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Biomedical subjects

R T Morrissy

Publications and source records attributed to R T Morrissy.

At least 37 records · Page 2Linked to original sources
PubMed1984

Principles of psychomotor skills courses.

Surgical education has not shown much progress in the past few hundred years. We have more to teach, and we have formalized and fancied the process, but it essentially remains the same--the preceptor model in the clinical setting during formal education and passive learning without feedback after that. Few would question, therefore, that new and innovative techniques in surgical teaching need to be explored. Psychomotor skills teaching is one method. It is important that both teacher and student realize that it is being evaluated and will change. Perhaps it, like much of continuing medical education, will give way to cost control. Or it may become a standard in postgraduate education. Whatever happens, a careful consideration of its fundamentals leads me to believe that psychomotor skills teaching may be the best thing that has happened to surgical education in this century.

Humans↗
PubMed1984

Deformity following distal humeral fracture in childhood.

We are reporting five cases of a seldom-reported complication following fracture of the distal end of the humerus during childhood. The complication consists of dissolution of a variable portion of the trochlea at a variable time after fracture. The fractures ranged from non-displaced to severely displaced supra-condylar fractures along with a lateral condylar fracture and a Salter-Harris Type-I fracture. The severity of the fracture did not correlate with the severity of the deformity. When the defect in the trochlea was wide enough to permit migration of the ulna proximally, the range of flexion and extension was severely affected. Excision of the olecranon in one twelve-year-old boy resulted in a moderate increase in extension.

Child, Preschool↗
PubMed1983

Localised immune complexes and slipped upper femoral epiphysis.

Slipped upper femoral epiphysis remains a disease of unknown aetiology. Recent evidence has bolstered speculation that the immune system may play a role in the aetiology or pathogenesis of slipped epiphysis or of one of its complications, chondrolysis. This study reports the finding of immune complexes in the synovial fluid of all but one hip affected with slipped epiphysis in a consecutive series. In seven patients, immune complexes were detected by both the Raji cell assay and C1q-binding assay; in two, by the C1q-assay only; and in one, by the Raji cell assay only. No patients had immune complexes in the serum. Twenty-one patients with synovitis of the knee or hip caused by a variety of disorders served as the control group. Two of these patients had immune complexes in their synovial fluid. It appears that the immune complexes characterise the synovitis found with slipped upper femoral epiphysis as distinct from most other synovitides.

Adolescent↗
PubMed1982

Congenital pseudarthrosis of the tibia. Factors that affect results.

Congenital pseudarthrosis of the tibia is a rare disease of unknown etiology and variable natural history. Treatment offers a high percentage of poor results. The decision of when the limb will be cosmetically and functionally better than a below-knee prosthesis is a critical one that the orthopedic physician must reach with the patient. The presence or absence of neurofibromatosis apparently does not alter the result. Those cases which show a cystic radiographic appearance have a more favorable prognosis than those which become or present as dysplastic. The more times the patient is bone grafted without success, the worse the result is likely to be. Shortening of the limb is not only important from a functional standpoint but may also serve as a prognostic index for the difficulty of achieving union as well as subsequent problems with ankle stiffness, pain, and deformity. The response to grafting may also be an important factor in determining the result; those patients who rapidly resorb the graft have a poor chance for a successful outcome. It does not appear that the type of bone grafting procedure is of large significance unless the graft has its own blood supply. Although prophylactic grafting cannot be demonstrated to alter the natural history of this disease, it, along with other developmental techniques, may be advisable.

Bone Neoplasms↗
PubMed1981

Synovial immunofluorescence in patients with slipped capital femoral epiphysis.

