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Biomedical subjects

R D Fitch

Publications and source records attributed to R D Fitch.

23 records · Page 2Linked to original sources
PubMedDate not supplied

Tibial tubercle avulsions.

Avulsion of the tibial tubercle is not common. Sixteen cases are recorded, with a mean age of 15 years 2 months. All subjects were boys, 15 cases were left-sided, and three individuals had other associated knee injuries. All were treated operatively. Immobilization time averaged 4.9 weeks, with a mean follow-up of 15 months. Fourteen subjects regained full motion and activity. Three complications were noted, none of which was associated with this injury. This injury occurs in a vulnerable period when the physis is undergoing physiologic changes that weaken its ability to resist tensile loading.

Adolescent↗
PubMedDate not supplied

Pediatric traumatic atlanto-occipital dislocation: five cases and a review.

Traumatic atlanto-occipital dislocation (AOD) has been thought to be a rare and fatal injury. Recently, more survivors, especially children, have been reported. During a 10-year period, the authors have encountered five children with traumatic AOD. A retrospective review of traumatic AOD in children from 1985 to 1995 was performed. Clinical presentation, initial radiologic findings, and final outcome were emphasized. Distance from the dens to the basion and the ratio of Powers were measured from initial lateral cervical spine radiographs. The average distance from the dens to the basion was 9.8 mm. The average ratio of Powers was 1.38. There were three survivors, two having a concomitant spinal cord injury. All survivors underwent a posterior occipitovertebral fusion. Three cases initially went undiagnosed. The diagnosis of AOD by lateral cervical spine radiographs can be difficult. The authors recommend detailed measurements of the initial cervical spine radiographs in pediatric patients at risk for traumatic AOD.

Atlanto-Occipital Joint↗
PubMedDate not supplied

Comparison of Cotrel-Dubousset and Harrington rod instrumentations in idiopathic scoliosis.

An analysis of the efficacy of two techniques of posterior spinal instrumentation in patients with idiopathic scoliosis was performed. Thirty-two consecutive patients treated with Cotrel-Dubousset instrumentation and no external bracing were compared with 30 consecutive patients treated with Harrington rod instrumentation supplemented by Bobechko hooks, sublaminar wires, and postoperative bracing. The groups were similar in age, curve magnitude, and type. Cotrel-Dubousset instrumentation demonstrated significantly improved immediate frontal plane correction. It was also more effective in improving thoracic kyphosis, particularly in patients with preoperative hypokyphosis. Both procedures were performed with similar operative time, blood loss, and minimal complication rates.

Adolescent↗
PubMedDate not supplied

Plastic deformation in pediatric fractures: mechanism and treatment.

The plastic deformation often observed in children's long bone fractures is due largely to the complex nature of the molecular and histologic aspects of pediatric bone. Pediatric cortical bone has a lower mineral content than adult bone, accounting in part for its different material properties. Although plasticity allows children's long bones to absorb more energy prior to fracture, a significant deformity may persist after injury. An algorithm and technique for treatment of plastic deformation of the radius and ulna, the two most commonly involved bones in plastic deformation, are reviewed.

Adolescent↗