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Biomedical subjects

S S Coleman

Publications and source records attributed to S S Coleman.

At least 37 records · Page 2Linked to original sources
PubMed1985

Simultaneous femoral and tibial lengthening for limb length discrepancies.

Simultaneous lengthening of the femur and tibia can be effectively and safely accomplished. However, the following issues must be kept in perspective: (1) patient selection is essential, and (2) meticulous attention to detail in all aspects of the operative procedure is vital. The advantages of performing such an ambitious operation include: (1) reduced morbidity, (2) reduced number of operations (not procedures), and (3) more rapid recovery when compared to performing the operations sequentially. This kind of program should be carried out only by those experienced in the limb lengthening procedure.

Bone Lengthening↗
PubMed1984

Foot deformities secondary to gluteal injection in infancy.

We report six cases of foot deformities in children due to sciatic nerve dysfunction that appear to have been caused by gluteal intramuscular injection. Of four patients who developed cavovarus foot deformities, two also exhibited a component of ankle equinus. A fifth patient had a calcaneocavus foot deformity. In the sixth patient foot palsy resolved completely 1 year after injury, and no deformities developed. Identification of the muscle imbalance, as well as appropriate correction of the deformity before the implementation of muscle balancing procedures, led to the attainment of a satisfactory plantigrade gait in the first five patients with deformities. Bases on our experience with these six cases and reports in the literature, we recommend that the superolateral gluteal area between the crest of the ilium and the greater trochanter be properly defined as the preferred site for intramuscular injection.

Buttocks↗
PubMed1984

Pelvic osteotomy: an alternative to total hip replacement in the young adult.

For the young adult patient with a painful hip in whom there is acetabular dysplasia, innominate osteotomy is not only an alternative to total hip replacement, but rather it is the procedure of choice. If the prerequisites for a Steel or a Chiari osteotomy are met and if the procedures are adequately carried out, satisfactory relief of pain and return to function can be expected. The length of the satisfactory result is unknown as yet because an insufficient number of patients have been followed over a long enough period to determine the life expectancy of these procedures. It would appear, however, that it is going to be more than 10 years, which is certainly longer than one could expect for the current generation of cemented total joint replacements to last. Cementless total joint replacements are so new that a comparison cannot be made, but intuitively, a procedure that can leave the patient with his own tissue is the procedure of choice. Certainly, in a well-executed Steel or Chiari osteotomy, later reconstruction or total joint replacement will not be compromised.

Acetabulum↗
PubMed1984

Isolated fracture of the lesser trochanter in adults: an initial manifestation of metastatic malignant disease.

An avulsion fracture of the lesser trochanter in the absence of known or appropriate antecedent trauma was the initial manifestation of unrecognized metastatic malignant disease in the subtrochanteric area of four patients. In three patients the fracture healed but a pathological subtrochanteric fracture then occurred, and in one patient prophylactic nailing of the hip was performed to prevent this fracture. A thorough search for occult metastatic malignant disease should be made whenever this fracture occurs in an adult. Prophylactic internal fixation to prevent or delay a subsequent pathological subtrochanteric fracture seems worth while.

Adenocarcinoma↗
PubMed1982

Surgical treatment of congenital pseudarthrosis of the tibia.

Dual tibiofibular intramedullary rodding with autogenous bone grafting is our treatment of choice in congenital pseudarthrosis of the tibia. The method has a high incidence of primary union. The intramedullary rods control angulation and protect against refracture without hindering growth, and they permit strengthening of the union on weight-bearing. A comprehensive treatment program must address the simultaneous problems of achieving and maintaining bone and joint alignment as well as effective osteogenesis.

Bone Transplantation↗
PubMed1981

Treatment of the calcaneocavus foot deformity.

The calcaneocavus foot is almost always the result of a neural disorder and subsequent weakness of the triceps surae muscles. It is inexorably progressive, always disabling, and refractory to bracing. Therefore, treatment is directed toward the surgical correction of any existing deformity and the restoration of muscle balance. We developed a treatment approach based on goals and requirements that must be individualized according to the underlying neural disorder, the exact nature of the muscle imbalance, the degree of bone deformity, and the skeletal age of the patient. Nineteen calcaneocavus feet have been treated at our institution since 1958, with follow-up averaging seven and three-quarters years. The objective evaluation of the correction obtained was determined from a ratio computed by measurements on radiographs. All feet were improved according to this raio, although three were not corrected as well as was desired. An effort also was made to establish the amount of functional improvement as it was reflected in improved gait and push-off. These were largely subjective determinations, however, and although all patients demonstrated improved function, the amount of improvement was difficult to quantitate and none had normal function. There was a substatially consistent relationship between the improved objective and subjective result evaluations.

