Search PubMed⌕ Search

Biomedical subjects

R T Loder

Publications and source records attributed to R T Loder.

14 recordsLinked to original sources
PubMed1992

Musculoskeletal aspects of prune-belly syndrome. Description and pathogenesis.

OBJECTIVE: To determine the types and prevalence of musculoskeletal involvement in children with prune-belly syndrome, and to analyze the pathogenesis of the syndrome in relationship to the musculoskeletal deformities. DESIGN: A retrospective review of charts and roentgenograms along with a comprehensive review of 188 cases from the literature. SETTING: Tertiary care children's hospital. PARTICIPANTS: Twelve boys treated between 1975 and 1990. MEASUREMENTS/MAIN RESULTS: The prevalence of musculoskeletal involvement in patients was 45%. The involvement can be congenital (eg, clubfeet, limb deficiencies, teratologic hip dysplasia, and vertebral malformations) or developmental (eg, renal osteodystrophy, scoliosis, and pectus excavatum and/or pectus carinatum). The embryologic characteristics of congenital musculoskeletal problems correlate better with the embryologic theory of the prune-belly syndrome (an aberration of mesenchymal development around 6 weeks of gestation) than with the distal urinary tract obstructive theory. CONCLUSION: Since children with prune-belly syndrome are now living into adulthood, these musculoskeletal aspects will become important regarding potential morbidity.

Adolescent↗
PubMed1992

Postoperative migration of the adductor tendon after posterior adductor transfer in children with cerebral palsy.

The adductor longus tendon was tagged with metallic markers after posterior adductor transfer in 17 children (33 hips) with cerebral palsy: 10 had spastic diplegia and seven had spastic quadriplegia. The average age at operation was 5 years 3 months, time of postoperative immobilization 5.7 weeks and average follow-up 1 year 7 months. In 19 hips the tendon remained attached to the ischium, in 11 hips it pulled away from the ischium and in three hips the result was equivocal. The incidence of detachment was higher among diplegic children than quadriplegic children.

Adolescent↗
PubMed1992

Slipped capital femoral epiphysis in black children.

We reviewed 74 black children with 97 slipped capital femoral epiphyses (SCFEs) with an average follow-up of 3.7 years. There were 24 bilateral, 22 right, and 27 left SCFEs. The average age at operation was 12 years 6 months. The average slip severity was 28 degrees with 61 mild, 21 moderate, and 14 severe slips. Group I slips (54) were treated with multiple pins, and group II slips (43) were treated with a single central screw. Satisfactory results were achieved in 74% of the group I and 91% of the group II slips, with only three cases of chondrolysis. We conclude that single central screw fixation of SCFE in black children can lead to excellent results with a low incidence of chondrolysis.

Adolescent↗
PubMed1991

Fracture patterns in battered children.

We reviewed cases of 75 battered children with fractures over a 2-year period. The average age was 16 months; 57% were boys. There were 154 fractures (2.0 per child); 77% were acute and 23% were old. The most common fracture occurred in the skull (32%) and the most common long bone fracture occurred in the tibia (16%). The most common long bone fracture pattern was transverse (41%); corner fractures accounted for 28% of long bone fractures. An isolated acute fracture was the orthopaedic injury in 65% of the children, whereas multiple fractures in various stages of healing were present in only 13% of children.

Battered Child Syndrome↗
PubMed1991

Spinal cord monitoring in patients with nonidiopathic spinal deformities using somatosensory evoked potentials.

Seventy-nine somatosensory evoked potentials were intraoperatively recorded in 52 patients undergoing spinal surgery for nonidiopathic spinal deformities. There were 37 true-negative, 28 true-positive (a significant change in the somatosensory evoked potential related to the surgical process), and 14 false-positive (a significant change in the somatosensory evoked potential not related to a surgical event) readings. There were, however, no postoperative neurologic deficits with any of the true-positive readings and no false negatives. Spinal and subcortical somatosensory evoked potentials gave few false-positive readings. True-positive somatosensory evoked potentials occurred in 44% of the patients with neuromuscular deformities, 17% with congenital deformities, 45% with Luque instrumentation, 22% with Harrington instrumentation, and none with fusion in situ. Fifty percent of the true positives occurred while the sublaminar wires were tightened. The predictive accuracy of intraoperative spinal cord monitoring in this patient population is not high, but the sensitivity to potentially harmful surgical events is high.

Child↗
PubMed1990

Seasonal variation of slipped capital femoral epiphysis.

