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Biomedical subjects

T E Whitesides

Publications and source records attributed to T E Whitesides.

At least 37 records · Page 2Linked to original sources
PubMed1992

The force exerted by the halo pin. A study comparing different halo systems.

Seven different halo systems were evaluated biomechanically to compare the force exerted by the halo pin in each system. In three different experiments torque values of 2, 4, 6, 7, and 8 in lb were applied to the halo pin, and the force at the skull end of the halo pin was measured using a load cell. In the first experiment, the threads on the halo pin were dry, in the second experiment saline was applied to the threads on the pin, and in the third experiment cadaveric bone from the skull was interposed between the pin and the load cell. The results showed that for a given value of applied torque to the pin, the force exerted by the pin end varied widely according to the halo system and whether or not the pin was "lubricated."

Adult↗
PubMed1985

Surgical reconstruction of late post-traumatic thoracolumbar kyphosis.

Thirty-four patients underwent surgery for late post-traumatic thoracolumbar kyphosis. Indications for surgery included increasing kyphotic deformity, pain, or increasing neurologic deficit. Procedures included anterior spinal fusion only, posterior spinal fusion only, anterior and posterior fusions as staged procedures, and anterior and posterior fusions under the same anesthetic. Eighteen of the patients with anterior fusions also underwent decompression of the spinal cord by resection of the vertebral body. Stable fusion with halt in progression of deformity was obtained in 33 of the 34 patients by following basic biomechanical principles.

Adolescent↗
PubMed1985

The Mauch hydraulic knee unit for above knee amputation.

Hydraulic knee units provide a mechanical means of simulating normal gait in the above knee amputee. Sixty-one above the knee amputees were fitted with 70 Mauch SNS hydraulic knee units. Four of 60 patients rejected or were unable to use the hydraulic knee. Only one patient rejected the hydraulic knee unit for another design. Therefore, the rate of acceptance of the prosthesis was 93%. If inappropriate prescriptions for two triple amputees are omitted, the acceptance rate rises to 97%. A significant majority of patients stated that the hydraulic knee unit gave them a smoother gait, ability to change cadence, increased activity level, increased stability in stance phase, fewer falls, and less fatigue.

Adult↗
PubMed1985

Mauch S.N.S. hydraulic knee units in above-knee amputees. A long-term follow-up study.

From 1963 to 1980, 70 Mauch S.N.S. hydraulic knees were prescribed for 60 service-connected, above-knee amputees. The average length of the follow-up period was 7.5 years and the average age of the patient at the time of follow-up evaluation was 47 years. Four of the 60 patients who were given the Mauch S.N.S. units rejected them, for a success rate of 93%. Three of the four patients who opted for devices other than this unit had been given inappropriate prescriptions. Thus, the overall success rate for appropriately prescribed hydraulic knee units was 98.2%. Chart records were available on all patients in the series and 47 patients were available for direct survey, most of whom had used other prosthetic devices prior to receiving the Mauch unit. Survey results and clinical evidence have shown that the hydraulic knee unit is superior to the single-axis hinged device when appropriately prescribed. The hydraulic knee units are recommended for use in the active above-knee amputee who has a strong, relatively long stump and desires a variable cadence gait and more stability in stance, along with the consequent ability to increase activity level. These units are not recommended for use in the weakened, debilitated patient or in patients not willing to care for and maintain the devices.

Adult↗
PubMed1984

Immediate, early, and late postsurgical management of upper-limb amputation.

This series is composed of 47 patients who underwent immediate, early, or late postoperative prosthetic fitting after upper-limb amputation. The purpose of this review was to analyze the impact of rapid postoperative fitting on upper-limb amputation, and to assess general prosthetic prescription and guidelines for upper-limb amputees. It would appear that in adult amputations there is a "Golden Period" of fitting for upper-limb prosthetic devices and this period appears to be within the first month after amputation. There appears to be no difference in ultimate prosthetic acceptance rate or use patterns as a function of the type of prosthesis initially provided. Based upon this combined review between the Tucson and Atlanta VA Medical Centers, the authors would suggest that all upper-limb amputees be fitted as rapidly as possible (within 30 days) with conventional prosthetic devices, and when they have shown motivation and skill in the use of conventional devices, then to re-evaluate them for appropriate externally powered prosthetic components.

Adolescent↗
PubMed1984

The stable internal fixation of peritrochanteric hip fractures.

Most series found in the literature on peritrochanteric fractures report failure rates of 9% to 35% for nonsliding fixation and 5% to 12% for devices that allow collapse about the axis of the barrel of the device, indicating that the concept of load sharing is a valid principle in the management of these injuries. Reviewing our experience with the fully collapsible devices reveals a remarkably low incidence of complications related to both metal failure and postoperative penetration of the femoral head. Most of the failures in our series occurred before the routine use of fluoroscopic operative placement control and can be related to inadvertent intraoperative penetration of the femoral head. With modern techniques, therefore, these complications are largely preventable. Despite those failures, which cannot be explained by technical error, we are extremely pleased with our overall results because the fully collapsible devices appear to allow early weight bearing without fear of fixation complications, even in unstable fractures. This concept allows for easier postoperative rehabilitation and attendant diminished mortality rates as compared with other devices currently used. Although no study can conclusively demonstrate the clear superiority of the slotted Richards screw and Ken-Pugh nail over other forms of sliding fixation, we believe that if the concept of load sharing is valid, this modification is a simple, sensible, and effective addition to most nail plate devices used today.

