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Biomedical subjects

R N Stauffer

Publications and source records attributed to R N Stauffer.

At least 37 records · Page 2Linked to original sources
PubMed1979

Limb fractures in a defined population. I. Frequency and distribution.

This population-based study revealed that 2,519 limb fractures occurring during a 3-year period produced an age-adjusted incidence rate for all limb fractures of 1,596 per 100,000 person-years. Fractures of the upper limb had a bimodal age distribution and were commoner than those of the lower limb, which had a J-shaped age distribution. The most frequent anatomic site was the lower end of the radius and ulna. Limb fractures occurred as solitary events in 93% of cases; only 4% were classified as open and more than half of the total were closed and undisplaced. Fractures were distributed evenly throughout all time periods of the day. The commonest place of fracture occurrence was the home, and the most important direct cause was falls, particularly in females. A wide range of sports activities were a major source of fractures, particularly in younger males. Underlying bone pathology was uncommon, other contributory causes being more important, particularly in the elderly. The increased ratio of metaphyseal to diaphyseal fractures with age indicated a relative loss of cancellous bone in the elderly, but no evidence was found to suggest that elderly women had reduced resistance of bone to impact forces in comparison with elderly men.

Accidents, Home↗
PubMed1979

Limb fractures in a defined population. II. Orthopedic treatment and utilization of health care.

This study describes the orthopedic treatment and utilization of health care obtained by 2,333 patients in the population of Rochester, Minnesota, who suffered 2,519 limb fractures during the period 1969 through 1971. Overall, 24% of fracture occurrences required patient hospitalization, the remainder involving care on an ambulatory basis only. The mean number of physician visits was 4.5 per fracture, with the visits occurring during an interval of 103 days from the time of first evaluation. Fifteen percent of limb fractures were subject to at least one surgical operative procedure as part of their orthopedic treatment. The frequency of operative treatment increased markedly with patient age. Seventeen percent of patients with limb fractures received physiotherapy or occupational therapy or both, 4% were ambulatory patients, and the remainder were hospital inpatients. Fractures of the head and neck of the femur constituted only about 7% of fractures in the series, yet utilized an inordinate proportion of health care resources. Hip fractures were responsible for 27% of the hospital admissions, 52% of all bed days utilized, and 56% of the physiotherapy sessions.

Adolescent↗
PubMed1977

Severe degenerative joint disease. Mild and moderately severe hemophilia A.

Severe degenerative joint disease developed in three adults with mild to moderately severe hemophilia A, as judged by the clinical course and by levels of factor VIII coagulant. Bilateral total hip arthroplasty was required in one patient, unilateral hip arthroplasty in the second, and a recommendation for bilateral knee replacement in the third. The pathogenesis of the arthropathy may be multifactorial and the result of repeated joint hemorrhage that remains unrecognized and inadequately treated. These observations suggest the need for more careful monitoring of patients who have relatively mild hemophilia.

Adult↗
PubMed1977

Quo vadis.

Explore the source record for details and available documents.

Arthroplasty↗
PubMed1977

Total ankle joint replacement.

The ankle is an inherently stable, kinematically simple joint that bears tremendous compression forces with relative ease because of a large load-bearing surface area. Disabling disease of the ankle is less common than at the hip or knee joints, but is not rare. Ankle arthrodesis seems less than ideal as a technique of surgical treatment. Total ankle joint replacement seems to be a clinically possible alternative on the basis of experience with 76 procedures performed during a 31-month period. Continuing clinical experience is resulting in more gratifying results by the avoidance of technical errors and better selection of patients.

Adult↗
PubMed1977

Muscle force analysis of the lumbar spine.

A mathematical analysis of the complex musculature controlling the lumbar spine was performed, using computer analysis of muscle areas seen on serial cross sections through two fresh human cadaver trunks. Physiologic cross sectional areas were used to approximate maximal potential forces generated, and three dimensional centroid lines of muscles were used to approximate their direction of action. Results indicate that the total extensor moment exceeds the total flexor moment only slightly; the rectus abdominis, internal oblique, and external oblique muscles contribute approximately one third to total flexor moment; the erector spinae group of muscles contributes approximately one half of the total extensor moment; and in rotation (twisting) the large abdominal oblique muscles dominate over small "rotator" muscles of the spine. The maximal calculated total extensor moment was 2860 kg.-cm. The magnitude of flexor and extensor moments suggests that the rise in intra-abdominal pressure during lifting is produced by the transverse and posterior oblique abdominal muscles, and not by the rectus abdominis.