To correlate the season of the year with the prevalence of slipped capital femoral epiphysis, we reviewed the cases of 177 patients who had 243 slips during an eleven-year period. We assessed the month when the patient was seen and the implied time of onset of the slip and found a statistically significant variation for both. The average time of onset was mid-June, with a standard deviation of 2.5 months, and was not significantly different for race, sex, or laterality. We attributed the increased incidence of slipped capital femoral epiphysis during the summer to increased physical activity in that season.

Adolescent↗
PubMed1979

Studies on gene control regions X. The effect of specific adenine-thymine transversions on the lac repressor-lac operator interaction.

Chemical and enzymatic methods were used to synthesize a transition (AT to GC) and a transversion (AT to TA) at a lac operator site known to interact with lac repressor through the thymine 5 methyl group. These operators also contained a poly(dA) . poly(dT) tail 8 to 12 base pairs in length at one end. Results suggest that the steric constraints of lac repressor relative to the position of the 5 methyl group are quite critical. For example a seven fold reduction in stability was observed for the transversion. Results also suggest that the operator spans at least 21 base pairs.

Adenine↗
PubMedDate not supplied

Orthopedic aspects of Rett syndrome: a multicenter review.

Twenty-three of 36 patients (64%) with Rett syndrome showed orthopedic problems at an average age of 8 years 7 months. Sixteen patients had spinal deformities (45%), six had scoliosis, one had sagittal deformity, and nine had scoliosis with sagittal deformity. Eight patients with scoliosis have shown progression, with two patients requiring surgery. Thirteen patients (36%) exhibited joint contractures; three of them have required surgery. Ten fractures occurred in five patients (14%). Coxa valga was present in all 14 hips. Skeletal ages in four preadolescent patients were normal.

Adolescent↗
PubMedDate not supplied

Association of congenital vertebral malformations with bladder and cloacal exstrophy.

The radiographs of 28 patients with bladder exstrophy and five with cloacal exstrophy were reviewed at an average age of 8 years 3 months to assess congenital vertebral malformations. Fourteen malformations in 11 patients were noted, including abnormal lumbosacral segmentation in five, congenital scoliosis and kyphosis in four, partial sacral agenesis in three, and interpedicular lumbar widenings in two. These findings are explained by an abnormal embryologic development of the spine and cloaca between 4 and 6 weeks of intrauterine life. We recommend entire spinal radiographs in these patients.

Abnormalities, Multiple↗
PubMedDate not supplied

Aortic anatomy in children with myelomeningocele and congenital lumbar kyphosis.

Preoperative aortograms were reviewed in six children with thoracic myelomeningocele and lumbar kyphosis at an average age of 25 months. In all children, the abdominal aorta bridged the lumbar kyphosis. In four children, the upper renal poles were close to the spine and were at potential risk during kyphectomy. All children had aortic shortening with an increased variability in origin of the major abdominal aortic branches. Abnormal lumbar arteries were noted in four children.

Aorta↗
PubMedDate not supplied

Extremity gunshot wounds in children.

A retrospective review of 85 children with extremity gunshot wounds at an average age of 12.3 years showed that 83% were male; there were 10 gunshot and 75 non-shotgun injuries. Thirty-eight children sustained 51 fractures. Seventy-six operations were performed. The average hospital stay was 7.3 days. There were no mortalities, secondary amputations, or progressive neurovascular deficits. There were two wound infections but no cases of chronic osteomyelitis.

Adolescent↗
PubMedDate not supplied

Late-onset tibia vara.

Fifteen children with late-onset tibia vara were studied. There were seven unilateral and eight bilateral cases. Eleven children were male, four were female and 13 were black; 14 were obese. All had a history of gradually progressive genu varus (average onset 11 years); 12 had preoperative knee pain. The average age at surgery was 12 years, with a preoperative tibiofemoral angle of 14 degree varus. The average follow-up was 4 years 4 months. The average tibiofemoral angle at follow-up was 0 degrees. There were 15 good, two fair, and six poor final results.

Adolescent↗
PubMedDate not supplied

Orthopaedic aspects of children with infectious (central nervous system) postnatal cerebral palsy.

Twenty-two children (15 girls, 7 boys) with postnatal infectious cerebral palsy were reviewed at an average age of 8 years. Orthopaedic deformities were noted in 82% of all children and involved the upper extremity (41%), spine (45%), hips (68%), knees (32%), and feet and ankles (55%). Both typical and atypical cerebral palsy deformities were noted, often severe. Surgical correction of deformities achieved 77% satisfactory results. Bony procedures did better than soft tissue procedures, especially around the hip.

Cerebral Palsy↗