayed diagnosis and the limitations on the use of routine therapeutic modalities (eg, radiation and chemotherapy) during pregnancy. The cases presented include two cases of Ewing's sarcoma, one case of osteosarcoma, and one malignant fibrous histiocytoma that is thought to be multicentric in origin. Three of these tumors involved the scapula. The patients' social customs and general medical ignorance significantly affected the outcome of these cases.

Adult↗
PubMed1992

Traumatic scapulothoracic dissociation. A case report.

A rare case of scapulothoracic dissociation which was not diagnosed initially is reported. Vascular injuries associated with this injury are potentially life threatening. The key to the diagnosis is accurate interpretation of the radiographs: the lateral dislocation of the acromion and lateral shift of the medial scapular border are evident on chest radiographs. Emergency subclavian arteriography is essential to assess the vascular status. A high index of suspicion has to be maintained so that this dangerous injury is not overlooked.

Accidents, Traffic↗
PubMed1992

Fibular osteosynthesis for delayed type II and type III femoral neck fractures in children.

Seventeen transcervical/basal femoral neck fractures in children were treated by free fibular graft and cancellous lag screw. Two cases were failures of a previous surgery, and 15 had been untreated for 3 weeks or more. Four cases had radiological evidence of avascular necrosis of the head and one of the neck preoperatively; five cases had neck resorption. At an average of 48.1 months postsurgery all fractures had united and there was only one new case of avascular necrosis. Four cases had coxa vara, and four cases had premature epiphyseal closure. There were 13 good, three fair, and one poor result(s) using Ratliff's criteria. We recommend this procedure in cases with delayed initial appearance or failed previous surgery. Complications of the procedure such as long screw/graft and fibular fracture are preventable. The incidence of coxa vara in cases with neck resorption may be reduced by adding subtrochanteric osteotomy to the procedure.

Adolescent↗
PubMed1992

Chronically unreduced traumatic anterior dislocation of the hip: a report of four cases.

Four cases of unreduced (2-11 months postinjury) anterior hip dislocation are reported. One public dislocation 2 months postinjury was treated by open reduction with a fair result. A unique case of iliac dislocation 11 months postinjury, overlooked due to an associated femoral shaft fracture, was treated by valgus/derotation osteotomy. Two obturator dislocations 7.5 and 9.5 months postinjury were treated by a subcapital osteotomy and displacement of the femoral neck into the acetabulum (modified excision arthroplasty). Both of these patients had fairly stable, painless, and mobile hips at 2.1 and 2.8 years follow-up. By our method, subsequent total hip arthroplasty remains a viable option, in contrast to the previously described method of trochanteric osteotomy, whereby the proximal femoral anatomy is distorted.

Adult↗
PubMed1992

Sciatic nerve palsy associated with total hip arthroplasty.

Six cases of clinically evident sciatic or peroneal nerve palsy occurred in a consecutive series of 380 total hip arthroplasties (THA). An additional eight cases of peroneal nerve palsy due to pressure from Thomas splint or tight bandages were seen. Factors apparently causing nerve palsy were significant lateralization and lengthening in four cases and dislocation of the hip in one case. The cases with neuroapraxia of the peroneal nerve were seen from the third to the fifth day of Thomas splint immobilization. EMG studies were conducted in all six group 1 patients; at the end of one year the results were good in two cases, fair in three cases, and poor in one case. The results suggest that limb lengthening should be limited to 4 cm to minimize this complication. It was also seen that patients with peroneal nerve palsy due to local compression do well, though some are bothered by mild residual dysesthesia over the dorsum of the foot. In contrast, patients with sciatic nerve palsy do not have such a good outlook.

Bandages↗
PubMed1991

Giant cell tumour of the proximal end of the ulna.

An extremely rare case of giant cell tumour of the proximal end of the ulna, which was clinically aggressive but histologically benign, is reported in a 28-year-old man. The tumor was excised in en bloc but patient died 8 months after surgery. To the best of our knowledge, this is the first reported case from South East Asia and the second available in the English-language literature. It therefore warrants report.

Adult↗
PubMed1991

Total hip arthroplasty after McMurray's osteotomy.

