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At least 757 records · Page 42Linked to original sources
PubMed1979

Field surgical intervention: an unusual case.

A case of crush injury to the lower extremities of an ironworker involved in the demolition of a bridge is presented. Extrication of the entrapped limbs was complicated by weakening of the bridge support due to acetylene torch cutting. After 3 hours the decision was made to complete the traumatic disarticulation of the right knee on site. Essential elements in the successful completion of such field intervention are presented and the unusual features of the case are emphasized.

Allied Health Personnel↗
PubMed1979

[The lower-limb amputation in geriatrics suffering from occlusive artery disease (author's transl)].

Owing to the biology of arteriosclerosis elderly previously affected patients have, as a rule, to undergo lower limb amputation for occlusive artery disease. This creates particular problems which must be taken into account when choosing the surgical technique and providing the prosthesis. The article surveys the common methods and describes, in particular, the knee disarticulation including the early prosthetic fitting carried out at the author's hospital, which in their experience can decisively improve the patient's rehabilitation.

Aged↗
PubMed1978

Interilioabdominal amputation.

Thirty two consecutive cases of interilioabdominal amputation are reported. They were performed for malignant tumours of the hip and the proximal end of the femur and thigh. This operation is rather more frequently indicated than disarticulation of the hip and involves less trauma.

Amputation, Surgical↗
PubMed1982

Treatment of osteosarcoma by interferon and differentiated surgery.

Since 1972, all cases of osteosarcoma (48 patients) at the Karolinska Hospital in Stockholm have been treated by leukocyte interferon. It has been administered by intra-muscular injections with a dosage of 3 million standard interferon units daily for one month and thereafter 3 times weekly for a further 17 months. Thirty-two patients were subjected to amputation or disarticulation, but in 16 cases local surgery has been resorted to and the defect after tumour resection has been replaced by autogenous bone grafting or endoprostheses. In 5 of 16 locally treated cases, local recurrence occurred and amputation was performed. Four of the patients later on succumbed from metastases. The selection of cases which can be treated by local resection is difficult. In the present series, the rate of survival was 58% after 5 years. Before 1972 (historical group) the survival rate was 14%. The corresponding - 5 - year survival figure for the contemporary group treated without interferon is 33%. Although the 58% survival rate seems to represent an effect of interferon on osteosarcoma, no statistically significant conclusions can be drawn.

Clinical Trials as Topic↗
PubMed1982

[High performance gymnasts during the period of growth].

Twenty-two high-performance gymnasts between 12 and 22 years of age were examined for possible vertebral column damage following three years of training in a federal sports center. Half of the gymnasts complained of generalized back pain. Three gymnasts presented with kyphosis, five with a flat back, three with hyperlordosis, and six with an abnormal position of the lumbar spine. Normal X-rays were obtained from four athletes, although seven presented with marked Scheuermann's disease. In three cases, differential diagnosis was necessary between spondylitic deformation with vertebral rim disarticulation and persisting apophysis. Despite the radiologically pathological findings, the gymnasts were mainly asymptomatic. This could be due to the hypertrophied dorsispinal and abdominal musculature which compensates for the pathological osseous structure. There is an urgent need for critical medical consultation in high-performance gymnastics involving children and youth.

Adolescent↗
PubMed1981

[Streptococcal gangrene. A report on 9 cases (author's transl)].

The authors have treated 9 cases of streptococcal gangrene of the limbs. They describe the clinical features:local oedema, erythema, and cyanotic spots. In 7 of the cases the infected general condition was very severe. At operation, the subcutaneous soft tissues were grey-green without pus. The authors have reviewed the literature and consider that treatment should be based on early excision of the skin and subcutaneous tissues. Antibiotics are of great help but are not sufficient by themselves. Nine patients reached a stable state but sequelae have been severe with one disarticulation of the shoulder, one ankylosis of the wrist, one ankylosis of the knee and one generalised stiffness of the hand. Only five patients have been completely cured.

Adult↗
PubMed1984

Bicycle injury pattern among children in rural India.

205 children treated with bicycle injuries during the four year period 1979-1982 at General Hospital, Sangli, in rural Western Maharashtra were reviewed. Amputation of the right toe was the most common injury comprising 74% of all the injuries. This occurred in children carried as passengers on the rear carrier of the bicycle, who hang their legs on either side of the spoke wheel. The right big toe of the passenger is then trapped by the chain above, the spokes at the extreme inner end, horizontal fork below and the free wheel posteriorly. Peddling of the bicycle in a reverse direction followed by forward propulsion results in amputation of the toe by the rotating teeth of the free wheel. In 122 cases amputation was through the proximal phalanx, in 28 cases through the distal phalanx and in 2 cases at the level of the metatarso phalangeal joint. A disarticulation through the proximal joint was performed in these cases. A four year follow up showed no residual disability.

Amputation, Traumatic↗
PubMed1984

Design and evaluation of a prosthesis control system based on the concept of extended physiological proprioception.

