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Biomedical subjects

W H Bohne

Publications and source records attributed to W H Bohne.

At least 19 recordsLinked to original sources
PubMed1992

The dynamics of peroneus brevis tendon splits: a proposed mechanism, technique of diagnosis, and classification of injury.

The etiology of peroneus brevis splits is unclear. Because longitudinal splits in the peroneus brevis tendon do not necessarily effect the integrity or strength of the tendon, it is difficult to ascertain whether or not injury to the peroneus brevis tendon is present. Recent clinical, anatomic, and histologic reports have suggested that the split develops from prolonged mechanical attrition within the fibular groove as a result of ankle trauma with resultant lateral ankle instability and incompetency of the superior peroneal retinaculum with resultant subluxation of the peroneal tendons. This cascade of events may result in splitting of the peroneus brevis tendon. The purpose of this paper was to report the investigation of the mechanism by which peroneus brevis splits develop, to describe a technique of diagnosis, and to propose a classification of injury. Peroneus brevis splits are the result of a dynamic mechanical insult at the fibular groove. Laxity of the superior peroneal retinaculum combined with peroneus longus mechanical compression causes the peroneus brevis to splay out and eventually split over the sharp posterior edge of the fibula. Anatomic factors, such as a shallow fibular groove (congenital convex groove) or the presence of an anomalous low-lying peroneus brevis muscle belly or peroneus quartus tendon, may also play a role in this mechanism by interfering with the competence of the superior peroneal retinaculum.

Adult↗
PubMed1992

Microvascular anatomy of the peroneal tendons.

The etiology of longitudinal splitting of the peroneus brevis tendon is unclear. It has been hypothesized that compressive load applied to the tendon as it passes through the fibular groove may compromise the vascularity of the tendon with resultant inhibition of the repair response and degeneration of tendon structure. To investigate this possibility, a study of the microvascularity of the peroneal tendons was undertaken. Twelve fresh, frozen cadaveric limbs were injected with India ink. The vascularity of the peroneal tendons was examined in situ and the tendons were harvested and cleared using a modified Spalteholz technique. The vascularity of the cleared tendons was evaluated utilizing a dissecting microscope. The vascular supply of the peroneal tendons arises from two posterolateral vincula, one for the peroneus longus tendon and one for the peroneus brevis tendon. These vincula are supplied by branches of the posterior peroneal artery. A zone of hypovascularity within the peroneus brevis or peroneus longus tendon correlating with the site of peroneus brevis splits was not found. There was no relationship between increasing age of specimens and alteration in vascular supply.

Adolescent↗
PubMed1992

Peroneal tendon subluxation in a case of anomalous peroneus brevis muscle.

We report a case of peroneal tendon subluxation as a result of an anomalous extension of the peroneus brevis muscle into the fibular groove, causing an encroachment phenomenon, stretching-out of the superior peroneal retinaculum, longitudinal splitting of the peroneus brevis tendon, subluxation of the peroneal tendons, and peroneal tenosynovitis. We describe a simple surgical technique for tendon stabilization, after decompression of the fibular groove.

Adult↗
PubMed1991

Cadaver correlation of peroneal tendon changes with magnetic resonance imaging.

Magnetic resonance imaging (MRI) is used to show the soft tissues of the body. The presence of anomalous tendons and muscles can be detected. Chronic lateral ankle pain and instability can be associated with peroneal tendon pathology and MRI may be used to assess both longitudinal attrition of the peroneus brevis tendon, as well as the presence of the peroneus quartus which may be useful in lateral ankle reconstruction. Tenography can occasionally present technical difficulties and can lead to patient dissatisfaction.

Adult↗
PubMed1991

Longitudinal splitting of the peroneus brevis tendon: an anatomic and histologic study of cadaveric material.

Gross and microscopic examinations of 21 split and 10 intact cadaveric peroneus brevis tendons were performed in an effort to determine the pathogenesis of longitudinal splitting of this tendon. The split regions were centered over the posterior margin of the distal fibula and were characterized by splaying of the collagen bundles with accompanying proliferation of blood vessels and fibrovascular connective tissue. Inflammatory infiltrates were not present. Regions of the tendons that were not altered had normal cellularity and orientation of the collagen. The findings of this study suggest that the splitting of the tendon develops through a mechanical mechanism.

Adult↗
PubMed1990

Congenital variations of the peroneus quartus muscle: an anatomic study.