Total hip arthroplasty (THA) was done as a secondary procedure after McMurray's osteotomy in 15 cases, with a time lapse of 14-132 months between the two operations. Marked improvement in pain and function was achieved in 14 cases, although hip stiffness was greater than that in primary THA cases. It was noted that delay in THA enhanced the operative difficulties and decreased the overall improvement obtained. No special femoral component was employed, and extensive soft-tissue dissection was carried out to obtain near-normal hip biomechanics to decrease the chances of long-term loosening. Marked medullary canal distortion was encountered in eight cases. In spite of this, there were no cases with femoral shaft fractures. Trochanteric osteotomy should be employed in cases in which the canal is severely distorted. In these cases, routine antibiotic prophylaxis and adequate preoperative planning should be done.

Adult↗
PubMed1990

Bilateral anterior fracture dislocation of the shoulders.

A case of bilateral anterior fracture dislocation of the shoulders is reported. Treatment included an open reduction and internal fixation on the right side and a Neer hemiarthroplasty on the left. The probable cause of injury was trauma, although a convulsive episode cannot be ruled out. Bilateral biceps tendon interposition was also seen in this case.

Bone Wires↗
PubMed1990

Ipsilateral fractures of femoral neck and shaft.

Thirteen cases of ipsilateral intracapsular femoral neck and shaft fractures were seen. All cases occurred in young adults, with the mechanism of injury in all instances being high-energy trauma. The diagnosis of the femoral neck fracture was missed initially in four cases. The patients were divided into four groups according to treatment protocol: group 1 (two cases), both fractures treated nonoperatively; group 2 (four cases), femoral neck fracture treated nonoperatively, open reduction and internal fixation of femoral shaft fracture; group 3 (three cases), McMurray's osteotomy for femoral neck fracture and internal fixation for the femoral shaft fracture; and group 4 (four cases), open reduction and internal fixation of both fractures. The follow-up period ranged from 6 months to 10.1 years. There was a nonunion of one femoral neck fracture, while all shaft fractures united. The best results were seen in group 4 cases. It is also recommended that routine high-quality X-ray films of the hip should be done in all cases of femoral shaft fracture to decrease the high incidence of missed femoral neck fractures in ipsilateral injuries of the femur.

Female↗
PubMed1986

Treatment of femoral neck fractures with a cancellous screw and fibular graft.

Twenty-six patients with femoral neck fractures were treated by open reduction, cancellous screw fixation and free fibular grafting. The patients were between 14 and 50 years of age. There were 16 old and 10 fresh fractures. Four patients had radiological signs of avascular necrosis before the treatment was instituted. Bony union was achieved in all patients except one, where the failure occurred because of a technical error. The patients were followed up for at least two years. No new case of avascular necrosis was detected after treatment, and there was clinical and radiological improvement in all four patients with pre-operative avascular necrosis.

Adolescent↗
PubMed1976

Variations of some plasma components after closed fractures.

1) Variations in the serum concentrations of total proteins and the electrophoretic fractions, glycoprotein, mucoprotein, fibrinogen, erythrocyte sedimentation rate, calcium, phosphorus, alkaline, and acid phosphatases were analyzed until the 30th day following uncomplicated fracture of shafts of long bones of the limbs in 25 cases. 2) A significant fall of albumin with concomitant rise of alpha 1, alpha 2, and beta globulins were noted until 30th day. 3) Mucoprotein, glycoprotein, and fibrinogen showed parallel elevations with that of alpha and beta globulins. 4) The peak values of alpha 1 and alpha 2 globulins, mucoprotein, and fibrinogen were registered on the 10th day after trauma. Albumin showed maximum fall on the 10th day in all these cases. 5) Glycoprotein showed a peak value on the 5th day. 6) Total protein and gamma globulin remained almost unchanged throughout the studies. 7) Beta globulin showed higher values and paralleled more closely the fibrinogen and erythrocyte sedementation rates. 8) The elevations of beta globulin, fibrinogen, and erythrocyte sedimentation rate were higher, and persisted beyond 30 days in lower-limb fractures as compared to upper-limb fractures. 9) Serum calcium, phosphorus, alkaline phosphatase, and acid phosphatase were not significantly different following fractures and therefore did not reflect much physiologic variation. 10) The most significant changes in the levels of plasma fractions studied were conspicuous on the 10th day and lasted for about 1 month.

Acid Phosphatase↗