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Biomedical subjects

W H Castro

Publications and source records attributed to W H Castro.

At least 73 records · Page 4Linked to original sources
PubMed1990

Bilateral posterior pendulum dislocation of the shoulder. Case report and review of the literature.

A 20-year-old patient with bilateral voluntary and involuntary dislocation of both shoulders is reported on. There was no history of significant trauma, no systemic hypermobility of joints, no signs of neurological or psychological problems, and no evidence of joint disease. According to Reischauer's classification of shoulder instabilities, the patient suffered from bilateral posterior pendulum dislocations of his shoulders. The literature is reviewed and different classifications of shoulder instability and the underlying pathology of voluntary and involuntary shoulder dislocations are discussed. After ruling out the possibility of psychological problems, we performed an operative stabilization by arthroscopic means. At 1-year follow-up the patient reported no recurrence, good shoulder musculature, and no disability at work. This result confirms the unsuspicious psychological evaluation and our therapeutic management.

Adult↗
PubMed1990

[Possibilities of sonography in patellar apex syndrome].

23 Patients suffering from jumper's knee were examined by sonography. Using ultrasound imaging, we demonstrated pathologic changes in the tendon. Reproducible documentation of the patella tendon was proved by using three specimens. In a control group of 110 normal objects normative values for the size and structure of the tendon were documented. We present a classification using ultrasound patterns. With this classification the diagnosis becomes objective and reproducible. The physician can decide which conservative therapy is appropriate to this state of the disease, the surgeon gets information for the operation, and the success of the therapy can be documented.

Adolescent↗
PubMed1990

[Secondary impingement syndrome in athletes].

Dysfunction of the shoulder joint is based not only on anatomic conditions. The consideration of the special kinesiology of the shoulder helps to understand the shoulder pathology. This mainly applies to young "overhead athletes" like swimmers, handball-, basketball-, volleyball-, and racketplayers. These disciplines cause stress on the anterior joint structures (capsule, ligaments, labrum, subscapularis tendon) and lead to anterior instability. This includes anterior subluxation or even dislocation. Finally, an impingement syndrome with the typical symptoms can frequently result from these conditions. The impingement-syndrome of the elderly must be considered as a primary disease, whereas the young overhead athlete suffers from the impingement syndrome as a secondary disease and does not take the first place in therapy. The first step in therapy should to be treat the muscular imbalance of the shoulder. To gain a regular pattern of motion the rotator cuff must be strengthened. This regimen is likely to be successful in 80-90% of the cases. If the conservative therapy fails the surgical treatment may come into consideration. Arthroscopic surgery has the advantage not to affect the proprioceptivity. To retain the previous level of performance an adequate rehabilitation programme is essential for the athlete.

Adolescent↗
PubMed1990

Damage of the long thoracic and dorsal scapular nerve after traumatic shoulder dislocation: case report and review of the literature.

A judo injury resulted in an anterior shoulder dislocation with a concomitant lesion of the long thoracic and the dorsal scapula nerve. This injury led to loss of function and extreme instability of the shoulder. Stabilization of the glenohumeral joint was successfully accomplished by surgery. The athlete declined further operative approaches to stabilize the scapula. The patient was able to return to the former level of athletic activity.

Adult↗
PubMed1990

[Bone banks in the FRG. Results of a survey].

In a nationwide survey, 1350 departments of general surgery, trauma surgery, and orthopedic surgery were approached in an attempt to determine how many surgeons use bone grafts and how they manage their bone banks; 961 responded to the postal enquiry. Bone banks are currently in use in 471 departments. The storage temperature varies between 0 degrees C and -30 degrees C in more than 50%. In 90% bone is stored for no longer than 12 months. In only 6 bone banks secondary sterilization of the bone is performed. In 1 year, 71,000 autogeneic and 25,000 allogeneic bone grafts are performed. A further 18,000 per year could be performed if bone grafts were available. We discuss the results of the survey and present an overview of the current problems concerning storage temperature and adjuvant local antibiotics, the role of HIV in bone banking, and the possibilities opened up by secondary sterilization.

Bone Transplantation↗
PubMed1990

Shoulder instability in Ehlers-Danlos syndrome. An indication for surgical treatment?

In a 19-year-old female patient with Ehlers-Danlos Syndrome and bilateral multidirectional voluntary dislocations, multiple surgical attempts to achieve stability were ineffective. Joint laxity and hyperelastic tissue are underlying factors contributing to failure of stabilization. More importantly, voluntary dislocations often achieve secondary gain and need preoperative psychological evaluation.

Child↗
PubMed1989

[Percutaneous nucleotomy: indications and preliminary results].

Percutaneous nucleotomy was developed in the late seventies. In the beginning special forceps were used to remove the nuclear tissue. However, because of the large diameter of the cannulas used there was a risk of nerve damage. In 1985 Onik et al. presented the 'automated percutaneous lumbar diskectomy'. The risk of damage to the surrounding tissues of the disc was low. The method proved to be successful. In this article we describe the method and analyse our first 40 patients treated for a disc protrusion between February and June, 1988. This pilot study also shows that CT discography is important for the selection of patients for treatment with this method.

Adolescent↗
PubMed1989

A rare tumor at the elbow: a glomangioma. Differential diagnosis and therapy.

Referring to a case of a glomangioma at the elbow, several aspects of this tumor are illustrated. Since the related hemangiopericytoma can be distinguished from the glomangioma by its biological behavior, the morphological differential diagnosis of both tumors is discussed in detail. Therapeutic consequences of one or the other diagnosis are also indicated.

