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At least 793 records · Page 44Linked to original sources
PubMed1984

Longitudinal study of three views of mandibular third molar eruption in males.

A longitudinal study, using three views simultaneously, was conducted on twenty North American black males to investigate mandibular third molar eruption. Each subject had two third molars present. Forty third molars were studied. Lateral, posteroanterior, and oblique (45 degrees left and right) cephalograms, along with plaster casts, were used. The following observations on the third molars were made; the age at which they can be identified; angulation of the occlusal surface; eruptive path, including the vertical, anteroposterior, and buccolingual positions; and the age of delineation between being unerupted or impacted, including factors related thereto. The Fisher's exact test from the SPSS package and the central tendency were the statistical instruments used to aid in interpreting the data. In some persons the crypt of the developing third molar was seen as early as 7.5 years and the occlusal surface was identified as early as age 8 years, with a mean of 9.75 years. Third molars usually form in the ramus with the distal cusp above the occlusal plane, the occlusal surface of the molar has a great cant facing anteriorly, the tooth descends below the occlusal plane, and appears to upright around 14 to 16 years of age. The impaction of the mandibular third molar is a complex multifactorial mechanism. The wide buccal location of mandibular third molars and the inadequate anteroposterior space between the distal surface of the second molar and the anterior surface of the ramus are important factors in third molar impaction. This study does not support the concept of early prediction of third molar impaction and enucleation of the asymptomatic developing third molars. If possible, the final decision for extraction of asymptomatic mandibular third molars that appear to be impacted should be delayed until after the age of 16 years.

Adolescent↗
PubMed1993

Anterior tooth relations in Kenyan Africans.

Dental plaster casts of 235 Maasai, 116 Kikuyu and 61 Kalenjin children aged 3-16 yr were studied to determine the incidence and magnitude of diastemas, overbite, overjet and anterior open bite. The highest prevalence of diastema was amongst the Maasai (61.3%), of overbite (84%) and overjet (99%) amongst the Kikuyu, and of anterior open bite amongst Kalenjin (24%), with values greater than 0.4 mm up to 11.5 mm. Comparison of the mean values showed that diastema (1.77 mm) and overjet (4.4 mm) were greatest in Maasai, overbite (3.53 mm) in Kalenjin, and anterior open bite (3.50 mm) in Kikuyu. In the total sample, the prevalence and mean of diastema were 49%, 1.68 mm; of overbite 77.4%, 2.96 mm; of overjet 88.6%, 3.83 mm; and of anterior open bite 16.5%, 2.69 mm (with values between 0.4-11.5 mm), while 5.5% had an edge-to-edge bite (-0.5-0.5 mm). The prevalence of diastema decreased whilst its magnitude increased with age. The mean values of overbite and overjet increased, while those for anterior open bite decreased with age. The mean values of diastema, overbite and overjet were greater amongst the females, but the difference was significant only for overjet. The high prevalence and greater values of measurements of anterior tooth relations may be related to variable growth of the bimaxillary dentoalveolar complex and soft tissue influences. This may be important in orthodontic treatment planning, dental prostheses and other clinical dental treatments in Kenyan populations.

Adolescent↗
PubMed1985

Quantitative evaluation of electromyogram activity in rat extensor and flexor muscles immobilized at different lengths.

Because immobilization of muscles in the "long" position mitigates the effects of inactivity and rapid wasting occurs when muscles are immobilized in the "short" position, a study was made of the EMG activity in the soleus (SOL)--an extensor muscle--and the tibialis anterior (TA)--a flexor muscle--in order to clarify the possible role of muscle function in modifying the course of disuse atrophy. EMG activity was recorded in the SOL and TA muscles in adult rats in which the ankle had been immobilized in a plaster cast either in plantar flexion or dorsiflexion. The number of action potentials per minute in samples of the EMG activity from control and immobilized muscles was assessed before, for 10 days during immobilization, and up to 9 days after removal of the cast. Immobilization in the short position (plantar flexion) led to a dramatic reduction in the EMG activity of the SOL (to 10% of the control). On the other hand, fixation of the SOL in the long position was without effect upon resting EMG activity. In the TA, EMG activity was exclusively phasic in character and corresponded to about 3% of that of the SOL. Neither the fixation of the ankle in plantar flexion nor dorsiflexion had any appreciable effect upon EMG activity in the TA. We conclude that, because immobilization in the lengthened position does not increase EMG activity in either extensor or flexor muscles, passive stretch appears to be the factor mainly responsible for mitigating the effects of disuse in this situation. On the other hand, when a typical extensor muscle (SOL) is immobilized in the shortened position and undergoes rapid wasting, an accessory role of decreased activity cannot be excluded.

Animals↗
PubMed1975

Tibial shaft fractures treated by rigid internal fixation: the early results in a 4-year series.

