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Biomedical subjects

T Duckworth

Publications and source records attributed to T Duckworth.

At least 19 recordsLinked to original sources
PubMed1991

Fracture healing of chick femurs in tissue culture.

Embryonic chick femurs were isolated, and a transverse osteotomy was performed at the midshaft. The femurs were transplanted individually onto the host chorioallantoic membrane and incubation continued. Cultured femurs were harvested at intervals from 1 to 9 days after the transplant. Histologic examinations showed that repair progressed rapidly: the fracture gap was invaded by blood vessels and fibrous ingrowth. Ossification followed, and the repair process was completed by Day 9.

Allantoin↗
PubMed1990

Features of algodystrophy after Colles' fracture.

We report the results of a prospective study of the incidence of algodystrophy following Colles' fracture in 60 patients, using sensitive or quantitative techniques for the assessment of each feature of the syndrome. Nine weeks after fracture, 24 patients had evidence of vasomotor instability, 23 had significant tenderness of the fingers and 23 had lost finger movement. These three abnormalities were significantly associated (p less than 0.001). Swelling was also significantly associated with these three variables. There was no statistical association between the occurrence of algodystrophy and the patient's age or sex, the severity of the fracture, the number of reductions performed or the adequacy of the reduction. We conclude that algodystrophy constitutes a precisely definable and quantifiable syndrome which is more common than has been suspected.

Adult↗
PubMed1990

The importance of the valgus hindfoot in forefoot surgery in rheumatoid arthritis.

The relationship between hindfoot deformity and forefoot pressure was assessed in 28 rheumatoid patients who had undergone forefoot reconstruction four years previously. Patients with valgus hindfoot deformities tended to have high forefoot pressures whereas those with a normal hindfoot recorded normal pressures on the dynamic pedobarograph. All patients with residual forefoot pain recorded abnormal forefoot pressures. We believe that orthotic control of hindfoot deformities should be considered for those patients who require forefoot surgery as a combination of surgical and orthotic management may offer the best chance of success.

Adult↗
PubMed1989

Is callus calcium content an indicator of the mechanical strength of healing fractures? An experimental study in rat metatarsals.

Changes in the mechanical properties and the calcium content of healing fracture callus were followed, using rat metatarsals. By 24 weeks post-fracture the mean ultimate tensile stress and elastic modulus were still less than half that of the contralateral unfractured bone, whereas the mean torsional modulus had almost reached that of the unfractured bone. The calcium content of the callus formed immediately between the fractured ends of the bone showed changes which coincided with the increases in mechanical strength and the moduli, thus measurement of callus calcium content would enable the prediction of the strength of a healing fracture.

Animals↗
PubMed1989

Algodystrophy following Colles' fracture.

The prevalence of algodystrophy in the hand was determined at nine weeks and six months following Colles' fracture. At nine weeks, 27 of 109 patients showed signs of algodystrophy, all of whom demonstrated more than one feature of the disorder. Thereafter, no unaffected patient developed the disorder. At six months, 62% of the previously affected patients showed some residual abnormalities. In 66% of these, there was evidence of continuing vasomotor instability or swelling, suggesting that the syndrome was still active. These observations suggest that algodystrophy of the hand is a more common complication of Colles' fracture than is generally realised.

Aged↗
PubMed1989

A prospective study of forefoot arthroplasty.

The Kates et al. metatarsal head resection arthroplasty has been modified and evaluated clinically and objectively using a dynamic pedobarograph in 35 adult rheumatoid arthritis patients. Preoperatively, all patients complained of severe forefoot pain, but only 70% recorded abnormal plantar pressure measurements. After a mean follow-up time of 36 months, 91% of the patients were satisfied with the result following surgery. Forty-two feet were pain-free, 16 feet still painful but less than preoperatively, and two feet worse. Thirteen of the 18 painful feet recorded abnormal pressure, but 16 additional feet with normal pressures were symptomatic. The clinical and pedobarographic results show that, in the majority of patients, the Kates et al. forefoot arthroplasty relieves pain, improves mobility, effectively decreases high abnormal plantar pressures, and should be considered when conservative methods of treatment have failed.

Adult↗
PubMed1988

The management of dropfoot using the Lambrinudi arthrodesis.

The results of 12 Lambrinudi arthrodeses in 10 patients with spinal dysraphism were compared with 11 operations performed in patients with only motor nerve deficits performed over the same 10 year period. The early failure and complications were more common in these patients and the tendency to recurrence of dropfoot occurred earlier. Despite this, the operation was effective in the management of these patients, especially for the improvement of co-existent sores or the fitting of shoewear.

Adolescent↗
PubMed1988

Foot pressure studies in the assessment of forefoot arthroplasty in the rheumatoid foot.

To assess the results of forefoot arthroplasty, dynamic and static foot pressure studies have been made of the rheumatoid foot in both a prospective study group of 60 feet and in a retrospective study group of 18 feet. Significant reductions of pressure in the forefoot were found. Problems associated with the first and fifth metatarsals were considered.

Adult↗
PubMed1987

Experimental study in rat metatarsals to determine whether callus vascularity is an indicator of the mechanical strength of healing fractures.

Changes in the mechanical properties and percentage area of blood vessels of healing fracture callus were followed using rat metatarsals. By 24 weeks after fracture the mean ultimate tensile stress and elastic modulus were still less than half that of the contralateral unfractured bone, whereas the mean torsional modulus had almost reached that of the unfractured bone. The percentage area of blood vessels declined from five days post-fracture and showed no changes which coincided with the increases in mechanical strength or moduli. We conclude that studies of vascularity would not justify a prediction of the strength of a healing fracture.