There has been little research concerning this muscle since the 1920s, when Hecker described this muscle to be present in (13%) of his dissections of cadaver legs. The purpose of our dissections was to establish the incidence of the peroneus quartus muscle, its origins, and insertions. One hundred and twenty-four legs from 65 fresh human cadavers were dissected under loupe magnification. When the peroneus quartus tendon was found, its origin, insertion, and anatomic relationship to the peroneus longus and peroneus brevis were observed. All specimens were sketched and photographed. The peroneus quartus muscle was present in 27 legs (21.7% of specimens). Its origins, insertions, and size varied. In 17 legs (63%) the muscle originated from the muscular portion of the peroneus brevis, and inserted on the peroneal tubercle of the calcaneus. The peroneal tubercle was hypertrophied at the insertion in most cases. The results of this study in general show that there was much higher incidence of the peroneus quartus muscle than Hecker claimed. Its course, origin, and insertion varied. Its tendon can be used for reconstructive procedures about the lateral aspect of the ankle, especially in anterior dislocation of the peroneal tendons and reconstruction of lateral ligaments.

Aged↗
PubMed1990

Longitudinal attrition of the peroneus brevis tendon in the fibular groove: an anatomic study.

There has been little research concerning the attrition of the peroneus brevis tendon since Meyer's observation in 1924. The purpose of our dissections was to establish the incidence of the attrition of the peroneus brevis tendon at the fibular groove, and observe the anatomical relationship of the tendon attrition to the bony anatomy of the distal fibula. One hundred and twenty-four fresh human cadavers ankles from 65 cadavers were dissected under loupe magnification. When attrition of the peroneus brevis was found, the extent of attrition was measured, and anatomic proximity of the tendon to distal fibular groove was observed. Evidence of other tendon attrition as well as the depth of the fibular groove was observed. Specimens which revealed attrition of the peroneus brevis were sketched and photographed. Attrition of the peroneus brevis tendon was found in 14 ankles (11.3% of specimens). The attrition was limited only to the peroneus brevis tendon, and in no specimens was the peroneus longus involved. The degree of tendon attrition varied from simple splaying out of the peroneus brevis in the fibular groove to longitudinal splits in the peroneus brevis tendon with significant fraying of the remaining halves of the tendon. The longitudinal ruptures in the peroneus brevis tendon averaged 1.9 cm (range 1-4 cm). In all cases, the central portion of the longitudinal split was centered over the distal tip of the fibula in the fibular groove. In no case was a complete rupture of the peroneus brevis tendon noted. There was gross evidence of chronic inflammation and synovitis in those ankles with attrition of the peroneus brevis tendon.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1979

Case report 91.

Explore the source record for details and available documents.

Adult↗
PubMed1978

Neuropathic injuries to the lower extremities in children.

Neuropathic injuries of the lower extremities in children due to meningomyelocele, congenital indifference to pain, and peripheral nerve damage were studied in 10 patients. The injuries fell into four categories: (a) fractures of the metaphysis and diaphysis of long bones, (b) epiphyseal separation, (c) Charcot joints, and (d) soft-tissue ulceration. These injuries are often unrecognized; untreated, they can lead to severe disability. For patients with impaired sensation, radiographs should be obtained at any sign of localized soft-tissue swelling, warmth, or hyperemia, especially near a joint. Following diagnosis, immobilization of the limb will lead to prompt healing of fractures and epiphyseal separation.

Child↗
PubMed1978

Thalassemic osteoarthropathy.

Patients with beta thalassemia major may develop a specific osteoarthropathy as they approach the second and third decades of life. Twenty-five of 50 patients between the ages of 5 and 33 years had evidence of periarticular disease that consisted of dull-aching ankle pain exacerbated by weight bearing and relieved by rest. Involvement was symmetrical with mild swelling and pain on bone compression. Arthrocentesis showed no evidence of inflammation. Radiographic changes included osteopenia, widened medullary spaces, thin cortices with coarse trabeculations, and evidence of microfractures. Histologic studies confirmed the presence of microfractures and showed osteomalacia and an increase in osteoblastic and osteoclastic surface area with iron deposites at the calcification front and cement lines. The relative roles of iron overload, divalent cation metabolism, erythroid hyperplasia, or other factors in the pathogenesis of the syndrome remain unknown, and no specific therapy can be recommended at present.

Adolescent↗
PubMed1977

A radiographic study of the ligamentous anatomy of the ankle.

Ankle trauma commonly results in significant injury. Knowledge of the anatomy of the normally nonopaque major supportive ligaments, and their relationships to the osseous structures seen on standard roentgenograms, facilitates interpretation of both plain films and ankle arthrograms. A group of normal, non-preserved ankles was dissected. The laterally located anterior talofibular calcaneofibular, posterior talofibular, distal anterior tibiofibular ligaments, and the medially located deltoid ligament were carefully defined. They were coated with a mixture of powdered tantalum, photographed, and then radiographed in standard projections. The normal gross anatomy of these major supportive ligaments of the ankle and their relationship to the osseous structures about the ankle are remarkably constant.