Biomechanical Phenomena↗
PubMed1983

Open fractures of the tibia treated with the Lottes nail.

Of fifty consecutive open fractures of the mid-part of the shaft of the tibia that were treated from 1975 to 1980 with immediate intramedullary Lottes-nail fixation and with débridement and irrigation, with minimum periosteal disruption, all but one healed. The rate of infection was 6 per cent; of delayed union, 16 per cent; and of malunion, 4 per cent. One fracture, with arterial injury, resulted in amputation. The wounds were classified as Gustilo and Anderson Type I (24 per cent), II (12 per cent), or III (64 per cent). Seventy-six per cent of the patients had other fractures, and 38 per cent had a fracture of the ipsilateral femur. Sixty-four per cent of the fractures were segmental and 36 per cent were transverse with comminution.

Adolescent↗
PubMed1981

Fractures of the tibia treated with Lottes nail fixation.

We have reviewed 60 consecutive cases, occurring in 57 patients, of intramedullary fixation of fractures of the midshaft of the tibia done over a ten-year period with the Lottes nail. Of 50 acute fractures, 38 were open fractures, nailed after adequate irrigation and debridement; the other 12 were closed fractures. The remaining ten cases were nonunions. All fractures healed with a rate of infection of 3.33% and a rate of malunion of 3.33%. Of the 50 patients with acute fracture, 29 had other fractures of long bones and 12 had ipsilateral fractures of the femur. The nailing facilitated their ambulation and care. All ten nonunions healed after nailing and bone grafting. Lottes nailing of tibial midshaft fractures is a simple procedure that gives stability, allows early weight-bearing with minimal shortening, and can be used in open fractures with minimal morbidity after adequate debridement.

Bone Nails↗
PubMed1981

Congenital elevation of the scapula. Surgical correction by the Woodward procedure.

We reviewed the cases of eleven patients with congenital elevation of the scapula who were treated by the Woodward procedure. A discussion of the characteristic findings, associated congenital anomalies, indications for operation, and surgical techniques, and a review of the literature, also are presented. The average postoperative increase in combined shoulder abduction in the eleven patients was 29 degrees. However, if preoperative abduction was less than 120 degrees (five patients), the average increase in motion was 50 degrees. The average scapular lowering was 1.6 centimeters. The cosmetic results were rated as excellent or good in 82 per cent of the patients. It is significant, however, that in more than 60 per cent of the patients unsightly surgical scars developed. The importance of the often-underemphasized rotational component of Sprengel's deformity is stressed, as well as the importance of the meticulous surgical technique and attention to detail that are essential for the best results.

Adolescent↗
PubMed1977

Traumatic kyphosis of the thoracolumbar spine.

The rationale of acute and chronic orthopedic management of traumatic throacolumbar kyphosis is determined by the type and location of the injury. The performance of laminectomy is condemned due to its historical failure in both the acute and chronic phase and its violation of simple mechanical principles.

Adult↗
PubMed1976

Acute hematogenous osteomyelitis complicating closed fractures.

Five cases of acute hematogenous osteomyelitis occurring at the site of closed fractures are reported. This is a serious and potentially lethal complication resulting in directly in the death of 3 of the 5 patients. This is an unusual occurrence seen infrequently, and subsequent delay in diagnosis is frequent. An awareness of this complication (which usually occurs in the face of decreased resistance to infection) coupled with careful inspection of the fracture site, evaluation of the patient as a whole, and a high index of suspicion will allow earlier diagnosis and possibly more successful early treatment. Because of the pathophysiology of this lesion and the usual delay in diagnosis, initial treatment should include wide surgical drainage of the abscess with proper debridement and bony resection. This may involve procedures which at first glance may appear to be mutilating. In these patients with decreased resistance to infection, the initial appropriate choice of antibiotics is essential.

Aged↗
PubMedDate not supplied

Tissue pressure measurements as a determinant for the need of fasciotomy.

An experimental and clinical tehcnique of measuring tissue pressures within closed compartments demonstrates a normal tissue pressure is approximately zero mmHg, and increased markedly in compartmental syndromes. There is inadequate perfusion and relative ischemia when the tissue pressure within a closed compartment rises to within 10-30 mm Hg of the patient's diastolic blood pressure. Fasciotomy is usually indicated, therefore, when the tissue pressure rises to 40-45 mm Hg in a patient with a diastolic blood pressure of 70 mm Hg and any of the signs or symptoms of a compartmental syndrome. There is no effective tissue perfusion within a closed compartment when the tissue pressure equals or exceeds the patient's diastolic blood pressure. A fasciotomy is definitely indicated in this circumstance, although distal pulses may be present. The measurement of tissue pressure aids in the early diagnosis and appropriate treatment of compartmental syndromes.

Aged↗