Adolescent↗
PubMed1980

Pes cavovarus. Review of a surgical approach using selective soft-tissue procedures.

This study reviews the surgical treatment of twenty-seven patients (thirty-nine feet) with cavovarus foot deformity. The patients' ages ranged from six months to fifteen years. Only those patients who had at least a two-year follow-up were selected for statistical analysis. This group comprised twenty patients (twenty-seven feet). A standardized treatment program was used, based on the flexibility of the deformity. A radical plantar or plantar medial release was employed as indicated, in combination with tendon transfers or osteotomy of the fore part of the foot, or both. All patients were available for follow-up examination and special roentgenograms of the hind part of the foot. Follow-up appraisal of the patients with more than two years' follow-up revealed more than 85 per cent acceptable results with no major complications.

Adolescent↗
PubMed1980

Hemodilution and induced hypotension for insertion of a Harrington rod in a Jehovah's Witness patient.

The case of a 28-year-old Jehovah's Witness illustrates the feasibility of using a combined technique of induced hypotension and hemodilution to minimize the surgical loss of red blood cells during the insertion of a Harrington rod. A Swan-Ganz catheter with thermister tip was inserted to measure pulmonary arterial pressure, pulmonary arterial wedge pressure and cardiac output. Other intraoperative monitoring included continuous arterial pressure, electrocardiography, oropharyngeal temperature, esophageal stethoscope, arm-cuff blood pressure and urinary output from an indwelling Foley catheter. A total of 10 L of crystalloid was infused over a 2 1/2-hour period while hypotension was induced by intravenous nitroprusside and enflurane anesthesia. Hematocrit was diluted from 46% to 26% intraoperatively with an estimated surgical blood loss of 2,740 ml. The 24-hour postoperative hematocrit was 30% and recovery was uneventful. This method may be useful in any orthopedic procedure in which heavy blood loss is anticipated and the patient refuses transfusion of blood or blood products. However, the patient must be in good health and have an uncompromised cardiopulmonary system.

Adult↗
PubMed1978

Tibial lengthening.

Tibial lengthening as a means of correcting certain discrepancies in lower limb length has become a well-accepted, though rarely indicated, procedure. Success depends upon knowledgable evaluation of all factors involved in the problem, upon adherence to the indications and prerequisites, and upon strict attention to all details of the operation. Nearly all cases of tibial lengthening are accompanied or followed by problems and/or complications. Problems such as delayed union, inadequate union and failure of union must be anticipated and appropriately coped with. Complications such as fracture through the lengthened area, compartment syndromes, infection, and foot and ankle deformities must be prevented if at all possible, and aggressively treated when they occur. Utilizing the appropriate indications and meticulous technique, one can expect to achieve lengthening of 4--5 cm in nearly all cases. Bone grafting and internal fixation will be required in a significant number of tibial lengthenings in order to achieve strong, solid union. The technique currently employed by the authors utilizes the Anderson percutaneous osteotomy, accompanied by the Wagner apparatus. In critically analyzing the results of 73 personal cases of tibial lengthening, the authors conclude that the procedure is justified in carefully selected patients.

Adolescent↗
PubMed1977

Isolated subcutaneous nodules (pseudorheumatoid).

Ten patients with isolated subcutaneous nodules histologically similar to rheumatoid nodules were studied. Because of the intense fibroblastic reaction in one such nodule, it was initially mistaken for a fibrosarcoma. The nodules tended to be multiple and recurrent, with eventual spontaneous regression, and they were not associated with any systemic illness. The etiology of these lesions is unclear but the possibility of subsequent development of systemic rheumatoid disease is remote.

Adolescent↗
PubMed1976

Nontraumatic myositis ossificans in healthy individuals.

Myositis ossificans has been subclassified into three categories: traumatic, progressive, or those cases associated with neuromuscular and chronic disease. Four cases of myositis ossificans occurred in otherwise healthy individuals without any history of trauma. These four patients illustrate a fourth and distinct subclassification of the disease.

Adolescent↗