Ankle↗
PubMed1977

Hypoplasia of the fibula.

Fibular hypoplasia occurs in differing degrees of severity with fibular hemimelia as its most severe form. Normally the distal epiphyseal plate of the fibula is at the same level as the distal end of the distal tibial epiphysis, whereas the tip of the proximal fibular epiphysis is level with the proximal tibial epiphyseal plate. Varying degrees of shortening of the fibula in relation to the tibia were found in 14 children, 6 of them boys. Shortening at the distal end of the tibia leads to instability of the ankle. Shortening at the proximal end of the fibula leads to hypoplasia of the lateral tibial plateau and valgus deformity of the knee. Syme type ankle disarticulation became necessary in five cases of fibular hemimelia because of leg length discrepancies or ankle instability.

Ankle Joint↗
PubMed1975

Primary osteoarthrosis of the knee or hip. Prevalence of Heberden nodes in relation to age and sex.

One hundred twenty probands with primary osteoarthrosis of the hip or knee were examined prospectively; there were 194 controls. In addition, 193 patients with hip or knee arthrosis were examined retrospectively. Restriction of rotation on physical examination accurately differentiated arthrotic hips from normal ones. Among women, 38% of the controls and 49% of the probands had Heberden nodes (P more than .1). Their prevalence increased with age. Individuals with multiple arthrosis joints were not older than those with single joint involvement, and they has a similar prevalence of nodes. Of the probands, 14% had arthrosis of both the knee and hip. Of those with bilateral hip arthrosis, 33% had knee arthrosis as well. Heberden nodes are unrelated to osteoarthrosis of the knee or hip. Knee and hip arthroses frequently occur together and remain confined to the initially affected joints. They may have a common cause.

Age Factors↗
PubMed1975

18-F scintimetric diagnosis of osteoid osteoma of the carpal scaphoid bone.

In a patient with symptoms suggestive of osteoid osteoma of the carpal scaphoid, 18-F scintimetry supported the diagnosis in the absence of clear cut roentgenographic signs. High concentration of 18-F in the area of the lesion allowed direct surgical approach and extirpation. The diagnosis was proven by histology.

Adult↗
PubMed1975

Further observations on 85Sr scintimetry in intracapsular fracture of the hip.

Sixty-seven hip joints with intracapsular fracture and the 67 opposite, normal hip joints were studied with 85Sr scintimetry from two weeks to six years after fracture. Consistently, fractures that developed osteonecrosis showed extremely high counts at the fracture site and the femoral head; fractures that failed to unite also showed extremely high counts at the fracture site and somewhat lower counts in the femoral head; fractures that were healing normally showed counts at the fracture site that were higher than those of the normal, uninjured hip but lower than those at fracture sites where osteonecrosis or nonunion was present. Prediction of complications by 85Sr scintimetry is not reliable within the first few months on injury; thereafter, however, the procedure has definite diagnostic value, particularly for osteonecrosis.

Adult↗
PubMed1975

The Syme amputation in children.

Twenty-three children had proportionate growth of bone and soft tissue between two and eleven years after a Syme ankle disarticulation. All walked with permanent prostheses within three months after operation. Ischemic necrosis occurred twice after inadvertent ligation of the posterior tibial artery. Suture of the extensor tendons into the heel pad eliminated its posterior migration. Prosthetic realignment compensated for progressive genu valgum in ten of fourteen amputees with fibular hemimelia. On the basis of these gratifying results, the Syme ankle disarticulation is suggested as early treatment for certain congenital anomalies of the lower extremity.

Adolescent↗
PubMedDate not supplied

The microvasculature of the sesamoid complex: its clinical significance.

The microvascular anatomy of the sesamoid complex was investigated in 15 cadaver specimens using histology and tissue clearing (Spalteholz) techniques. It was found that both sesamoids appeared equally well vascularized and the vascular supply to each sesamoid originated from two major sources (proximal and plantar) and one minor source (distal). Proximally, vessels originating from the first plantar metatarsal artery enter the sesamoid at its attachment to the flexor hallucis brevis. In addition, vessels enter the plantar surface of the sesamoid near the midline and arborize throughout the bone, anastamosing with the proximal vessels. The distal vascular supply to the sesamoids originates from its distal capsular attachment and appears to contribute minimally to the overall vascular scheme. The lateral attachments of the sesamoids to the plantar plate and joint capsule were relatively avascular. In two bipartite specimens examined, the major blood supply originated from the proximal and distal poles of the sesamoid. No vessels were observed entering the plantar surface of these specimens. The results of this study suggest that injury to the proximal or plantar aspects of the sesamoids could disrupt the vascular supply to these bones. These areas should, therefore, be avoided during the surgical approach to the sesamoids.

Hallux↗