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Biomedical subjects

S T Canale

Publications and source records attributed to S T Canale.

At least 37 records · Page 2Linked to original sources
PubMed1981

Neonatal osteomyelitis of the os calcis: a complication of repeated heel punctures.

Neonatal osteomyelitis has been frequently reported, but only rarely as a complication of repeated heel punctures. The need for constant monitoring of premature newborns and those having low birthweight and serious deformities necessitates repeated blood samples, usually obtained by heel puncture. Os calcis osteomyelitis occurred in three patients, possibly secondary to heel puncture. A swollen lower extremity in newborns should alert clinicians to the possibility of infection originating in the heel. Treatment involves adequate doses of appropriate antibiotics, but if the infection does not respond within 48 hours, then surgical drainage is indicated. Secondary extension to more proximal areas can and may occur with catastrophic consequences. Orthopedic surgeons should help other physicians become aware that repeated heel punctures may cause os calcis osteomyelitis and that they should be avoided.

Calcaneus↗
PubMed1980

Osteochondral lesions of the talus.

In a retrospective study of thirty-one ankles in twenty-nine patients with osteochondral lesions, we found that lateral lesions were associated with inversion or inversion-dorsiflexion trauma, were morphologically shallow, and were more likely to become displaced in the joint and to have persistent symptoms. Medial lesions were both traumatic and atraumatic in origin, morphologically deep, and less symptomatic. Using the classification system of Berndt and Harty, it appeared that Stage-I and Stage-II lesions should be treated non-operatively, regardless of location. Stage-III medial lesions should be treated non-operatively initially but if symptoms persist surgical excision and curettage are indicated. Stage-III lateral lesions and all Stage-IV lesions should be treated by early operation. Long-term results indicated that few lesions unite when treated non-operatively. Degenerative changes in the ankle joint, whether symptomatic or not, were common (50 per cent of the ankles) regardless of the type of treatment.

Ankle↗
PubMed1980

Legg-Calvé-Perthes disease. Long-term evaluation of non-containment treatment.

Eighty hips with unilateral Legg-Calvé-Perthes disease were evaluated at an average follow-up of 22.4 years to determine the long-term results of treatment by a weight-relieving sling or harness. Results were good in sixty-four patients, fair in nine, and poor in seven. The patients with fair results had no clinical symptoms despite unacceptable roentgenograms. The hips that were most likely to have unsatisfactory results were those with Catterall Group-III or IV involvement and with onset at the age of six years or later, but of fifty-eight patients with Catterall Group-III or IV grades (eighteen of whom were six years old or older), forty-two had good results. Catterall's classification could not be accurately applied for an average of 8.1 months after the onset of disease. Identification of so-called head-at-risk signs, while it was important, appeared to add little to the Catterall grading as a prognostic index or therapeutic guide. Thirty-nine hips were identified as being at risk, including six of the seven with poor results and all of the nine hips with fair results.

Adolescent↗
PubMed1979

Fractures of the tibia through the proximal tibial epiphyseal cartilage.

Thirty-nine fractures of the tibia involving the proximal tibial epiphyseal cartilage were treated at the Campbell Clinic over a twenty-five-year period. Stress roentgenograms were essential in making the diagnosis in three patients. Two patients had disruption of the popliteal artery, and both had posterior displacement of the tibial shaft. The other immediate complications that we encountered were anterior compartment syndrome, peroneal-nerve palsy, and associated ligamentous and meniscal injuries. Of twenty-eight fractures (twenty seven patients) with an average follow-up of 7.1 years, there were satisfactory results in twenty-four. Unsatisfactory results (four fractures) were due to chronic neurovascular insufficiency, growth disturbance, or traumatic arthritis.

Adolescent↗
PubMed1979

Irreducible traumatic dislocations of the hip.

Little attention has been paid to the various causes preventing or blocking a concentric reduction following traumatic dislocation of the hip without apparent fracture. In a review of fifty-four dislocations, nine required open reduction after either a failed attempt at closed reduction or a non-concentric reduction. The factors preventing closed reduction included the femoral head buttonholed through the capsule and the piriformis muscle displaced across the acetabulum. A concentric anatomical reduction was prevented because of an inverted lumbus or an osteocartilaginous loose body in the acetabulum. Guidelines for diagnosis and treatment are discussed.

Acetabulum↗
PubMed1978

Fractures of the neck of the talus. Long-term evaluation of seventy-one cases.

