Biomedical subjects
Publications and source records attributed to P Moens.
The results of 12 surgically treated wrists with Madelung's deformity were reviewed. The correction was rarely achieved, but most patients (9/12) were satisfied. Only when the distal radioulnar joint was stabilized was an excellent result obtained. Our preferred technique has already been published (J. Ped. Orthop. 1993, 2-B, 96-98).
An EPR study of human tooth enamel dried at 400 degrees C is presented. Enamel blocks as well as powdered samples were investigated. The discussion deals mainly with three different spectral components, i.e., a CO3(3-) and two different CO2- signals. Using the anisotropic enamel block spectra, a convincing differentiation between the latter two radicals was possible. The first CO2- signal shows no dependence on the orientation of the enamel blocks, disappears from the spectrum upon heating, and was assigned to a surface radical. The second CO2- component is mainly responsible for the angular variation of the enamel blocks and is assigned to a bulk position. For the CO3(3-) ion, the (pseudo) angular variation of its isolated spectrum is presented and discussed. By means of the results presented in this study, earlier interpretation problems are considerably reduced.
The split posterior tibial tendon transfer procedure was first reported by Green for correction of equinovarus hindfoot deformity in patients with cerebral palsy. A modification of the split posterior tibial tendon transfer combined with an Achilles tendon lengthening is described in 17 children (21 procedures) with a minimum follow-up of 3 years. This modified technique is indicated in young children with a continuously spastic posterior tibial tendon to correct a dynamic equinovarus. It restores active dorsiflexion when the anterior tibial and extensor muscles are weak. The anterior half of the split tibialis posterior is transferred through the interosseus membrane to the dorsum of the foot. Excellent or good results and two poor results were noted after a mean follow-up of 29 months. In the patients with an excellent or good result, marked improvement of their equinovarus foot deformity in stance and swing phase of gait was seen. In two patients, the procedure failed because of technical errors.
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We describe a technique of femoral derotation osteotomy performed according to the Ilizarov principles of percutaneous corticotomy and fixation with a frame. We performed 24 femoral osteotomies in 16 patients, four with cerebral palsy and 12 with idiopathic femoral anteversion. All had rapid union and there were few complications. The advantages of the method include early ambulation, good control of rotation and axial alignment, and minimal scarring.
PURPOSE OF THE STUDY: CD instrumentation has been presented as a system which is able to achieve a 3-dimensional correction of idiopathic scoliose. We performed a prospective study about the apex derotation following CD instrumentation. MATERIALS AND METHODS: 24 consecutive patients with idiopathic scoliosis were included in this study. On pre- and postoperative CT scans the rotation angle relative to the sagittal plane according to Aaro and Dahiborn (RA sag) were measured the pre- and postoperative changes were evaluated with paired T-tests together with the significance. Kruskal Wallis tests were performed to correlate the mean values of those calculated changes with the number of instrumented levels and with the different King types of scoliosis. RESULTS: There was no statistical significant increase or decrease of the rotation if we consider the sag without taking into account the type of curve. DISCUSSION: The different ways to measure rotation in scoliosis are presented. The limits of the method we used (RA sag) are also discussed. We reviewed the literature concerning derotation with CD instrumentation to compare it with our results. CONCLUSION: The evaluation of rotation in scoliosis is not easy. The CT scan seems to be the best method. Nevertheless, the postoperative changes of the morphology of the patient can be a factor of error in rotational measurement.
Parallel and series compliances have been studied in extensor digitorum longus (fast) and soleus (slow) muscles in normal (strain C57BL/10) and dystrophic (strain mdx) mice, and in muscles regenerated after transplantation. Resting elasticity was analysed by measuring the tension-length relationship in unstimulated muscles. Passive tension is larger in mdx and in transplanted muscles than in their normal controls: at 1.15L0, passive tension is 0.12P0 in controls, 0.32P0 in mdx, and 0.40P0 in transplanted muscles. The differences are statistically significant. This indicates that passive tension is mainly determined by the amount of connective tissue. The stress-strain relationship of the series compliance was analysed by the method of isotonic releases during tetani. It is adequately described by a single exponential equation, with a rate constant of about 8P0/P. No difference was found between the various muscles studied. Extension of the series compliance at P0 is 0.02L0. Compliance is about 3% (L0/P0) at 0.2P0, and is not significantly different from zero at P0. Series compliance is thus very low in mouse muscles, substantially lower than in frog and rat muscles. Consequently, it can be neglected in studies of whole mouse muscle in which tension is higher than 0.4P0.
Holt-Oram syndrome is an autosomal dominant disorder with congenital heart defects and skeletal malformations of the upper extremities. A patient with a deletion of 14q23-24 and Holt-Oram syndrome has been described. In this report, however, genetic linkage to the 14q23-24 region is excluded in a multigeneration family with five available individuals affected with Holt-Oram syndrome. Familial Holt-Oram syndrome might be different from the syndrome with the 14q23-24 deletion.
