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Biomedical subjects

S R Skinner

Publications and source records attributed to S R Skinner.

32 records · Page 2Linked to original sources
PubMed1980

Functional evaluation of the pes anserinus transfer by electromyography and gait analysis.

The effectiveness of the pes anserinus transfer, proposed by Slocum and Larson to control anteromedial rotatory instability of the knee, depends on the pes anserinus muscles contracting at times when the instability threatens the patient's function. To examine the activity of the transferred pes anserinus muscles, quantitated dynamic electromyography, isometric testing of muscle strength, and gait-analysis techniques were employed. Seven normal subjects and nine patients who had undergone pes anserinus transfer for anteromedial rotatory instability were tested. In contrast to the normal subjects, who demonstrated pes anserinus muscle activity primarily during swing phase, the patients displayed conspicuous activity of the semitendinosus, gracilis, and sartorius tendons during stance phase. Quantitated electromyography indicated that the pes anserinus muscles worked harder in the patients than in the normal subjects, and more effort was required from the muscles of patients with poor results than from those of patients with good results. All of the patients also demonstrated reduction of single-limb support time, as well as a shorter stride length and reduced gait velocity. We concluded that the pes anserinus transfer is kinetically sound. Since instability of the knee is a functional defect that is present during stance, the finding of marked activity of the pes anserinus muscles during stance phase in the patients but not in the normal subjects suggests that these muscles were being used to control the instability.

Adolescent↗
PubMed1978

Valgus slip of the capital femoral epiphysis.

Valgus slip of the capital femoral epiphysis, a rare entity which may be acute or chronic, occurred in a 12-year-old boy. The displacement may be associated with a pre-existing coxa valga. The patient also had a varus slip of the capital femoral epiphysis on the contralateral side. Both hips were successful treated by in situ pinning. A review of the English literature reveals only 8 previously reported cases of valgus slipping of the capital femoral epiphysis. Either valgus or lateral slips are unusual.

Child↗
PubMedDate not supplied

Results of hip arthrodesis in adolescents by using the cobra-head plate for internal fixation.

A retrospective study was conducted to examine the efficacy and potential morbidity of hip fusion using the Cobra-head plate in adolescents. A heterogeneous group of 11 adolescents, with recalcitrant hip pain and an average age of 14.6 years, underwent unilateral hip arthrodesis with the Cobra-head plate for internal fixation. Seven (64%) patients achieved an uneventful clinical and radiographic arthrodesis after a mean postoperative interval of 7.4 months. Four index operations (36%) were complicated by pseudarthrosis. All patients who developed a postoperative pseudarthrosis ranked at or above the 90th percentile for their age-determined weight. The relationship between the percentile-weight-for-age and the incidence of pseudarthrosis was statistically significant (p < or = 0.001). Hip-arthrodesis procedures with the Cobra-head plate in adolescents at or above the 90th percentile weight-for-age are associated with an unacceptably high rate of pseudarthrosis. In this subset of patients, alternate or supplementary stabilization methods should be considered.

Adolescent↗
PubMedDate not supplied

An analysis of posture and gait following spinal fusion with Harrington instrumentation.

This study was stimulated by a paretic spinal injury patient who required crutches for a forward lean, which his trunk developed following spinal instrumentation. Ten patients who underwent Harrington instrumentation to correct scoliosis also displayed reduced lordosis. Partial compensation by increased lumbosacral angle occurred when this joint was open. The patients' standing posture and that of 11 normal adults were assessed with the visible vector system. Five stood with excessive hip hyperextension and three had exaggerated knee flexion. The latter three also demonstrated, during walking, inadequate terminal swing knee extension with excessive knee flexion and ankle dorsi-flexion during stance. There was increased frontal and sagittal sway in four patients.

Adolescent↗
PubMedDate not supplied

Three-dimensional digital displays in congenital dislocation of the hip: preliminary experience.

Four patients with congenital dislocation of the hip (CDH) were studied on a research basis with three-dimensional computed tomography (3-D CT) or, alternatively, with three-dimensional magnetic resonance imaging (3-D MR). 3-D CT and 3-D MR proved useful in demonstrating the extent of anterior and posterior acetabular coverage. 3-D CT was limited to patients greater than 6 months of age with ossified femoral heads. 3-D MR, in contrast to 3-D CT, demonstrated the cartilaginous femoral head in children less than 6 months of age, while avoiding gonadal irradiation. Both 3-D CT and 3-D MR appear promising in confirming the diagnosis and facilitating the choice of treatment modality in the child with complicated CDH.

Child, Preschool↗
PubMedDate not supplied

Effects of ankle-foot orthoses on the gait of children.

Gait analysis was performed on five normal children walking barefoot with bilateral double-upright ankle-foot orthoses (AFOs) and with plastic AFOs. When orthoses were worn, walking speed and cadence were reduced and quadriceps EMG timing was prolonged. Changes in lower extremity motions and torques were observed. The metal-and-leather AFOs impaired normal walking, more than the plastic orthoses. This study provides baseline information for evaluation of new orthotic designs and materials for children. In clinical practice, this information may be useful in selection of orthotic materials for some patients.

Ankle Joint↗
PubMedDate not supplied

Latent onset unilateral toe-walking secondary to hemangioma of the gastrocnemius.

Acquired unilateral pes planus due to hemangioma of the gastrocnemius is an unusual and rarely reported event. In recent years, three children with latent onset unilateral toe-walking due to hemangioma of the proximal gastrocnemius have received treatment at our facility. This report details the usual clinical syndrome and presents postsurgical results. Our experience suggests that in children, a presumptive diagnosis of benign hemangioma of gastrocnemius can be predicated on the basis of history, clinical examination, imaging studies, and laboratory assessment. In contrast to previous reports recommending primary tumor resection, isolated open tendoachilles lengthening can provide acceptable results with minimum morbidity.

Achilles Tendon↗
PubMedDate not supplied

Dynamic electromyography analysis of habitual toe-walkers.

The distinction between congenital short tendo calcaneus and mild cerebral palsy may often be difficult to ascertain by standard physical examination. Dynamic electromyography (EMG) was used to study the muscular activity during walking of four children who had a clinical diagnosis of congenital short tendo calcaneus. Two children displayed EMG evidence of cerebral palsy, while two had studies similar to normal children walking on their toes. Dynamic EMG may be a useful diagnostic tool in the evaluation of children with toe-walking.

Achilles Tendon↗