Seventy-one fractures through the neck of the talus were clinically evaluated and classified on the basis of roentgenographic appearance. The follow-up interval averaged 12.7 years. Good or excellent results were achieved in 59 per cent of the fractures. Accurate anatomical reduction of displaced fractures, if necessary by open reduction and internal fixation, is recommended. Avascular necrosis of the talar body occurred in 52 per cent of the fractures (in two of thirteen non-displaced fractures, in half of the fractures with subluxation or dislocation of the subtalar joint, and in sixteen of nineteen fractures with complete dislocation of the body of the talus). Many patients with avascular necrosis treated conservatively had satisfactory results. The complications of avascular necrosis, malunion, subtalar arthritis, and infection required twenty-five secondary procedures. Triple arthrodesis, tibiocalcaneal fusion, and dorsal beak resection of the talar neck all resulted in a high percentage of satisfactory results, but talectomy did not.

Adult↗
PubMed1977

Fracture of the neck and intertrochanteric region of the femur in children.

End-result evaluations after an average follow-up of seventeen years are reported in sixty-one cases (sixty patients). There were five Type-1 (transepiphyseal), twenty-seven Type-II (transcervical), twenty-two Type-III (cervicotrochanteric), and seven Type-IV (intertrochanteric) femoral fractures. The majority of Type-I, Type-II, and displaced Type-III fractures were treated with closed or open reduction and Knowles-pin fixation. The majority of undisplaced Type-III and Type-IV fractures were treated with abduction plaster spica casts. Fifty-five per cent were found to have good resultswhile 20% were fair and 25%, poor. The incidence of complications--avascular necrosis, coxa vara, premature epiphyseal closure, infection, and non-union--was compared with that in previously reported series. The use of Knowles-pin fixation appeared to reduce the complications of non-union and coxa vara. Avascular necrosis caused most of the poor results. However, younger children with avascular necrosis obtained better results than did older ones. Some children with results graded as poor roentgenographically were only mildly symptomatic.

Adolescent↗
PubMed1975

Pelvic displacement osteotomy for chronic hip dislocation in myelodysplasia.

Twelve children with lumbar-level myelodysplasia (average age, eight and three-quarter years) underwent twenty-one pelvic displacement osteotomies for subluxated or dislocated hips. Nineteen of the twenty-one hips remained reduced on three-year follow-up. Gains in gait pattern, ease of bracing, and reduced pelvic obliquity were noted. Active function about the hips was not improved, nor was there a decrease in the amount of bracing needed following the osteotomy. Pelvic displacement osteotomy can be utilized in selected cases as part of the over-all management of chronic hip dislocation in myelodysplasia.

Adolescent↗
PubMedDate not supplied

Displaced femoral neck fractures at the bone-screw interface after in situ fixation of slipped capital femoral epiphysis.

Two patients had displaced femoral neck fractures at the bone-screw interface after in situ fixation of slipped capital femoral epiphysis. Both fractures required closed reduction and internal fixation. Inadvertent derotation of the femur occurred in both patients and allowed fixation of the fracture through the intramedullary canal of the femoral neck without anterior penetration of the pins into the joint; a nonunion occurred in this patient. The other patient developed chondrolysis and avascular necrosis. Because the femoral neck is vulnerable to stress fractures in young adults, there is some question whether pins placed anteriorly through the femoral neck cortex should be removed.

Adolescent↗
PubMedDate not supplied

Does aspiration of bones and joints affect results of later bone scanning?

To determine the effect, if any, of needle aspiration on 99mTc bone scanning, three different areas of 15 dogs were first aspirated and then imaged with technetium bone scintigraphy. The hip joint was aspirated, the distal femoral metaphysis was drilled and aspirated, and the tibial periosteum was scraped with an 18- or 20-gauge needle. Varying amounts of trauma were inflicted to simulate varying difficulties at aspiration. 99mTc bone scans were obtained from 5 h to 10 days later. There was no evidence of focal technetium uptake after any hip joint aspiration. This was consistent regardless of the amount of trauma inflicted or the time from aspiration to bone scanning. Metaphyseal cortical drilling and tibial periosteal scraping occasionally caused some focal uptake when scanning was delayed greater than 2 days. When osteomyelitis or pyarthrosis is clinically suspected, joint aspiration can be performed without fear of producing a false-positive bone scan.

Animals↗
PubMedDate not supplied

Interlocking intramedullary nailing of femoral-shaft fractures in adolescents: preliminary results and complications.

Thirty-one femoral-shaft fractures in 30 patients were treated with interlocking intramedullary nails. The 19 boys and 11 girls ranged in age from 10 to 15 years (average age 12 + 3 years) at the time of injury. All fractures united, and the average leg-length discrepancy (comparing the injured to the uninjured extremity) was 0.51 cm. Two patients had overgrowth of > 2.5 cm; none had angular or rotational malunions. One patient developed asymptomatic segmental avascular necrosis of the femoral head, which was not seen on radiographs until 15 months after injury. All nails were removed at an average of 14 months after injury; no refracture or femoral neck fracture has since occurred. Intramedullary nailing is a reasonable alternative for the treatment of isolated femoral-shaft fractures in older adolescents and in younger adolescents with multiple trauma.

Adolescent↗