Aged↗
PubMed1989

[Possibilities of sonography in the diagnosis of instabilities of the shoulder joint].

We present ultrasound investigation as a diagnostic tool for shoulder instability. The following structures are visible in the posterior transversal plane: subcutis, deltoid muscle, infraspinatus muscle, infraspinatus tendon, humeral head, scapula, dorsal glenoid rim, dorsal labrum, and the joint capsule. The relation of the humeral head to the glenoid can be judged statically and dynamically. Anterior and posterior instabilities and secondary signs of dislocation such as Hill-Sachs lesion and effusion can be seen. This technique is easy to learn. By comparing the injured with the normal shoulder the examiner can control his diagnosis. There is no need for positioning the patient in a special way. Sonographic evaluation is non-invasive and inexpensive.

Humans↗
PubMed1989

[The value of sonography in injuries of the knee joint].

In an experimental study we examined three knee specimens with regard to the value of ultrasound for imaging soft tissue structures. Subsequently we documented artificial lesions at the menisci and ligaments. With this experience we started a prospective study comparing the preoperative ultrasound investigation with the results of arthroscopy in 101 patients. For ultrasound evaluation we used a 5 MHz linear and a 7.5 MHz sector scanner. In the experimental as well as in the clinical study the menisci were well visualised. For medial meniscus lesions the accuracy and the predictive value was 81%. For the lateral meniscus the predictive value was 80%, although there was only an accuracy of 7% because of a large number of false positive results. We were not able to reliably detect cruciate ligament ruptures. However, ultrasound was useful to visualise Baker's cysts, bursitis, and jumper's knee.

Arthroscopy↗
PubMed1989

[Possibilities for using sonography in sports injuries of the shoulder joint].

Sonography is a useful tool for the examination of the shoulder joint. Concomitant cartilaginous and soft tissue lesions (Hill-Sachs, effusion, cuff-tears) can be visualized. Subacromial pathology can be differentiated. The type of instability in the unstable shoulder can be documented. The ultrasound investigation is of diagnostic value for the unstable shoulder as well as for the impingement shoulder in athletes. Therefore it may be helpful for planning the adequate treatment and also for the follow up of the patients.

Athletic Injuries↗
PubMed1989

[Intracompartmental pressure in the anterior tibial compartment. Demonstration of the course of pressure in the gait cycle].

During walking the anterior tibial compartment pressure was measured continuously using a new technique. The test subjects were made to walk on a treadmill at the standardised walking spees fo 3, 6, and 8 km/h. Documentation of intrafascial pressure was obtained continously, while gait-analysis and pressure changes were simultaneously documented on video-tape. Readily reproductible pressure curves were obtained. The increase in walking speed correlated to increase in intracompartmental pressure, and the varying pressure was accurately correlated to gait phases. Minimum pressure was recorded in the phase immediately prior to initial heel contact (IC). During "mid-stand" (MST) the pressure remained constant. "Terminal-stand" (TSZ) and pre-swing (PS) are associated with peak pressure. The method described is suitable for continuous and reproducible measurement during walking.

Adolescent↗
PubMed1989

[A new method of bone sterilization].

Bone transplantation is associated with two major problems: the sterility in particular with respect to HIV, and the osteoinductivity of the transplant. We describe a procedure which sterilizes the graft while keeping the osteoinductive potential of the bone. After harvesting the material the bone is immediately deep frozen (-80 degrees C), and then freeze dried. To sterilize the bone it is treated with gamma-radiation at a dose of 2.5 Mrad in an argon atmosphere. All grafts are subsequently stored in argon at -80 degrees C.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Diagnosis and therapy for a leiomyosarcoma of vascular origin.

A case of a leiomyosarcoma of vascular origin in the left calf is presented. Because of the rarity of occurrence, some clinical aspects, and in particular, diagnostic procedures and therapy for the tumor, are discussed along with a review of recent literature.

Aged↗
PubMed1989

A lesion of the musculocutaneous nerve. A rare complication of anterior shoulder dislocation.

A 47-year-old male patient with an anterior shoulder dislocation underwent reduction 3 days later. A residual neurologic injury remained, consisting primarily in weakness of shoulder and elbow flexion and sensory involvement of the ventral side of the forearm. Secondary sequelae included muscle atrophy with a concomitant frozen shoulder. The clinical examination and electromyography revealed a lesion of the musculocutaneous nerve, which is a very rare complication in shoulder dislocation.

Humans↗
PubMed1989

[Etiology of sub-acromial impingement syndrome--a biomechanical study].

Eight fresh shoulder specimen were dissected and the functional relationship of the rotator cuff tendons to the acromion was demonstrated through various arcs of shoulder motion. The scapula was fixed and the arm was elevated, rotated, and abducted by pulling the muscle tendon according to EMG activities. Using FUJI compression films the subacromial compression of the rotator cuff was measured. Different forms of acromion were tested. While moving the shoulder with normal relationship of deltoid to rotator cuff, there is no -or at least less than 0.1 mPa compression of the rotator cuff in the subacromial space. Weakness of the rotator cuff results in a moderate compression of 0.6 mPa. In type III acromion there was significant increase up to 1.0 mPa between the acromion and the rotator cuff. This study suggests, that a mechanical subacromial compression only occurs in shoulder joints with a Bigliani acromion type III and/or in joints with a imbalance of the deltoid/rotator cuff relation. Thus an acromioplasty should be primarily undertaken only if the pathology affects the acromion. If there is a muscle imbalance, we recommend a special rehabilitation program in order to strengthen the cuff-muscles the first place.

Acromion↗