Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Disarticulation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed1990

Fibula dimelia in association with ipsilateral proximal focal femoral deficiency, tibial deficiency, and polydactyly. A case report.

A 16-year-old girl with bilateral tibial deficiency, left fibula dimelia, left proximal focal femoral deficiency, polydactyly, and congenital heart disease is now ambulatory and able to attend public school. This combination of anomalies has been overcome by cardiac surgery followed by Boyd-type amputation, prosthetic restoration, and therapy. The shortened left distal femur was lengthened by implanting both amputation fibulae proximally. In the same surgery, the amputation os calcis was fused distally to these fibulae. The right fibula was disarticulated at the knee. The female patient was fitted with bilateral knee disarticulation prostheses. She became fully ambulatory with a walker, progressing to bilateral forearm crutches. Recurrent deformity at the fusion site of the left femoral segment to the fibulae required a subsequent wedge osteotomy and multiple surgeries during the years following. Today she remains ambulatory with the use of nonaxillary crutches, attends public school, and is without pain. She takes part in athletics within the range of her abilities and hopes to obtain a driver's license and use a modified car. She is independent and well adjusted. Her progress has been followed from the age of 11-and-one-half months to present.

Abnormalities, Multiple↗
PubMed1989

[Knee exarticulation: technique for amputation of ischemic extremities].

A knee disarticulation or a trough-knee amputation stump is superior to an above-knee stump. Knee disarticulation does not require that bone be sectioned or muscle cut. The stump allows total end-load capacity. The muscle balance remains undisturbed. Due to the bulbous shape of the stump prosthetic fitting of modern appliances no longer presents problems. An operative technique especially developed for vascular patients is described in detail, including the postoperative treatment and the principles of prosthetic fitting.

Amputation, Surgical↗
PubMed1996

Major ablative procedures in orthopaedic surgery.

In the presence of the notable progress in limb-sparing techniques afforded by the developments in microsurgery and musculoskeletal oncology, major ablative surgery of the extremities still remains a last-resort, yet powerful tool in managing patients with primary tumors in whom wide excision is not possible, as well as in cases with severe trauma to the limbs. During the last thirteen years, eight major ablative procedures were performed at the Department of Orthopaedic Surgery of the University of Ioannina Medical School. Seven out of the eight procedures were performed in patients with primary malignant tumors either because the anatomical location or multiple recurrences of the tumor did not allow removal by wide local excision or by amputation at a lower level. In one patient, the procedure was related to a severe, mangling trauma. Four illustrative cases of the eight major ablative procedures performed are reported to highlight the current indications of this rarely used, complex, and extensive surgery. The characteristic cases presented are: hemipelvectomy in a patient with chondrosarcoma of the pelvis, disarticulation of the hip in a patient with a malignant histiocytoma of the supracondylar area of the knee, forequarter amputation in a patient with a basal cell carcinoma of the axilla, and disarticulation of the shoulder in a patient with an incomplete nonviable amputation at the level of the shoulder girdle associated with severe damage to the brachial plexus and axillary artery. After a five to over a ten year follow-up, six of the eight patients who where subjected to major ablative procedures are doing well and are satisfactorily active. These cases reflect the dilemma that orthopaedic surgeons geons still face in selecting limb salvage or major ablative surgery in cases of aggressive malignant tumors to severe trauma.

Amputation, Surgical↗
PubMed1975

Otoadmittance measurements in cases of dual ossicular disorders.

Audiologic evaluations, including otoadmittance measurements, were obtained on two patients, each of whom had dual, series-connected disorders of ossicular fixation and disarticulation. In one case, the disarticulation was the lateral-most disorder; in the other case the fixation was the lateral-most disorder. In both cases, it was the lateral-most disorder that had the dominant effect on the otoadmittance of the tympanic membrane, due to the fact that the sites of the two disorders were connected in series with the tympanic membrane.

Adult↗
PubMed1975

Surgical management of osteogenic sarcoma of the mandible.

Osteogenic sarcoma is the most common malignant tumor of the mandible. It is less aggressive than osteogenic sarcoma of the long bones, and mortality is often due to local persistence or intracranial extension. We report such a case to emphasize that disarticulation of the mandible is necessary, since clinical and pathologic evaluation of tumor extent may be impossible. Except for parasymphysial lesions, disarticulation with midline hemimandibulectomy and frozen section assessment of all margins is recommended.

Adult↗
PubMed1987

Local vs systemic effects of acoustic trauma on cochlear structure and transport.

