How can chronic heel pain be treated?
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Anti-Inflammatory Agents, Non-Steroidal↗
Biomedical subjects
W C McMaster
Publications and source records attributed to W C McMaster.
Shoulder injuries in competitive swimmers.
Sports medicine literature often refers to "swimmer's shoulder." Increasingly, however, it is evident that swimmer's shoulder is a spectrum of maladies whose underlying origins may be incidental to athletic activity. Those dealing with the treatment of swimmers should have a thorough understanding of the differential diagnosis of the shoulder, the age range of competitive swimmers, and the effects of the aging process, and age-related disease processes and should consider the possibilities of neoplasm, degenerative diseases, and acquired processes such as arthritis or metabolic diseases.
Athletic Injuries↗
Swimming injuries. An overview.
Most injuries and complaints encountered in swimming athletes are repetitive microtrauma or overuse, and successful management does not usually require surgical intervention. Rest and other measures to reduce inflammation are often required. Many injuries originate from faulty techniques or mechanisms, and an assessment must be made of the swimming biomechanics of any injured athlete to identify faults that may contribute to injury. It is also important to look at the total training programme of the athlete to identify other factors, such as weight training or dry land programmes, that may be contributing to injury. It is important to understand that, while rest or reduced training may be necessary, every effort to keep the swimmer "in the water' should be made, as cessation of training may lead to a rapid detraining effect.
Axillary Vein↗
Technique for intraoperative construction of PMMA spacer in total knee revision.
A technique to custom design an manufacture an appropriate spacer for use in the salvage procedure for an infected total knee replacement uses cheap, readily available materials and is simple to construct. The use of the spacer has been a valuable adjunct to the salvage procedure and has enhanced patient care and comfort in the prosthesis-free interval.
Anti-Bacterial Agents↗
Comparison of bipolar implants with fixed-neck prostheses in femoral-neck fractures.
A retrospective study of 76 Bateman universal proximal femoral endoprostheses with a mean follow-up period of 32 months was compared to a group of 36 Thompson endoprostheses and 16 Moore endoprostheses, with a mean follow-up period of 35 months and 31 months, respectively. Harris hip scores, when corrected for preoperatively impaired function, yielded a mean score of 85 for the Bateman group, compared to a mean of 77 for both the Thompson and Moore groups. Fifteen patients received the Bateman device for reconstructive purposes and had a mean Harris hip score of 90. Morbidity was comparable between the Bateman and Thompson groups. The deep-infection rate was 3.9%, and the 32-day perioperative mortality was 4.6%, rising to 29% at the time of review. Preselection factors placed younger, more functional patients in the Bateman group (mean age, 65 years; mortality, 11%), compared to the Thompson group (mean age, 72 years; mortality, 39%) and the Moore group (mean age, 73 years; mortality, 41%). Continued evaluation of the Bateman endoprosthesis is required to better define its potential to lessen the long-term problems of pain, loosening, and acetabular wear.
Adult↗
Mechanical properties and early clinical experience with xenograft biomaterials.
Evaluation of new materials for ligament and tendon reconstruction has opened up a new area of orthopaedic research. This report outlines the mechanical properties, animal evaluations, and early clinical results from tests of a xenograft biomaterial of bovine source treated with a gluteraldehyde-based process. A clinical trial under FDA guidelines is currently underway.
Animals↗
Bovine xenograft collateral ligament replacement in the dog.
A study of the use of glutaraldehyde-stabilized bovine xenograft material as a collateral ligament replacement in 16 dogs has been done. Six xenograft implant complexes harvested 4 months postoperatively failed in tension at 772.2 +/- 463.5 versus 799.7 +/- 162.7 N (+/- 1 SD) for controls (p greater than 0.05, paired t test). Histologic evaluation in 10 dogs after implants of up to 1 year duration demonstrated a progressive invasion of the xenograft by host tissues. Xenograft remnants were easily identifiable at 1 year. The host tissues invaded in parallel to the passive collagen scaffolding of the xenograft and consisted of vessels and fibroblastic elements that produced collagen of host origin.
Animals↗
A histologic assessment of canine anterior cruciate substitution with bovine xenograft.
Glutaraldehyde cross-linked bovine xenograft anterior cruciate ligament replacement has been investigated in dogs. The implants were functional for the activities of the dogs at one year of follow-up study. The knees were stable, and the articular surfaces on gross inspection showed only minimal evidence of degenerative changes. Histologic evaluation of the implants demonstrated a progressive ingrowth of the xenograft by host tissues. The host tissues grew parallel to the collagen scaffolding of the graft and consisted of host blood vessels and fibroblastic elements that produced collagen of host origin. The host response was benign in appearance without cellular evidence of rejection phenomena.
Animals↗
Does the gas exchange anaerobic threshold occur at a fixed blood lactate concentration of 2 or 4 mM?
The anaerobic threshold (theta an) is defined as the VO2 at which blood lactate concentration [lactate] begins to systematically increase (lactate "break point") during incremental exercise. Numerous studies have shown that gas exchange break points at the anaerobic threshold correlate highly (r congruent to 0.90) with the lactate break point. Recently, it has been suggested that the anaerobic threshold occurs at a fixed [lactate] of 2 mM or 4 mM. We therefore compared the gas exchange theta an to the three lactate criteria (break point, 2 mM, and 4 mM) for theta an estimation. Fourteen subjects performed an incremental cycle ergometer test. Ventilation and gas exchange were computed every 30 s. During the same 30-s intervals, venous blood was sampled for [lactate]. Four criteria were used for theta an determination: (1) systematic increase in VE/VO2, without a concomitant increase in VE/VCO2; (2) lactate break point; (3) 2 mM [lactate]; and (4) 4 mM [lactate]. Relative to the gas exchange criterion (i.e., #1), theta an was higher by 44, 280, and 1028 ml X min-1 for the three lactate criteria, respectively; the last two being significantly different (P less than 0.05). Thus, the anaerobic threshold discerned from gas exchange or the lactate break point does not correspond with a fixed, absolute [lactate] of 2 mM or 4 mM.
