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Biomedical subjects

W T Jackson

Publications and source records attributed to W T Jackson.

At least 127 records · Page 7Linked to original sources
PubMed1989

The value of internal oblique radiographs for posterolateral bone grafting of the tibia.

A 35 degrees internal oblique radiographic view of the tibia was used for the purpose of demonstrating posterolateral tibial bone grafts. This radiograph of the supine patient is made by internally rotating the affected leg 35 degrees obliquely toward the midline. This view eliminates superimposition of both the tibia and fibula on the graft. This method of radiographic evaluation has been found useful in visualization of graft margins intraoperatively and assessing bone graft incorporations in clinical follow-up evaluations. The authors recommend 35 degrees oblique views in preference to anteroposterior and lateral views for patients who have had posterolateral bone grafts of the tibia performed.

Bone Transplantation↗
PubMed1988

Cigarette smoking and Dupuytren's contracture of the hand.

Microvascular occlusion has been implicated as a possible causative factor of Dupuytren's contracture. Cigarette smoking is one of the most significant factors in the development of peripheral vasculopathy. The relationship between smoking and Dupuytren's contracture of the hand is explored in this article. One hundred thirty-two consecutive patients who had a partial fasciectomy for treatment of Dupuytren's contracture from 1980 to 1985, were analyzed retrospectively. There were 111 males and 21 females. Ninety (68.2%) of 132 patients smoked cigarettes compared with 110 (37.2%) of 296 randomized hospitalized control patients (p less than 0.00001). Eighty (72.1%) of 111 men smoked cigarettes compared with 65 (44.2%) of 147 male control patients (p = 0.000015). Cigarette smoking is linked statistically to Dupuytren's disease and may be involved in its pathogenesis by producing microvascular occlusion and subsequent fibrosis and contracture or by some other mechanism.

Adult↗
PubMed1988

Reflex sympathetic dystrophy and cigarette smoking.

Although the cause of reflex sympathetic dystrophy (RSD) remains unknown, hyperactivity of the sympathetic nerves and secondary vasospasm may be pathogenic in this syndrome. A retrospective epidemiologic study of RSD was done on 53 in-patients from 1978-1985. Cigarette smoking was strikingly increased in patient frequency in RSD (68% versus 37% of hospitalized controls, p less than 0.0001). Eighty-seven percent of the patients had a history of trauma or surgery, and 38% had other associated diseases. Cigarette smoking is statistically linked to RSD and may be involved in its pathogenesis by enhancing sympathetic activity, vasoconstriction, or by some other unknown mechanism.

Adolescent↗
PubMed1988

A surface ultrastructure study of ganglia and digital mucous cysts.

Three digital mucous cysts and three dorsal wrist ganglia were studied by light and scanning electron microscopy. Both exhibited the same findings, namely a porous network of collagenous fibers forming the wall and a fibrillated inner surface composed of a random arrangement of collagen fibers. An intermittent thin membrane was observed on the inner surface, but no evidence of a cellular lining was apparent. This anatomic study lends support to a shared cause.

Cysts↗
PubMed1988

Open scapulothoracic dissociation with intact neurovascular status in a child.

A case of open scapulothoracic dissociation with intact neurovascular status in an 8-year-old girl is reported. Scapulothoracic dissociation is a rare injury. Most cases present with significant soft tissue disruption in the shoulder region secondary to separation of the scapula from the thorax, and involve major vascular and brachial plexus injuries. This case report illustrates that an obvious roentgenographic scapulothoracic dissociation may be seen without any neurovascular deficit in a child. Successful treatment, with anatomical repair of the muscles and stabilization of the scapula, is described.

Amputation, Traumatic↗
PubMed1988

Occult rectal perforation in a major pelvic fracture.

Major pelvic fractures are a common sequela of motor vehicle accidents. Hemorrhage, sepsis, and laceration of viscera contribute significantly to the patient's morbidity and mortality and should be promptly evaluated. Early use of computed tomography is helpful in establishing the integrity of viscera and tissue planes. Knowledge of the retroperitoneal pathways of spread of disease may significantly accelerate primary repairs and subsequent early return of function. A case illustrating these concepts is presented.

