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PubMed1976

Energy expenditure during walking in patients recovering from fractures of the leg.

The oxygen consumption during walking has been studied in 13 patients recovering from fractures of the leg and in 8 control subjects. Oxygen consumption of normal subjects when walking at velocities of 0.5, 1.0 and 1.5 m sec-1 was 8.0, 9.8 and 13.6 ml kg-1 min-1 respectively. For subjects walking on crutches with the leg encased in a Plaster of Paris cast, the oxygen consumption at these velocities was 12.0, 17.5 and 25.3 ml kg-1 min-1 respectively. The energy cost of walking was reduced when the cast was removed, when the crutches were replaced by sticks and when all aides were discarded. When all aids had been discarded the energy expenditure was normal at 0.5 and 1.0 m sec-1 but was still significantly higher at faster velocities.

Adult↗

PubMed1997

[Treatment results for tibial condyle fractures in material from the Orthopedic and Traumatology Department in Siedlce].

Early results of treatment for tibial condyles fractures in 39 patients are presented. Mean follow-up was 12 months (range 6-14 months), mean patient age was 54 years (range 37-74). Tibial plateau depression smaller than 5 mm was managed conservatively (15 cases). In 23 patients surgery was performed within 7 days from injury. It consisted of subchondral osteotomy and application of frozen cancellous bone graft. The extremity was immobilized in plaster of paris cast for 8 weeks. Bad results in 2 cases were attributed to previous degenerative changes. The authors claim good functional results after reconstructive surgery with the use of frozen cancellous bone grafts.

Adult↗

PubMed1998

Accuracy and precision of volumetric determinations using two commercial CAD systems for prosthetics: a technical note.

The aim of this study was to evaluate the validity and reliability of volume determinations using the commercially available Seattle ShapeMaker CAD/CAM system for production of prosthetic sockets and to compare it with the commercially available CAPOD system. We used three types of reference objects for volumetric determinations: steel tubes, plaster of Paris casts, and residual limb models. Three different sizes were examined for each type of object. Volume measurements with the two CAD/CAM systems were compared with measurements obtained by water filling, water immersion, or mathematical calculation (tubes only). We found an inconsistent systematic error of less than 3.1% for ShapeMaker and no systematic error for CAPOD. Random errors, represented by the coefficient of variation, were below 1.3% for the ShapeMaker and, in most cases, below 0.4% for the CAPOD. Theoretical changes in volume of 2.6% and 0.8% are possible to detect with these CAD/CAM systems. In our opinion, both systems have sufficient precision for routine clinical use in prosthetics and orthotics. However, in our study, the ShapeMaker committed larger random and systematic errors than CAPOD. This means that, according to our study, CAPOD offers the best possibility to determine and detect small changes in residual limb volume as a function of time.

Artificial Limbs↗

PubMed1998

Fracture healing and callus innervation after peripheral nerve resection in rats.

The effects of femoral and sciatic nerve resection on fracture healing and innervation of the fracture callus were studied using a stable fracture model. In 34 rats the right tibia was subjected to a standardized closed fracture and stabilized with a modular intramedullary nail. In half of the animals, resection of 1 cm of the femoral and sciatic nerves was performed (nerve resection group), whereas the other animals had sham operations (sham group). To avoid unequal load-bearing between the two groups, all fractured hindlimbs were immobilized in a plaster of Paris cast. The trial was terminated after 5 weeks of fracture healing. Callus size was scored radiographically, and bone mineralization was measured by 85-strontium incorporation. Seven rats from each group had immunohistochemical examination for neural regeneration and ingrowth. Antisera for protein gene product 9.5, neurofilaments, neural growth associated protein 43/B-50, calcitonin gene related peptide, and substance P were used. The mechanical properties of the healing fractures were recorded in a three-point cantilever bending test. After 5 weeks, the normally innervated, fractured tibias had regained approximately 50% strength compared with the unfractured side, in comparison with only 20% in the animals that had nerve resection. Although the fracture calluses were mechanically weaker, they were significantly larger in the nerve resection group, indicating defects in tissue composition or organization rendered by the nerve injury. The mineralization rate, as measured by 85-strontium incorporation, was the same in the two groups. However, the nerve resection did not provide complete denervation but changed the innervation pattern of the healing fracture, as the density of sensory nerve fibers immunostaining for substance P and neurofilaments was less in the group with femoral and sciatic nerve resection. The results suggest that intact innervation is essential for normal fracture healing because nerve injury induced a large, but mechanically insufficient, fracture callus.

Animals↗

PubMed2002

[Bone graft repair of adolescence spondylolysis with lag screw and tension band fixation].

OBJECTIVE: To investigate direct bone graft repair with lag screw and tension band fixation technique and its value for the treatment of adolescence spondylolysis. METHODS: Lysis was prepared and the fibrous tissue within the gap was removed in 12 patients from 12 to 26 years (average 18.4). 1 - 2 mm extra bony element was resected on both sides with fresh interface with the bone graft harvested from the iliac crest. From the entry point 8 mm away from the midline at the inferior margin of the lamina, titanium lag screws of 35 - 45 mm long and 3.5 mm in diameter were placed at 300 upward and outward and tighted through the lysis, bone graft and the superior and lateral aspect of the pedicle. Extra match bone graft was placed around the surface of defect, an high intensity Nilon wire tension band between the cap of the screw and the basis of transverse process was constructed before wound closure and suction drainage. The patients were immobilized with plaster brace of Paris for 2 months. RESULTS: Average operation time was (10 +/- 55) minutes, and average blood loss was 170 ml. Follow-up ranged from 12 to 36 months (mean 17 months), and cases of 22 lysis healed within 3 months. CONCLUSIONS: Technique of direct bone graft repair with lag screw and tension band fixation for the treatment of adolescence spondylolysis is simple, safe and reliable. Combined biomechanical and biological processes, it is less invasive but advantageous in preserving the motion in the affected segment.

Adolescent↗

PubMed1965