Adult↗
A comparison of gas exchange indices used to detect the anaerobic threshold.
This study was undertaken to determine which of four commonly used ventilatory or gas exchange indices provides the most accurate and reliable detection of the anaerobic threshold (AT). Sixteen subjects performed two cycle ergometer tests to volitional fatigue. After 4 min of unloaded cycling, the work rate was increased 20 W/min. Ventilatory and gas exchange measurements were made every 30 s throughout each test. During one of the two tests (randomly assigned), venous blood was also sampled every 30 s for subsequent determinations of blood lactate (HLa) concentration. Four ventilatory and gas exchange indices (VE, VCO2, R, VE/VO2) were used separately to detect the AT. The AT determined from systematic increases in HLa concentration was used as the criterion measure. AT values (means +/- SE) (VO2, l/min) using VE, VCO2, R, VE/VO2, and HLa were 1.79 +/- 0.11, 1.74 +/- 0.11, 1.58 +/- 0.06, 1.84 +/- 0.11, and 1.85 +/- 0.11 l/min, respectively. The highest correlation between a ventilatory or gas exchange AT and ATHLa (i.e., criterion measure) was found for VE/VO2 (r=0.93, P less than 0.001). The VE/VO2 also provided the highest test-retest correlation for detection of the AT (r = 0.93, P less than 0.001). Multiple correlational analyses did not significantly enhance detection of the AT. These results favor the use of VE/VO2 for noninvasive detection of the AT because it proved to be the most sensitive and reliable ventilatory or gas exchange index studied.
Adult↗
Closed treatment of femoral fractures with the fluted Sampson intramedullary rod.
A technique of closed intramedullary rodding of femur fractures using a curved fluted Sampson rod under fluoroscopic control is presented. Seventy-nine patients have been treated by this technique over the past four years. In this series there have been no cases of nonunion. There was a 6.3 per cent infection rate. There were three nerve injuries. No leg length discrepancy greater than 1 inch was encountered. We believe that the technique has been successful and has answered the demands of our young trauma population. We remain enthusiastic about its use.
Biomechanical Phenomena↗
Tendon grafting with glutaraldehyde fixed material.
An evaluation of 0.2% buffered glutaraldehyde fixed tendon as a potential tendon replacement prosthesis was evaluated in rabbit and chicken models. In vivo implantations were done to determine compatability, function, and strength of grafts. Autogenous fresh grafts were used as controls in the strength evaluations. The fixed tendon elicits no cellular rejection response, is invaded and replaced by host tissues, and anastomosis strength in tension compares favorably to a fresh autogenous control. These preliminary evaluations indicate a useful potential for this fixed biomaterial as a tendon prosthesis.
Aldehydes↗
Cast brace for the upper extremity.
Management of a traumatized elbow or intra-articular fracture with concomitant upper extremity long bone fracture is tedious, especially when early elbow motion is desirable. An adaptation of the lower extremity hinged cast brace to the elbow provides controlled flexion while protecting against varus/valgus stress and translation forces. A cast brace is constructed from readily-available materials, and can be applied in an out-patiet clinic. The functional results obtainable in a variety of upper extremity injuries are excellent, and the patients generally accept the elbow cast brace very well.
Adult↗
Intraoperative reduction of phalangeal fractures.
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Finger Injuries↗
An urological complication of Dwyer instrumentation.
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Child↗
Surgical procedures and hemophilia.
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Factor IX↗
The management of long bone fracture in the spinal cord injured patient.
Principles of management of long bone fractures in patients with spinal cord injuries vary with the type of fracture and duration of quadriplegia. Class I fractures (acute injuries) are managed by existing principles of long bone fracture management with a tendency to open reduction and internal fixation to dispense with the necessity of plaster casts on insensate skin. Class II fractures (pathologic--osteoporotic) heal well, require minimal specific treatment, and open reduction is usually contraindicated. Class III fractures (acute injuries in chronic paraplegia) are treated with methods least likely to disrupt the patient's life style in a wheelchair. Open reduction should be used whenever there are difficulties with circular casts and traction methods.
Arm Injuries↗
Isolated posterior cruciate ligament injury: literature review and case reports.
A review of the recent literature on posterior cruciate ligament injury reveals few descriptions of isolated injury. The major findings in this injury include abrasions over the anterior tibial surface, presence of a posterior drawer sign, recurvatum of the knee, bloody effusion, and X-ray evidence of avulsion of the posterior tibial margin. The mechanism of injury appears to be a direct blow to the anterior tibial surface with the knee acutely flexed and the posterior capsule lax. The force of the blow drives the tibia posterior, thereby causing a tension injury to the posterior cruciate ligament while actually increasing the laxity in the posterior capsule. All injuries were treated surgically through a posterior approach using internal fixation of the avulsion fracture. Satisfactory wound and fracture healing occurred in all cases and function at 3 months was good with ligamentous stability present.
Adult↗