Whether certain effects of acoustic trauma on cochlear structure and function were due to local or systemic agents was investigated in the chinchilla. After unilateral ossicular disarticulation, the animals were given a noise exposure known to cause cochlear damage and vessel transport changes in the stria vascularis. The cochleas with disarticulated ossicular chains received an effective exposure well below one that causes pathologic damage. Only the cochleas with intact ossicular chains showed an increase in the permeability of the strial vessels to horseradish peroxidase tracer and manifested strial edema and organ of Corti damage. These results indicate that the effects of acoustic trauma on cochlear structure and strial vessel transport are induced locally, not systemically. In addition, the minimum time of exposure to 120-dB, 700- to 2800-Hz noise that causes massive cochlear damage in the chinchilla was shown to be between five and ten minutes.

Animals↗
PubMed1981

Prospective use of xenon Xe 133 clearance for amputation level selection.

Xenon Xe 133 clearance was used to select the most distal amputation level that would allow sufficient blood flow for healing. Capillary blood flow was first measured at the most distal potential amputation level, then at successive proximal levels until an amputation site was found that had a capillary skin blood flow rate greater than or equal to 2.6 mL/min/100 g of tissue. Xenon Xe 133 in saline (100 to 500 mCi) was injected intracutaneously at each level, and flow rates were determined using a gamma camera interfaced with a computer system programmed for the Ketty-Schmidt formula modified for capillary blood flow. There were 45 cases, including one toes, six transmetatarsal, five Syme's, 25 below-knee, four knee disarticulation, three above-knee, and one hip disarticulation amputation. All amputations in patients with flow rates exceeding 2.4 mL/min/100 g of tissue healed, with two exceptions.

Aged↗
PubMed1997

Methanol causes posteriorization of cervical vertebrae in mice.

Inhalation of methanol by pregnant mice before gestation day nine (gd 9) produces fetal skeletal alterations, principally in the cervical region. The appearance of these defects suggests homeotic shifts in segment identity, patterning, or both. To explore this possibility, detailed morphological analyses of the effects of methanol on fetal skeletal development were done. Pregnant mice were gavaged with 0, 4.0, or 5.0 g/kg methanol (MeOH) split in two doses on gd 7, the most sensitive day for induction of skeletal alterations with methanol. Dams were killed on gd 18 and the fetuses were counted, weighed, and examined externally. Fetuses were double stained with alcian blue and alizarin red for examination of cartilaginous and ossified vertebral and rib characteristics, and in selected fetuses cervical vertebrae were disarticulated for more detailed analysis. Observations indicative of methanol-induced homeotic transformations were as follows: [tabular data: see abstract volume] Examination of disarticulated vertebrae revealed foramina and other distinguishing characteristics on vertebrae anterior to those on which they normally appear. These results demonstrate that maternal methanol exposure can alter segment patterning in the developing mouse embryo, producing posteriorization of cervical vertebrae.

Abnormalities, Drug-Induced↗
PubMed2006

Mechanical contribution of the fibula to torsion stiffness in the lower extremity.

The role of the fibula in rotational stability of the lower extremity, taking into account the intact knee joint and tibia, to the best of our knowledge, has not been investigated. A cadaver study was designed to determine the torque transfer down the lower extremity, with and without the fibula. Six fresh, frozen human cadaver legs were used. The knee joint was left intact and the foot disarticulated. An external rotation up to 5 degrees , coupled with axial compression, was applied to the femur passing through the knee joint in extension and down the lower extremity to the fixed distal end, where torque (N m) was measured via a load cell. Each specimen was further tested with the fibula, cut 4 cm from the distal end, and finally with the entire fibula disarticulated at the proximal end and removed. To achieve 5 degrees rotation, torques reached 1.82 N m (SD, 0.66 N m). When the fibula was cut, the torque reduced a small yet significant amount of 5%. With the entire fibula removed, the torque reduction was significant and more pronounced at 11%. The fibula provided a small yet significant role in torsion stability. From this study, where the biomechanical characteristics of the fibula is explicated, it is hoped that this information will have use in further understanding the biomechanical role of the fibula, especially, in relation to the altered mechanics associated with lower limb pathology involving a deficient fibula.

Aged↗
PubMed1996

Visualization by magnetic resonance imaging of focal cartilage lesions in the excised mini-pig knee.