Adult↗
PubMed1988

Cervical stabilization by plate and bone fusion.

Anterior stabilization with combined plate and bone fusion was performed after neural decompression on ten patients for spondylotic cervical myelopathy, and for radiculopathy or trauma in three patients. Medial corpectomy was performed at one to four levels. Iliac crest or fibular bone grafts were secured by plates anchored to the graft and adjacent vertebral bodies. All patients were placed in Minerva braces postoperatively. There was successful fusion in all cases, and no graft dislodgement or kyphosis. Early initiation of rehabilitation was achieved. Morbidity occurred in patients with severe spondylotic cervical myelopathy. This include respiratory depression requiring reintubation in 2/13 procedures, dysphagia (2/13) from loosening of the screws or prominent hardware and graft, and screw loosening (2/13). Neurological improvement was present in 85% (11/13) of patients. There was no deterioration of neurological function in any case. We conclude from this early follow-up that anterior bone fusion with supplemental plates provides effective stabilization for the unstable cervical spine. Greater morbidity risk exists in patients with severe spondylotic cervical myelopathy and spastic quadriparesis who required multilevel medial corpectomies and fusion.

Adult↗
PubMed1988

Tibial nerve branching in the tarsal tunnel.

Tarsal tunnel syndrome is an infrequent and probably underdiagnosed clinical condition. Diagnosis and treatment depend on understanding the tibial branching pattern within the tarsal tunnel. A total of 68 foot dissections were performed. Bifurcation into the medial and lateral plantar nerves occurred within the tunnel in 93% and proximal in 7%. Proximal bifurcation may predispose to tarsal tunnel syndrome, and its infrequent occurrence correlates with the infrequent clinical diagnosis. Nine different calcaneal branching patterns were noted; they provide an anatomical explanation for heel sparing. An understanding of anatomic variations should aid in providing complete surgical release and in avoiding accidental heel denervations.

Ankle↗
PubMed1988

Osteolysis of the pubic bone simulating malignancy. A case report and review of literature.

A 78-year-old white female presented with groin pain of 3 months' duration. Radiographs revealed an osteolytic lesion in the pubic bone, simulating a malignancy or infection. A closed needle biopsy was performed and pathological findings were consistent with post-traumatic osteolysis, showing avascular necrotic tissues. A review of the literature found 16 previous cases presenting with groin pain and a radiographic lesion in the pubic bone that appeared malignant. All of the patients reported in the literature were postmenopausal women most with a recent history of trauma or increased physical activity. All of the lesions were benign and, when treated conservatively, usually resolved within 6 months.

Aged↗
PubMed1988

Scapulothoracic dissociation.

Scapulothoracic dissociation is a rare entity that consists of disruption of the scapulothoracic articulation. The mechanism of injury is probably traction caused by a blunt force to the shoulder girdle. This lesion is characterized by massive soft-tissue swelling of the shoulder; lateral displacement of the scapula, measured radiographically; an injury to bone (an acromioclavicular separation, a displaced fracture of the clavicle, or a sternoclavicular disruption); a severe neurovascular injury; and a variety of upper and lower-extremity fractures. We treated fifteen patients who had this lesion, most of whom had several associated injuries. Three patients died: two from exsanguination and one from a cardiac arrest. In most patients, the damaged artery was repaired and the brachial plexus was explored. All of the twelve patients who had a complete brachial-plexus injury were left with a flail upper extremity. Most patients refused amputation.

Acromioclavicular Joint↗
PubMed1987

Scapulothoracic dissociation (closed avulsion of the scapula, subclavian artery, and brachial plexus): a newly recognized variant, a new classification, and a review of the literature and treatment options.

Scapulothoracic (ST) dissociation is a closed complete traumatic forequarter amputation manifested by a flail pulseless arm and well-defined roentgenographic findings. These roentgenographic findings were previously reported to be lateral displacement of the scapula and either acromioclavicular separation (17) or displaced clavicular fracture (20). In this paper we present four patients with ST dissociation who had a previously unreported combination of roentgenographic findings: lateral displacement of the scapula and sternoclavicular separation. Polytrauma was present in all previously reported cases of patients with ST dissociation. We present one patient, however, in whom ST dissociation is an isolated finding. A review of the literature, and a review of treatment options that includes some combination of amputation, shoulder arthrodesis, prosthetic fitting, and reconstructive tendon transfers, are presented.