MATERIAL AND METHODS: 38 feet in 36 patients who underwent a progressive foot correction without osteotomies, with an Ilizarov frame have been reviewed. There were 23 equinovarus, 2 equinovalgus, 13 equinus deformities. In 20 patients, the deformity had relapsed after one to four previous operations. The mean follow-up was 22 (12-35) months. The mean age was 17 years (6-68). There were 15 females and 21 males. RESULTS: All but 4 patients were satisfied with the result, although 15 still had pain during daily activities. The shape of the feet was distinctly improved in all patients, although residual equinus was found in 6 patients, residual varus in 2 and forefoot problems in 6. Pintract infections were encountered in half of the patients, all settled with local treatment, adjustement of the tension of the wires and antibiotics. Three specific complications were encountered: talus subluxations (7), toe contractures (6), relapse of equinus (4). DISCUSSION: Few alternatives are available to correct severe foot deformities. Soft tissue releases and/or wedge osteotomies are technically demanding, cause shortening of the foot, correct only one predominant component, are contraindicated in patients with infections or a poor vascular or skin condition. Progressive correction by the Ilizarov method is a valuable alternative, although we would like to stress the importance of some details in order to avoid the specific complications. Progressive correction of foot deformities by the Ilizarov frame is demanding for patient and surgeon. It should be reserved for the indications mentioned earlier and also for foot deformities combined with shortening or axial deviations.
We retrospectively reviewed 28 pin-removal procedures in 20 patients with slipped capital femoral epiphysis, who were all treated by in-situ pinning with Kowles pins. Failure to extract the pins occurred in 8 cases (28.6%), and in another 8 cases (28.68%), pin retrieval was only possible after major excavation of the lateral femoral cortex. In view of these data we do not recommend routine removal of Knowles pins used for in-situ pinning of slipped capital femoral epiphysis.
Absence of dystrophin in mdx muscles may render the muscle more susceptible to damage when submitted to high stress levels. To test this, typically slow (soleus) and fast (EDL) limb muscles of dystrophic (mdx) and normal (C57BL/10) mice were submitted (in vitro) to a series of isometric contractions, followed by a series of contractions with stretches. Muscle injury was assessed by monitoring the force signal. Membrane damage was evaluated by bathing the muscle in Procion Red, a dye that does not penetrate intact fibres, and subsequent analysis by light microscopy. After isometric contractions, only a very small force drop (< 3% of maximal isometric force) was observed which indicated that no injury had occurred in soleus and EDL muscles in either mdx or C57 strains. After contractions with a stretch, a force drop of 10% was observed in soleus muscles from both strains and in EDL muscles from C57 mice. However, in mdx mice EDL muscles displayed an irreversible force drop of 40-60%. Histological analysis of the muscles indicates that force drop is associated with membrane damage. These results show that EDL muscles from mdx mice are more vulnerable than their controls, supporting the structural role hypothesis for dystrophin. Furthermore, they suggest that contractions with stretches may contribute to the muscle damage and degeneration observed in DMD-patients.
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Resection of the distal-third of the fibula for tumor may improve important static troubles of the ankle. The authors report an original technique which permits to benefit to osteogenic ability of periosteum to produce new bone in children and teenagers. This technique avoids to take out autograft and permits a complete regeneration of the fibula, using a "lift" procedure. It can be also used when a large bone graft has to be taken in the medial-third of the fibula and when the periosteum is separable enough to be completely preserved.
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Acrometastases are rarely diagnosed. We present a new case. A literature review provides the opportunity to summarise the frequency, the clinical forms, the diagnoses, and proposed treatments. A biopsy of each chronic lesion in the hand, even without anamnesis seems to be indicated.
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Soleus muscles from C57BL/10 and mdx mice were isotransplanted to induce a cycle of degeneration/regeneration. Sixty days post-surgery, transplanted and contralateral soleus muscles were removed for mechanical and biochemical analyses. The regeneration which occurs after transplantation, induces in both mdx and C57BL/10 soleus muscles a decrease in maximal isometric force, together with an increase of the velocity of contraction. This increase in velocity is accompanied by the expression of typically fast-type myosin heavy chains. Thus degeneration/regeneration of both mdx and normal mice are very similar, causing a shift towards physiologically 'faster' muscle. Previous physiological and biochemical studies of mdx muscles have shown that mdx muscle is shifted towards 'slower' muscle compared to normal mice. One explanation of these findings was that the degeneration/regeneration cycles inherent in dystrophin-deficient mdx muscle causes a shift towards 'slow'. Our results argue against this hypothesis: degeneration/regeneration in both normal and mdx mice causes a shift towards 'fast'.
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