This paper describes the design and evaluation of an experimental prosthesis-control system based on the concept of extended physiological proprioception (EPP). It was originally hypothesized that EPP control effected by residual shoulder motion could be effectively applied in multifunctional prostheses for shoulder disarticulation amputees. The experimental system developed for this study utilized a force-driven control scheme and a shoulder motion transduction system in which direct cable linkages to the prosthesis components were used to implement EPP position-servo relationships between shoulder elevation-depression and prosthesis elbow flexion, and between shoulder protraction-retraction and prosthesis wrist rotation. The results of experiments performed with this prosthesis (and with an experimental velocity-controlled prosthesis implemented for comparison purposes) clearly demonstrated the superior performance provided by EPP control of prosthesis function.

Arm↗
PubMed1984

An analysis of extended physiological proprioception as a prosthesis-control technique.

This research was devoted to an investigation of the practicality and potential effectiveness of applying the concept of extended physiological proprioception (EPP) to the control of upper-limb prostheses. The purpose of this study was to verify that EPP control, implemented by coupling prosthesis function to residual shoulder motion in a position-servo relationship, could be effectively applied in multifunctional prostheses for shoulder disarticulation amputees. Although Simpson has shown that the principle works, the authors wanted to quantify its effectiveness and analyze its limitations. Studies were performed analyzing the feasibility of using shoulder elevation-depression and protraction-retraction as prosthesis control inputs. The results of this study showed that a prosthesis mechanism with nonlimiting dynamic response characteristics and shoulder-activated EPP control of wrist rotation and elbow flexion/extension, exhibited functional characteristics comparable to those of the physiological elbow and wrist as defined by tracking capabilities. The results of this investigation also showed that shoulder-effected position control of prosthesis function has considerably more potential for providing effective control than similarly effected velocity control.

Arm↗
PubMed1983

Antiblastic hyperthermic regional perfusion in the treatment of malignant neoplasms of the limbs.

The authors describe the theoretical principles and the experimental and clinical investigations that form the basis for the technique of selective hyperthermic perfusion of the limbs, with or without the addition of antiblastic agents. Neoplastic cells are much more sensitive to heat than normal cells, undergoing necrosis at a temperature of 42.5 to 43 degrees C. The authors discuss the histological appearances and the clinical results obtained in the treatment of 29 cases of malignant neoplasms of the limbs in which antiblastic hyperthermic perfusion was carried out one month before surgical removal of the neoplasm. The long term results show that antiblastic hyperthermic perfusion significantly reduces the risk of local recurrences in cases of resection and in some cases enables amputations rather than disarticulations to be performed. This type of treatment is particularly indicated in the highly undifferentiated and aggressive forms such as osteosarcoma, malignant fibrous histiocytoma, adamantinoma, fibrosarcoma, giant-cell sarcoma, Ewing's tumour, and synovioma.

Adolescent↗
PubMed1983

Neurogenic tumors of the sciatic nerve. A clinicopathologic study of 35 cases.

Thirty-five cases of neurogenic sciatic nerve tumors are described. Pain is the major clinical manifestation but may give rise to diagnostic confusion because of its often prominent site far distant from the neoplasm. Nonpalpable tumors are best identified by computed tomographic scan of the pelvis and thighs. Early surgical therapy is advisable. Neurilemomas are treated by simple enucleation with preservation of the sciatic nerve. They rarely recur. For neurofibromas, total excision is often not possible. As long as they are small and neurologically nondestructive, subtotal excision with preservation of the nerve trunk is recommended. When they are large or have caused marked neurologic dysfunction, radical tumor and nerve resection is required. In the usually highly malignant neurofibrosarcomas, disarticulation of the hip joint or hindquarter amputation affords the best chance for cure and should not be delayed once the diagnosis has been established.

Adolescent↗
PubMedDate not supplied

Pathology of the skeleton and tendons of broiler chickens reared to roaster weights. II. Normal chickens.

Broiler chickens were raised to 74 days of age under different feeding and housing regimens. Conformation, growth plates and tendon strength were studied in clinically normal chickens of various ages. A change with age from slight valgus deviation of the metatarsal bones to varus deviation was recorded. Separation of the proximal femoral epiphysis from the femur on disarticulation of the coxofemoral joint was a common post-mortem artifact. It was more common in chickens on full feed than in chickens fed a restricted amount of feed. Two distinct growth-plate abnormalities were recognized. Dyschondroplasia was most common in the proximal tibiotarsus and was almost completely absent in chickens fed a restricted amount of feed. Eosinophilic streaks were found in growth plates of the proximal femur and the thoracic vertebral bodies. The incidence of these streaks was not affected by feed restriction. It is suggested that these streaks represent microscopic tears in growth plates exposed to shear forces and that they may be similar to osteochondrosis in mammals. The tensile strength of the flexor digitus perforatus and perforans tendon to the third digit increased with age. It was not affected by housing or feeding regimen, but the ratio of tensile strength over body weight was less in chickens fed ad libitum than in those fed a restricted amount of feed.