Adult↗
PubMed1987

Percutaneous computed-tomography-stabilization of pelvic fractures: preliminary report.

The authors performed percutaneous computed-tomography (CT)-guided stabilization of reproduced pelvic fractures in eight cadaver studies and in three additional clinical cases. The details of the technique are illustrated in this article. The authors conclude that percutaneous CT-guided stabilization of pelvic fractures in selected cases can be performed safely, rapidly, and with less associated morbidity than conventional open methods presently used. Clinical studies are currently being expanded.

Adult↗
PubMed1987

CT detection of intrapelvic origin of lower extremity infections in traumatized limbs.

Late appearing, lower extremity infections in previously traumatized limbs may originate from occult intrapelvic sources. Computerized tomography can accurately document the intrapelvic source and trace its pathway into the lower extremity. In this paper, we describe two cases of thigh infections originating from pelvic abscesses in limbs that were previously operated on following trauma. Computerized tomography was instrumental in making the diagnosis and directing the appropriate surgical treatment.

Abscess↗
PubMed1987

Transient simultaneous sciatic and femoral nerve palsy secondary to iliacus and gluteal hematomas following heparinization for pulmonary embolus in a patient with posterior hip dislocation.

Sciatic nerve palsy as a result of a posterior hip dislocation has been reported in the literature. Femoral nerve palsy as a result of a iliacus hematoma has also been documented. However, a simultaneous sciatic and femoral nerve palsy occurring after heparinization for a pulmonary embolus in a patient with a posterior hip dislocation has not been reported. This combined nerve palsy was found in a 64-year-old white woman who had been involved in a motor vehicle accident and sustained a posterior hip dislocation. This patient subsequently had a pulmonary embolism, was heparinized, and then developed a large iliacus and gluteal hematoma, resulting in a simultaneous sciatic and femoral nerve palsy. Without treatment, the patient regained motor and sensory of the sciatic nerve in a few days, and a gradual improvement of function of her femoral nerve was evident over several months.

Female↗
PubMed1987

Heterotopic ossification and pseudoarthrosis in the shoulder following encephalitis. A case report and review of the literature.

Heterotopic bone formation, or myositis ossificans, is common, particularly following trauma, total hip arthroplasty, spinal cord injury, severe head injury, and long-term coma. Although the mechanism is unknown, the pathogenesis is assumed to depend on transformation of mesenchymal cells to bone forming cells in response to a variety of stimuli. The clinical findings, laboratory data, roentgenograms, and radionuclide studies are standard aids in the diagnosis of heterotopic ossification. The treatment usually consists of range-of-motion exercise, nonsteroidal antiinflammatory drugs, X-ray therapy, disodium etidronate (EHDP), and excisional surgery. Reported here is a rare case of periarticular heterotopic ossification in the shoulder of a 38-year-old woman following head injury and 13 months in a coma. The unusual feature was the development of a pseudoarthrosis within the heterotopic bone. The patient's shoulder became markedly stiff with the development of a heterotopic pseudoarthrosis. Excision of the heterotopic bone and pseudoarthrosis was performed to improve the range of motion. Clinical roentgenographic, radionuclide, and pathologic observations are presented on the formation of a synovial joint within the heterotopic bone.

Adult↗
PubMed1986

Anatomical variations in the first extensor compartment of the wrist. A clinical and anatomical study.

We studied 300 wrists from cadavera and the wrists of forty patients with de Quervain disease to determine the variation in the pattern of the tendons and septa in the first extensor compartment. In 75 per cent of the wrists from cadavera, we found that the number of tendons within the compartment differed from what is considered standard; there was complete or partial septation in 40 per cent. In about a third of the specimens from cadavera, the first extensor compartment was divided by a septum and two tendons or more were present within the major subcompartment. These features might readily result in inadequate decompression of the compartment in the treatment of de Quervain disease. In our prospective study of forty patients with de Quervain disease, septation was found in twenty-seven. There was no significant difference between the number of patients and the number of specimens from cadavera that had no, one, or two accessory abductor tendons.

Cadaver↗