Biomechanical Phenomena↗
PubMed1977

Force and motion analysis of the normal, diseased, and prosthetic ankle joint.

A 2-dimensional motion and force study of the ankle joint during gait has been carried out on normal subjects and patients with ankle joint disease, before and 1 year following total ankle replacemetn. The methods employed involved the use of high-speed motion picture film, force plate and foot-switch data. The Achilles and anterior tibial tendon forces, the compressive and tangential (shear) forces across the ankle during stance phase of gait were determined, based on a quasi-static analysis. During stance phase of gait normal subjects used a mean of 24.4 degree of sagittal plane ankle motion. Patients with ankle joint disease showed reduced motion which returned to near normal values 1 year following total ankle replacement. Compressive force across the ankle joint rose to about 5 times body weight during the latter part of stance phase. Backward, or aft, shear forces or nearly full body weight were demonstrated during all but the last 20% of stance phase. Patients with ankle joint disease apparently altered their gait to markedly reduce these forces. Following total ankle replacement, shear forces returned toward more normal values, but compressive forces were not significantly changed.

Adult↗
PubMed1976

Total hip arthroplasty in Paget's disease of the hip.

For thirty-two patients with Paget's disease of the pelvis, mechanical disruption of the hip joint caused sufficient pain and disability to require total hip-replacement arthroplasty. Three of the patients had had fractures of the femoral neck. No unusual complications were encountered and the results were excellent.

Aged↗
PubMed1976

Functional evaluation of normal and pathologic knees during gait.

The functional performance of the knee joints of 29 normal volunteers, 65 patients with degenerative joint disease and 30 patients with rheumatoid arthritis was studied according to clinical (historical, physical and roentgenographic) and biomechanical gait parameters. Temporal and distance gait factors (velocity, cadence and stride length) were significantly reduced in patients with diseased knees. Sagittal plane knee motion was markedly reduced, as was stance phase flexion, indicating poor tolerance of loading the flexed knee in the patient groups. There was no correlation between passive motion of the diseased knee and the amount of motion used during gait. Patients with rheumatoid arthritis generally showed more compromise of knee joint function than did patients with degenerative joint disease. Statistically, significant correlations between various clinical and biomechanical gait parameters suggest that the techniques used are an objective measurement of knee joint function and may be employed as a means of evaluating various treatment modalities for the diseased knee.

Arthritis, Rheumatoid↗
PubMed1975

Pyogenic vertebral osteomyelitis.

Pyogenic vertebral osteomyelitis is a disease of adults that should be distinguished from true disk space infection. It is due to a hematogenous seeding (either venous or arterial) of the subchondral bony elements of the vertebral body. The disk space is involved secondarly, later in the course of the disease. The underlying bacteremia is from another focus of infection, frequently in the urinary tract. Disk space infection in adults is caused by direct violation of the disk, most commonly at the time of surgical excision of the nucleus pulposus. The bony elements of both adjacent vertebral bodies are secondarily involved. The clinical feature common to both types of infection is back pain that generally begins insidiously and then gradually increases in severity and becomes continuous and is accompanied by marked muscle spasm. The sedimentation rate is always increased; it decreases only with resolution of the infection. The diagnosis of vertebral infection is often not suspected because fever and leukocytosis generally are absent. The most common organism is Staphylococcus aureus, although gram-negative bacterial infections also occur. Bacteriologic diangosis should be sought in each case by blood cultures (generally negative with postoperative disk space infection) or percutaneous needle biopsy. Soft tissue abscesses may require open débridement and drainage. Treatment of both types consists of rest, immobilization, and specific antibiotic treatment. The prognosis for resolution of the infectious process within six to nine months, with adequate treatment, is excellent.

Adult↗