Age Factors↗
PubMed1983

An investigation by transmission electron microscopy of freeze replicas of dog articular cartilage surfaces: the fibre-rich surface structure.

Femoral condylar cartilage blocks from the disarticulated stifle joints of five inbred beagle dogs were rapidly frozen. Single stage platinum and carbon replicas were prepared at 78 K from the unfixed, hydrated frozen material. Transmission electron microscopic investigations of the replicas were then made. Two different forms of fine cartilage surface structure were suggested by the low temperature replicas. The first, amorphous and with few fibres, was thought to represent the normal, superficial lamina obscurans. The second displayed many delicate parallel arrays of collagen fibrils with a periodic structure of 68-71 nm. Between these arrays were gently convex smooth-surfaced elevations, 150-500 nm in diameter, and therefore two orders of magnitude smaller than the tertiary surface undulations previously identified by light microscopy and by scanning electron microscopy. It is suggested that the 150-500 nm elevations seen at the replicated surface may be expanded proteoglycans, restrained laterally and deeply, less restrained superficially because of the loss, during preparation, of the lamina obscurans. Other hemispherical, replicated surface deposits 400-1700 nm in diameter are believed to be lipid.

Animals↗
PubMed1983

Child spacing effects: a comparison of institutionalized and normal children.

Data were collected on 52 psychiatrically abnormal and 101 normal children, as part of a study of the effects of sibship constellation variables on intellect, achievement, personality traits, and social adjustment. The two groups are closely equivalent with respect to age, social class (lower and lower-middle) and sibship size. There was a significantly higher percentage of psychiatrically abnormal than normal children having a sibling less than two years older. conversely, the normal children had a significantly higher percentage of widely spaced (to the next older) than did the psychiatrically abnormal children. Unwantedness by parents (especially the mother) may be a factor in increasing the likelihood of learning and behavioral difficulties and other social disarticulation.

Achievement↗
PubMed1984

Pantyhose prosthesis: a cosmetic alternative.

A cosmetic prosthesis for the nonambulatory patient with unilateral or bilateral above-knee amputation is described. This device can be made with minimal cost and difficulty, and it offers advantages of durability, flexibility, and excellent appearance. Cosmetic prostheses for patients with below-knee or hip disarticulation amputations can be made in a similar manner.

Artificial Limbs↗
PubMed1983

Radiation-induced arterial injuries.

In a 20-year period from 1961 to 1981 at the University of Kentucky Medical Center, there were 20 patients with vascular lesions directly attributable to irradiation. Two distinct patterns of arterial injury attributable to radiotherapy were identified--arterial disruption and occlusion. Arterial disruption occurred in 12 patients--11 carotid blowouts and 1 iliac artery rupture. Two patients underwent prophylactic carotid artery ligation for impending rupture. In the 11 carotid artery ruptures, ligation of the artery in nine patients resulted in stroke or death in five patients. Iliac artery disruption necessitated ligation, which eventually led to severe ischemia requiring hip disarticulation. Unusual arterial stenosis or occlusion occurred in six patients 7 to 24 years after irradiation. Three patients had severe stenosis or occlusion of the common, internal, or external carotid arteries leading to cerebrovascular insufficiency. Three other patients with focal stenosis of the iliofemoral region were successfully treated with bypass grafting.

Adult↗
PubMed1983

Emergency hemipelvectomy in the control of life-threatening complications.

Emergency hemipelvectomy (HP) is a rare procedure. Only three incidents have been previously reported. This paper describes six additional cases, analyzes our results, and sets forth criteria for patient selection. There were five men and one woman. The median age was 38.5 years. Primary underlying diseases were sarcoma (three cases), peripheral vascular disease (one), deep vein thrombosis (one), and drug abuse (one). Life-threatening peripelvic sepsis and hemorrhage were indications for emergency HP. All six patients had multiple procedures prior to definitive HP. Four classical and two modified HPs were performed. The mean operative time was 3.5 hours, the mean blood loss 2292 ml. There were no intraoperative complications. The median duration of hospitalization was 56 days. Five of six patients were saved. Life-threatening peripelvic sepsis or hemorrhage associated with tumor recurrence, radiation, or failed vascular reconstruction is an indication for emergency HP. Neither age nor physical condition should be a deterrent. The patient should not be allowed to advance to a premorbid state before HP is considered, although concomitant intra-abdominal disease is a contraindication. HP is recommended in lieu of hip disarticulation. We anticipate that the need for emergency HP will increase as limb salvage procedures for extremity sarcomas and dysvascular disease become more frequent.

Adult↗
PubMed1983

A 50-cm fillet flap for preservation of maximal lower extremity residual limb length.

A 50-cm fillet flap permitted above-knee amputation in lieu of hip disarticulation in a 20-year-old woman who had sustained severe injuries in a motorcycle accident. Although the flap was unusually long, the principles followed were the same as those for posterior flaps used in below-knee amputations and fillet flaps of the digits. The flap allowed preservation of maximal length in the residual limb and fully sensible skin coverage, both of which facilitated prosthetic usage.

Adult↗