Animals↗
PubMed1987

The natural history of foot pressure abnormalities in neuropathic diabetic subjects.

The pressures under the feet of 39 subjects with diabetic neuropathy were initially assessed during walking using an optical pedobarograph. The upper limit of normality for pressure readings in non-diabetic subjects had previously been established as 10 kg/sq.cm. These subjects were then followed for a mean period of 3 years after which foot pressure studies were repeated. 39 feet had abnormal results when initially studied, compared with 33 at the follow-up study (p = NS). However, changes in the distribution of pressure under the metatarsal heads were seen in 13 feet, while 20 feet showed changes in abnormal pressures under the same site. Recurrent metatarsal ulcers occurred in 6 feet during the study, with 5 occurring at documented sites of high pressure. It is concluded that important changes in the distribution and level of pressures under diabetic neuropathic feet occur during a relatively short time. As it has previously been demonstrated that increased foot pressures are associated with foot ulceration, it is important for the orthotist to re-assess the feet regularly to establish whether significant changes in pressure distribution that might warrant new insoles or footwear have occurred.

Adult↗
PubMed1986

Os calcis osteotomy in the management of deformities of the hindfoot in spinal dysraphism.

The results of 52 primary os calcis osteotomies in 44 patients with spinal dysraphism are reviewed. There were 42 varus hindfoot deformities and ten valgus hindfoot deformities. The results indicate that the operation is simple and uncomplicated, but over a mean 5.8 year follow-up for the varus feet and 6.5 years for the valgus feet, over 50% of the feet developed either a moderate or severe recurrence of deformity. Os calcis osteotomy appeared from this series to be a moderately successful interim operation for the equinus varus foot, delaying the need for premature triple arthrodesis, but the long-term results in cavo-varus feet with claw toes were uniformly poor. Furthermore, it appeared to be unsatisfactory in the mobile flail valgus foot unless the subtalar joint had been stabilised by fusion. Correction of proximal joint or bone deformity and muscle imbalance is considered necessary if satisfactory results are to be achieved from the osteotomy.

Adolescent↗
PubMed1986

A prospective trial comparing operative and manipulative treatment of ankle fractures.

A series of 42 ankle fractures have been randomised into two groups respectively undergoing either open reduction and internal fixation or manipulative reduction and plaster. Their progress after removal of all external splintage has been followed using simple gait analysis techniques. There appears to be no difference in the outcome of treatment of the two groups in the early recovery period (up to 20 weeks).

Adolescent↗
PubMed1985

The comparative properties of plaster of Paris and plaster of Paris substitutes.

Modern casting materials are becoming available in an increasing and bewildering variety. A series of tests has been devised to investigate the properties of these materials. They have been tested for strength, flexibility, lamination, fatigue life and radiolucency. Their properties have been compared with those of plaster of Paris in order that the role of the newer materials can be defined. It is suggested that the tests described might form the basis of a standard from which user trials could be designed to appraise the value of these materials in clinical practice.

Calcium Sulfate↗
PubMed1985

The long-term results of the surgical management of paralytic pes cavus by soft tissue release and tendon transfer.

Twenty-six patients with paralytic pes cavus were managed by early soft tissue correction and tendon transfer. Eighteen had spina bifida, 6 had peroneal muscular atrophy and two had cerebral palsy. The most frequent operations were flexor hallucis longus tenodesis, Girdlestone's flexor to extensor tendon transfer and plantar release. The indications for these procedures are discussed and the results presented, with particular reference to static and dynamic foot pressure studies performed at review. Follow-up averaged 5.2 years. Toe correction was found to be successful in most cases but plantar release failed in 55% of feet, with many progressing to fusion. Many failed feet had presented at an earlier age and it was felt that the initial procedures had delayed the need for bony correction thus minimising growth disturbance.

Adolescent↗
PubMed1985

Plantar pressure measurements and the prevention of ulceration in the diabetic foot.

Static and dynamic measurements of foot pressure have been carried out on three groups of subjects: diabetic patients with neuropathy (with and without a history of ulceration), diabetic patients with no neuropathy, and normal subjects as controls. In many cases both techniques of measurement detected areas of abnormally high pressure under the foot, but in some cases a particularly high-pressure spot was detected on only one of the tests and sometimes both methods were needed to reveal all the areas of the foot which might be considered to be at risk. The dynamic measurements tended to show multiple areas of high pressure better than the static measurements. Our results indicate the importance of making both types of measurement when seeking to devise suitable means of protecting the foot from ulceration.

Diabetes Mellitus↗
PubMed1985

Neuropathic ulcers of the foot.

We report a prospective study of the causes and treatment of 26 long-standing neuropathic ulcers of the foot in 21 patients. The most important causal factor, well illustrated by pressure studies, was the presence of a dynamic or static deformity leading to local areas of peak pressure on insensitive skin. All but one of the 26 ulcers had healed after an average of 10 weeks of treatment in a light, skin-tight plaster cast, with the prohibition of weight-bearing. Recurrent ulceration was prevented in all but one foot by early operation to correct the causative deformity; this was performed after the ulcer had healed and before allowing weight-bearing on the limb. Pressure studies after operation confirmed that pressure points had been relieved.

Adolescent↗