This study showed that magnetic resonance imaging can be used to visualize partial thickness cartilage lesions, 0.7 x 10 mm in area and 0.5 mm in depth, surgically induced in the femur (femoropatellar compartment) of a mini-pig knee joint. Formalin-fixed joints, intact as well as disarticulated, were studied by high resolution imaging using a 2.35 T, 31 cm horizontal-bore superconducting magnet. The two-dimensional and three-dimensional spatial resolutions achievable were as follows: 0.12 x 0.23 mm (two-dimensional) and 0.35 x 0.35 x 0.35 mm (three-dimensional) for the intact joint, and 0.08 x 0.08 mm (two-dimensional) and 0.14 x 0.14 x 0.27 mm (three-dimensional) for the disarticulated joint. These results demonstrate that magnetic resonance imaging, together with edge detection and volume rendering, can be used to visualize focal cartilage lesions.

Animals↗
PubMed1999

Morphologic and imaging studies of duplicate optic canals in dry adult human skulls.

Three dry adult human skulls, two with bilateral and one with unilateral duplication of the optic canal were found. Their gross morphologic features were studied. Optic canals were separated by a septum of variable thickness dividing the posterior part of the canal into a large canal in the usual position and a smaller one inferior to it. The skull with unilateral duplication of the right side had a bony bar forming the carotico-clinoid canal. One of the skulls was disarticulated and its sphenoid had bilaterally duplicated optic canals divided by thin septa, both having a slit. Conventional radiography and CT scans for the optic canal were performed on two of these skulls but not on the disarticulated bone, and the imaging representations of these features were correlated with the anatomic findings on the dry skull.

Adult↗
PubMed2005

Map-based analysis of genes affecting the brittle rachis character in tetraploid wheat (Triticum turgidum L.).

The mature spike rachis of wild emmer [Triticum turgidum L. ssp. dicoccoides (Körn. ex Asch. and Graebner) Thell.] disarticulates spontaneously between each spikelet leading to the dispersion of wedge-type diaspores. By contrast, the spike rachis of domesticated emmer (Triticum turgidum L. ssp. turgidum) fails to disarticulate and remains intact until it is harvested. This major distinguishing feature between wild and domesticated emmer is controlled by two major genes, brittle rachis 2 (Br-A2) and brittle rachis 3 (Br-A3) on the short arms of chromosomes 3A and 3B, respectively. Because of their biological and agricultural importance, a map-based analysis of these genes was undertaken. Using two recombinant inbred chromosome line (RICL) populations, Br-A2, on chromosome 3A, was localized to a approximately 11-cM region between Xgwm2 and a cluster of linked loci (Xgwm666.1, Xbarc19, Xcfa2164, Xbarc356, and Xgwm674), whereas Br-A3, on chromosome 3B, was localized to a approximately 24-cM interval between Xbarc218 and Xwmc777. Comparative mapping analyses suggested that both Br-A2 and Br-A3 were present in homologous regions on chromosomes 3A and 3B, respectively. Furthermore, Br-A2 and Br-A3 from wheat and Btr1/Btr2 on chromosome 3H of barley (Hordeum vulgare L.) also were homologous suggesting that the location of major determinants of the brittle rachis trait in these species has been conserved. On the other hand, brittle rachis loci of wheat and barley, and a shattering locus on rice chromosome 1 did not appear to be orthologous. Linkage and deletion-based bin mapping comparisons suggested that Br-A2 and Br-A3 may reside in chromosomal areas where the estimated frequency of recombination was approximately 4.3 Mb/cM. These estimates indicated that the cloning of Br-A2 and Br-A3 using map-based methods would be extremely challenging.

Chromosome Mapping↗
PubMed2005

Cardiopulmonary bypass in surgery for complex-combined vascular malformation of the lower limb: case report.

A 16-year-old boy was referred with features of Parkes Weber syndrome (PWS) involving the right lower limb. He had presented at birth with cutaneous vascular malformations (VM) in the right thigh and at the age of 7 years developed congestive cardiac failure, which was controlled with drugs. He received alpha interferon and steroids during this period without any benefit. He defaulted follow-up and at 12 years of age presented with further enlargement of the VM in the right thigh and leg with skin and soft tissue thickening. At this stage, embolization and subsequent excision of the VM were tried, but the surgery was abandoned because of massive hemorrhage. Over the next 4 years, the boy became totally bedridden because of massive increase in the size of the limb, repeated hemorrhages, and secondary infection of the VM. Right hip disarticulation was considered the best option to improve his quality of life. To prevent uncontrollable hemorrhage during surgery, the disarticulation was done under cardiopulmonary bypass with low circulatory flow. Postoperatively, the patient required intensive care nursing for a week. He is presently ambulatory with crutches. Cardiopulmonary bypass with low flow has been used for treating posttraumatic arteriovenous malformations. However, its use in surgery for PWS has not been reported earlier.

Adolescent↗
PubMed1998

Re-implantation of autoclaved bone segments in musculoskeletal tumor surgery. Clinical experience in 9 patients followed for 1.1-8.4 years and review of the literature.

