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Biomedical subjects

R N Hensinger

Publications and source records attributed to R N Hensinger.

At least 91 records · Page 5Linked to original sources
PubMed1976

Rotational problems of the lower extremity.

Rotational abnormalities in the lower extremities are common in the growing child, but they seldom represent any serious handicap in adult life. When confronted with such a problem, the physician should carefully rule out any underlying pathologic abnormality and should approach the problem in a step-wise fashion. The component parts of the lower extremity should be examined carefully and individually to assess their role in the rotational problem. The usual causes of internal rotation problems, or toeing in, are metatarsus adductus, internal tibial torsion, and femoral anteversion. External rotation problems are infrequent and pose fewer problems. These include calcaneovalgus, external rotation of the tibia, and external rotatory contractures of the lower extremity. The natural history of these conditions favors improvement with time. However, some patients may require conservative treatment, such as stretching and splints. Rarely, a patient may require surgical intervention.

Child↗
PubMed1976

Spinal deformity associated with heritable neurological conditions: spinal muscular atrophy, Friedreich's ataxia, familial dysautonomia, and Charcot-Marie-Tooth disease.

Children with progressive neurological conditions such as spinal muscular atrophy, Friedreich's ataxia, familial dysautonomia (Riley-Day syndrome), and Charcot-Marie-Tooth disease have a significant risk of acquiring a serious spinal deformity. As with paralytic scoliosis following poliomyelitis, the curves are difficult to control with bracing, and progression does not cease with maturation. An increasing spinal curvature may lead to loss of ambulation or, for the wheelchair-bound patient, loss of sitting balance. The curvature may further compromise pulmonary function that may already be compromised by the neurological deficit. Twenty patients are reported with an average follow-up of six years (range, one to fourteen years). For the properly selected patient, surgical stabilization of the spine arrested the progress of the curve and improved function. Complications were few; however, pseudarthrosis was more common than in patients with non-neurological problems.

Charcot-Marie-Tooth Disease↗
PubMed1975

Gangrene of the newborn. A case report.

Gangrene of the newborn is an uncommon condition usually resulting from decreased perfusion of a part, usually an extremity. There are a variety of situations which can result in this condition. Knowledge of the exact sequence of events which lead to the insult and the conditions surrounding it is helpful in determining the etiology and as a consequence the treatment of the lesion. In the patient described, direct pressure from the maternal pelvis was probably the contributing factor which led to venous occlusion of the extremity. Arterial thrombosis, emboli, trauma, congenital heart disease, sepsis, dehydration, coagulopathies, and venipuncture are other possible causes which should be considered. The treatment is in general supportive, allowing the ischemic area to demarcate and slough. Range-of-motion exercises and splinting to avoid contracture are helpful in the rehabilitative phase.

Adult↗
PubMed1975

Congenital dislocation of the hip associated with central core disease.

Central core disease is a congenital, non-progessive myopathy with proximal muscle weakness most prevalent about the pelvic girdle. Including out two patients there have been seven recorded cases of congenital hip dislocation associated with central core disease in children. Initial and recurrent contractures about the hip and knee should suggest the possibility of central core disease. However, the definitive diagnosis can only be made by muscle biopsy.

Adult↗
PubMed1974

Cast collar.

Explore the source record for details and available documents.

Casts, Surgical↗
PubMed1974

Klippel-Feil syndrome; a constellation of associated anomalies.

Of fifty patients with the diagnosis of Klippel-Feil syndrome, less than half had the classic clinical triad of findings, while more than half had scoliosis, and a third had renal anomalies. All patients were at risk of having other serious, but less apparent, anomalies, including: Sprengel's deformity (twenty-one patients), impairment of hearing (fifteen patients), synkinesia (nine patients), and congenital heart disease (seven patients). The discovery of one of these lesions should, therefore, stimulate a careful search for associated anomalies.

Abnormalities, Multiple↗
PubMedDate not supplied

Hip arthroscopy using a limited anterior exposure: an alternative approach for arthroscopic access.

SUMMARY: Hip arthroscopy is a technically difficult procedure to perform. A limited anterior approach to the joint has made hip arthroscopy technically less difficult in our hands and has enabled us to treat a wide range of hip pathology. Five hip arthroscopies were performed using a modified 4-cm Smith-Petersen anterior approach to the hip exposing the joint capsule as manual traction is applied. The arthroscope is then easily introduced making visualization of the hip joint possible. The 5 hip arthroscopies resulted in either removal of loose bodies or debridement of an osteochondral fragment, synovitis, or cartilaginous debris. There were no complications postoperatively. We believe that hip arthroscopy through a limited anterior approach provides an easy and safe alternative method for arthroscopic access to the hip joint. Importantly, there is a decreased risk of neurovascular trauma and iatrogenic damage to the articular cartilage and acetabular labrum when introducing instruments into the hip joint.

