Femur fractures: treatment with roller traction and early ambulation.
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Biomedical subjects
Publications and source records attributed to V Mooney.
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The role of surgery in the care of back pain and sciatica is discussed. Surgery's role in this case is relatively minor considering the overall problems of back disorders. The history, signs, and symptoms of various diagnostic categories are reviewed. Factors in deciding on the need for surgical care are analyzed. An algorithm that displays the diagnostic approach as well as various treatment plans helps in the decision-making process. Various exercise programs for postsurgical care are outlined. Details of the surgical procedures are also presented to explain the degree of tissue damage created by surgery itself.
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The second-generation cast-brace system offers some advantages over previous systems of cast-brace treatment for fractures of the femur. Because the thigh section is adjustable, loosening of the cast-brace is not a problem. The device can be applied earlier and need not be reapplied when the girth of the thigh is reduced. Using a roller traction system, the cast-brace can also be used initially for traction and suspension without the complexity of traditional systems. With the use of commercially available plastic knee joints, special skills in alignment of the joints are not necessary, and no specially trained personnel need be on hand. The lightweight thigh section coupled to custom-fit plaster leg section, with the foot and ankle free, are less bulky than a totally plaster cast-brace with metal side joints. Walking may be begun earlier with the device, and in-patient hospital time is reduced. However, this system requires a high level of patient cooperation in that the patient is free to adjust the system himself and, therefore, the system may not be safe for application in all settings.
In the past eight years, developing a percutaneous electrode system has advanced to a successful, yet simple, method to transmit electrical signals, overcoming the serious problems of excessive mechanical irritation at the skin interface. Experience with over 50-74% in the clinical applications of 1) chronic pain relief; 2) contracture correction; and 3) sensory feedback.
Of 190 consecutive patients with below-the-knee amputation done for diabetic or arteriosclerotic vascular disease, 167 were successfully fitted with a prosthesis and used the prosthesis in some or all of the activities of daily living. The surgical failure rate was 4.2 per cent; only eight patients required surgical revision to a higher level of amputation. The technique of rigid plaster dressing followed by delayed application of a plaster cast and pylon was not detrimental to wound healing and did not increase the interval between surgery and the use of the prosthesis, nor did it depress the eventual level of function. When compared with our own previous experience with other flaps, the long posterior flap offered a significant advantage in healing rate.
Five methods of personality assessment are evaluated to provide guidance for the psychological treatment of patients with chronic back pain. Patient pain drawings, pentothal pain studies, stress score index, psychological testing with the Minnesota Multiphasic Personality Inventory (MMPI) and response to treatment challenge are used as measurements for evaluation. This evaluation gives the treating staff guidelines for individual treatment programs utilizing operant conditioning techniques. Using this approach, three fourths of the severely disabled patients seen have been successfully treated.
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