Nine patients who had malignant bone tumors of the lower extremity were managed with wide en bloc resection and re-implantation of the extracorporeally autoclaved specimens. The segments were fixed by plate osteosynthesis, knee arthrodesis rod, or intramedullary nails. In one patient the complete femur was re-implanted. After a mean follow-up of 66 months (range 13-101 months), 8 out of 9 patients were still free of disease. One patient with Ewing's sarcoma and re-implantation of the complete femur died of systemic recurrence. No local recurrence was seen. One patient with Ewing's sarcoma of the tibia who had undergone postoperative irradiation developed a local infection 18 months postoperatively which finally had to be treated by knee disarticulation. After an average duration of 13 months, all graft-host junctions had healed. The functional result of the patient with the knee disarticulation was poor. In all other patients, the functional outcome was good or excellent. The evaluation of 115 patients (106 from the literature, 9 from our study) with a mean follow-up of 63 months showed 8 local recurrences. There were 4 secondary infections and only 1 primary infection. In tumors of the extremities and the pelvis, the functional outcome was excellent or good in about 80%. Limb salvage using re-implantation of autoclaved tumor-bearing bone segments for reconstruction has a low complication rate and good functional results in appropriately selected patients compared with other options of management.

Adolescent↗
PubMed1982

The postnatal development of the palatomaxillary region studied on human autopsy material.

Greater understanding of the postnatal region of the maxilla is necessary if the normal growth of the maxillary complex, as well as its reaction to orthopedic forces, is to be comprehended. The area in question was studied at various stages of development, both on dry skulls and on autopsy material. The skull material demonstrated an increasing approximation between the palatal bone and the adjacent bones, the maxilla and pterygoid process. Disarticulation of the bones studied was possible only on skulls representing the infantile and earliest adolescent periods. Attempted disarticulation in the later juvenile and early adolescent periods was always accompanied by fracture of the heavily interdigitated osseous surfaces. The complexity of the articulating surfaces was studied further and, by means of quantitation of the bony surfaces, an "index of complexity" was calculated. The findings of the present study that the palatal bone acts as a "buffer" between two areas of differing intrinsic growth pattern and that the remodeling processes in the area seem to reflect different functional demands to the bony pharynx and the maxillary complex. The rigidity of the area as a result of the observed sutural complexity indicates that the center of rotation for the observed spatial changes in the maxillary complex as a result of orthopedic forces could be localized in the palatomaxillary region.

Adolescent↗
PubMed1986

Mechanical analysis of the malformed, yet functional, mandibular joints of a wild timber wolf, Canis lupus.

In spite of grossly malformed jaw joints, presumably from birth, the animal survived in the wild for at least 3 years. Instead of a deep glenoid fossa folded over a cylindrical condyle to form a hinge, both joints had freely open articulating surfaces and a mandibular condyle without neck. The neckless condyle produced a shorter moment arm of resistance in all biting positions. The moment arm of the masseter, the jaw-adductor tending to disarticulate the jaw, was longer as a result of an elongated angular process. The combined effect at the carnassials was a 36 per cent improvement in the efficiency of the lever for which the joint is the fulcrum and thus an equivalent reduction in the disarticulating force. The joints were held together by an extra stout ligament about 5 mm in diameter and 8 mm long, linking the lateral pole of the condyle to the zygomatic arch.

Animals↗
PubMed1982

Multifunctional prosthesis and orthosis control via microcomputer identification of temporal pattern differences in single-site myoelectric signals.

The paper discusses results of on-line tests on amputees and hemiplegics of multifunctional prostheses and orthoses control by identifying the parameters of single-site temporal EMG signal signatures. The results relate to tests on above-elbow amputees, on shoulder-disarticulation amputees (including a congenital disarticulation amputee) and on hemiplegics, varying from 5 to 50 years of age. The system employed is based on an 8-bit Intel 8080 microprocessor, when computation is in double precision, to obtain an effective 16-bit work-length. The system employs a sequential least-squares algorithm to identify a 4-parameter auto-regressive time-series model of the EMG signal, and a Bayesian rule discrimination algorithm.

Adolescent↗
PubMed1993

Disassembly of a modular humeral prosthesis. A case report.

A modular humeral hemiarthroplasty utilizing a prosthesis with a taper-lock design was performed on a 77-year-old woman with a diagnosis of rotator cuff arthropathy. Radiographic examination at 3 months after surgery revealed disarticulation of the modular head and neck from the humeral prosthetic stem. This is a case report of a disarticulated modular humeral hemiarthroplasty.

Aged↗