To evaluate if the immune system is active in slipped capital femoral epiphysis (SCFE) or chondrolysis, 16 patients with SCFE were studied by evaluation of their serum immunoglobulins, histology of their synovium, and immunofluorescent staining of their synovium. Patients with Perthes' disease, chondromalacia patellae, septic arthritis, sickle cell disease, and torn meniscus were controls. Serum immunoglobulins were normal in all patients. The histology demonstrated synovitis in all patients except in one normal knee. Plasma cells were a prominent feature of the synovitis in the patients with SCFE. Three patients had positive synovial immunofluorescence for IgG and C3. Two of these patients subsequently developed chondrolysis and one did not. One additional patient who had negative synovial immunofluorescence developed chondrolysis. It is postulated that the immune system is active in some patients with SCFE, but what, if any, role it plays in the disease or its complications remains to be shown.

Adolescent↗
PubMed1981

Congenital pseudarthrosis of the tibia.

Forty cases of congenital pseudarthrosis of the tibia were reviewed. The results were assessed so as to emphasise function rather than simply the presence or absence of union. At the time of review, 14 patients had undergone amputation; eight others had non-union or tenuous union. No surgical procedure except the Farmer operation (a composite skin and bone pedicle graft from the other leg) showed any clear superiority. Among the factors associated with a poor result were considerable shortening, older children, and rapid resorption of the bone graft. It is felt that congenital pseudarthrosis of the tibia is a biological problem and not merely a mechanical one; consequently biological approaches to its treatment are needed.

Adolescent↗
PubMed1980

Low efficacy radiography of children.

Radiographic procedures performed at a 100-bed pediatric hospital were reviewed jointly by a radiologist and the primary physician staff. The reviewers judged several procedures to be performed unnecessarily, with undue patient risk or cost. Low efficacy examinations were divided into two categories: (1) low-yield examinations with significant gonadal radiation as well as significant cost, and (2) low-yield examinations with low gonadal radiation but significant cost. A joint policy recommendation was then delivered to the house staff concerning appropriate indications for the performance of these low-yield procedures. This active review process is submitted as a model for other medical facilities that seek to reduce risk and cost to the pediatric patient.

Angiography↗
PubMed1979

Dislocation of the distal radioulnar joint: anatomy and clues to prompt diagnosis.

The articular disk is a strong, complex structure responsible for the stability of the distal radioulnar joint. It is injured by a hyperpronation or hypersupination injury which disrupts the disk or its strong central attachment to the ulna. Prompt diagnosis is essential for a good result as no good late reconstruction is available. Reliance on radiographs for the diagnosis will seldom be rewarding, and they are mainly of value in ruling out associated fractures. A careful clinical examination and a high index of suspicion are the best tools available for diagnosis in this injury.

Female↗
PubMed1977

Distal radial fracture with tendon entrapment. A case report.

Entrapment of the extensor pollicus longus tendon can occur in distal radial fractures of the Smith type. This can be recognized by failure to obtain good reduction and inability of the patient to extend the thumb after reduction. The treatment is surgical and should be through a dorsal approach which allows repositioning of the tendon and internal fixation of the fracture.

Adult↗
PubMed1976

Spina bifida.

Explore the source record for details and available documents.

Adult↗
PubMedDate not supplied

Idiopathic torticollis: sternocleidomastoid myopathy and accessory neuropathy.

Biopsies of the two heads of the sternocleidomastoid muscle were studied in 9 children with idiopathic torticollis, from 8 months to 17 years of age, who were undergoing surgical release of the sternal and clavicular attachments on the side of the contracture. Extensive fibrosis involved mainly the sternal head. Nonspecific myopathic changes, also mainly in the sternal head, included cytoarchitectural alterations of muscle fibers, necrosis, and focal inflammation. Histochemical type grouping and grouped atrophy were extensive in some cases and present in all except one, but the clavicular head was predominantly involved. Denervation and reinnervation are common chronic features in idiopathic torticollis, probably secondary to entrapment neuropathy: the accessory nerve reaches the clavicular head by passing through the sternal head. Separate arterial supplies predispose to ischemia in the sternal head, resulting in focal myopathy and fibrosis.

Adolescent↗