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Biomedical subjects

R K Aaron

Publications and source records attributed to R K Aaron.

26 records · Page 2Linked to original sources

Laterally comminuted fracture-dislocation of the ankle.

Laterally comminuted fracture-dislocations of the ankle are highly unstable injuries in which anatomical reduction of the talus and restoration of fibular length and rotation are difficult. To our knowledge, no descriptions of the fracture pattern of these injuries and the surgical technique for treating them are available, and surgical results with this fracture have been disappointing. Discontinuity of the fibula as a result of comminution makes accurate assessment of fibular length and rotation impossible if the fibula is reduced first. Anatomical stabilization of the talus beneath the tibia is achieved by reduction and fixation of the medial malleolus. The fibular malleolus is then anatomically positioned in the lateral articular facet of the talus and fixed in this position. The osseous discontinuity of the fibula is grafted with bone. Clinical and radiographic results of the technique were highly satisfactory after a mean length of follow-up of thirty-four months.

Adult↗

Supracondylar fracture of the femur after total knee arthroplasty.

In a review of 250 total knee arthroplasties, five patients with rheumatoid arthritis incurred supracondylar fractures of the femur. These fractures may be associated with a surgical encroachment of the anterior femoral cortex during resection of the patellar trochlea. Forty-two percent of patients with excessively deep resections of the patellar trochlea suffered fractures. No fractures occurred in patients without encroachment of the anterior femoral cortex. All patients with fractures also had significant osteoporosis, which may have predisposed them to fracture. A resection of the patellar trochlea that is made too deeply would interrupt the transmission of stresses through the cancellous bony trabeculae of the anterior femoral cortex and could predispose to fracture.

Aged↗

The relationship of intravascular coagulation and fibrinolysis to venous thrombosis following total hip replacement.

Soluble fibrin complexes, fibrin degradation products, and anti-thrombin III levels were determined in the plasma of 20 patients undergoing elective total hip replacement. The presence of deep venous thrombophlebitis was determined by venography at the end of the first postoperative week. Patients who developed thrombosis exhibited impairment of fibrinolysis as de-Patients who developed thrombosis exhibited impairment of fibrinolysis as detected levels of anti-thrombin III and soluble fibrin complexes were not useful in indicating the presence of deep venous thrombosis. However, the preoperative level of soluble fibrin complexes closely correlated with the subsequent development of thrombosis. Elevated soluble fibrin complexes appear to identify a group of patients with activated coagulation systems who are prone to develop thrombosis during total hip replacement.

Antithrombin III↗