Adolescent↗
PubMedDate not supplied

Role of intentional abuse in children 1 to 5 years old with isolated femoral shaft fractures.

We reviewed 42 children, aged 1-5 years, with isolated femoral shaft fractures to investigate the possible role of intentional injury in these children. Those children with documented motor vehicle accidents or pathologic fractures were excluded. Follow-up from the Department of Social Services regarding the potential for the fractures being inflicted was obtained. The average age of the children was 3.1 +/- 1.2 years; the fracture was spiral in 28. oblique in six, and transverse in eight; history of a fall was present in 34 and absent in eight. The history was considered suspicious for intentional injury in 14 children. In all 42 children, only one fracture was documented to be inflicted; one other child had prior documentation of intentional injury. From this review, the likelihood of intentional injury to the femoral shaft appears to be low; unfortunately, there were no discriminating clinical parameters to help to determine which injuries were intentional. The clinician should continue to have a high index of suspicion and have the circumstances investigated if concern exists regarding the fracture.

Age of Onset↗
PubMedDate not supplied

Lower extremity lawn-mower injuries in children.

Lower extremity lawn-mower injuries in children result in significant morbidity with a significant financial burden to the family and society. We reviewed 24 children with lower extremity lawn-mower injuries; all mothers completed standardized psychologic assessments of their children, and 18 children were interviewed. Fifty percent of the mothers had defensive profiles on the standardized psychologic assessment, suggesting the likelihood of denial or underreporting of the child's psychologic difficulties. Therefore, we found the interview with the child to be a more accurate measure of psychologic distress. Prevention measures aimed at parents must emphasize that a child must not be allowed in a yard that is being mowed with a riding mower.

Accident Prevention↗
PubMedDate not supplied

Slipped capital femoral epiphysis associated with renal failure osteodystrophy.

A retrospective institutional and literature review of 31 children (20 boys and 11 girls) with 58 renal failure-associated slipped capital femoral epiphyses (RFASCFEs) was performed. The average age at diagnosis of renal failure was 8.9 years, and for RFASCFE 11.5 years, with a linear correlation between these two ages. All patients had secondary hyperparathyroidism at diagnosis of the RFASCFE. The median height and weight were below the 5th percentile. The RFASCFEs were stable and bilateral in 95% of the children. Slip magnitude was mild in 53%, moderate in 8%, and severe in 39%. Avascular necrosis was associated with steroid immunosuppression in children with renal transplants. All children were treated with medical management; surgery was used in an additional 29 hips. If correction of secondary hyperparathyroidism is not achieved within 2 months, RFASCFEs are likely to progress and surgical stabilization is recommended.

Adolescent↗
PubMedDate not supplied

Slipped capital femoral epiphysis associated with radiation therapy.

We reviewed 32 children with 41 radiation-therapy associated slipped capital femoral epiphyses (RTASCFE). Ten were from the authors' institutions and 22 from the literature. Gender distribution was equal. The age at diagnosis of the malignancy was 4.3 +/- 3.1 years; the amount of radiation was 4,240 +/- 1,445 rads. Children with RTASCFE presented younger (10.4 +/- 3.2 years) than a routine SCFE. The average symptom duration was 5 +/- 6 months. Children with RTASCFE are usually thin (median weight, 10th percentile) in contrast to children with typical SCFE, who are usually obese (<95th percentile). The majority (82%) of the slips were mild, compared to routine SCFEs (approximately 50%); 28% were bilateral. There was a positive linear relationship between the age at presentation of the SCFE and the age at diagnosis of the malignancy; there was a negative linear relationship between the age at presentation of the SCFE and the amount of radiation therapy.

Adolescent↗
PubMedDate not supplied

The induction of congenital spinal deformities in mice by maternal carbon monoxide exposure.

Carbon monoxide (CO) has been shown to be teratogenic in mice. High altitude hypoxia has also been shown to induce congenital vertebral anomalies in mice. The purpose of this study was to investigate the effect of maternal hypoxia owing to CO exposure and the production of congenital spinal deformities in the offspring. Sixty DBA-1J mice were bred using polygamous timed breeding methods. Pregnant females were exposed to 200, 400, or 600 ppm CO using a custom-designed gas blender system. Seven-hour exposures were performed on day 8.5, 9.5, or 10.5 of the 21-day gestation cycle. The neonates were euthanized at birth; the specimens were fixed, eviscerated, and radiographed. Congenital spinal deformities were observed (wedge, hemi, fused, and missing vertebrae; fused ribs) and were located in all regions of the spine. There was a statistically significant difference in the number of spinal deformities between all groups, with no defects in the controls and a 77% incidence at 600 ppm (p < 0.0001). There was no apparent correlation between the time of exposure and defect location. The most sensitive time of gestation was 9.5 days. We identified an animal model of congenital spinal deformities that compares favorably with the evidence of human congenital spinal deformities in cases of maternal exposure to CO and other gas and chemical fumes.

Animals↗