Ninety-nine fractures of the shaft of the tibia in 98 patients were treated by rigid internal fixation over 4 years. One patient died after operation from myocardial infarction; and one patient went abroad. The healing course of the remaining 97 fractures is described, classified according to the type of fracture and the accuracy of operative reduction. Seventy-five fractures had a normal time to union, defined as the lasting achievement of full weight-bearing within 4 months. In 7 fractures the healing period was moderately delayed (full weight-bearing being achieved in 4-6 months) and in 5 it was seriously delayed, requiring 6-11 months after injury. Nonunion occurred in 4 cases and refracture in 6 cases. Osteitis developed in 2 cases and was successfully treated with antibiotics within 6 weeks. A second internal fixation was necessary in 12 patients. In 5 patients a plaster cast was applied to treat delayed union. Amputation was necessary in a 75-year-old man with senile dementia who developed infection after a second operation for refracture. One patient still has a pseudarthrosis after 2 years and 2 further operations. In the other 95 fractures union was the end-result. Of the 21 comminuted and open fractures only 13 healed within 4 months. We recommend a different approach in the treatment of badly comminuted and open 'high-energy' fractures. With this reservation, we find that the method of rigid internal fixation which we employ has given satisfactory early results. The frequency of both delayed healing and infection is reasonably low compared to the results in similar series.

Adolescent↗
PubMed1981

Fracture of the shaft of ulna and radius with associated dislocation of the radial head.

Fourteen cases of fracture of the shaft of ulna and radius with associated dislocation of the radial head in adults are presented. The dislocation was initially missed in 42 per cent of cases. Several closed and open therapeutic procedures were performed either for the dislocation or the shaft fractures. In these patients, with follow-up averaging 5.9 years, the incidence of complications (redislocation, mal-union, pseudarthrosis, radio-ulnar synostosis, peri-articular ossification) was noteworthy. Final evaluation according to the range of motion of the forearm, showed a high incidence of unsatisfactory results. Predisposing to these results were delayed reduction of the dislocation, repeated and forceful manipulation and manual pressure on the radial head, inadequate reduction or stabilization of the fractures and a long period in the plaster cast. Guide lines for early diagnosis and efficient treatment are suggested.

Adolescent↗
PubMed1981

Isolated fractures of the shaft of the tibia.

We have reviewed 106 fractures of the tibia with an intact fibula. Most patients were treated in above-knee plaster casts and allowed to walk. Only 2 fractures failed to unite and there were 4 refractures. In 27 patients (25 per cent) the fracture healed with more than 5 degrees of varus angulation. The cause of this deformity and its prevention are discussed.

Adolescent↗
PubMed1981

The treatment of osteitis complicating tibial fractures.

A six-part scheme for the treatment of osteitis complicating tibial fractures is presented: (1) wound excision; (2) external fixation; (3) open irrigation drainage; (4) cancellous bone grafting; (5) split skin grafting; (6) full weight bearing in a plaster cast. Of 20 cases, 14 of which were ununited, remission of the infection was achieved in 17 with in 27 months (mean 10.8 months). All 14 ununited fractures went on to union within 20 months (mean 9.5 months).

Adolescent↗
PubMed1987

The radiological deformity of Colles' fractures.

The behaviour of the bony deformity in Colles' fractures and factors influencing this were prospectively investigated in 187 patients over the age of 55. Radiographic assessment was made throughout a 13-week period and during this time the deformity progressively recurred, even after the plaster cast had been removed. Radial length and radial deviation reverted virtually to their positions before reduction. Only those fractures with a volar tilt greater than -15 degrees when first seen showed any improvement. In all fractures the initial deformity clearly influenced the final radiological result whereas the quality of reduction was not of critical importance. The extent of dorsal comminution and quality of the bone influenced the final anatomical result in those fractures which were not manipulated.

Aged↗
PubMed1988

The significance of arthroscopy and examination under anaesthesia in the diagnosis of fresh injury haemarthrosis of the knee joint.

Arthroscopy and examination under anaesthesia were performed for 328 consecutive knee injuries with haemarthrosis. These examinations were grouped according to a modified classification (Jackson and Abe, 1972) into very useful (117/328, 36 per cent), useful (98/328, 30 per cent) and useless (113/328, 34 per cent) categories. The probability of arthroscopy being useful was estimated mathematically. The factors which made this procedure useful were knee pain on exertion before the injury (P = 0.0561), the mechanism of the injury (P less than 0.0001) and the clinical stability of the patella (P = 0.0007). On arrival in the emergency department it was first decided whether the leg should be mobilized, immobilized in a plaster cast, operated on or, if a definitive diagnosis could not be reached, arthroscopy was deemed necessary. This resulted in the treatment following arthroscopy, and examination under anaesthesia, being altered from conservative to operative (P less than 0.0001). Results suggest that arthroscopy and examination under anaesthesia should always be considered to help in the diagnosis of acute injury haemarthrosis of the knee especially after a valgus or varus strain.

Adolescent↗
PubMed1990

Fatigue fractures of the foot.

While fatigue fractures are common in military practice they are much less so in civilian practice and thus tend to be overlooked. Fractures occur most commonly in the distal second and third metatarsal shafts and within the calcaneum, but occur in almost any other bone of the foot. Any suspicious history of repetitive stress or sudden change in activity, athletic or otherwise, associated with swelling and point tenderness warrants further investigation by bone scintigraphy. Attention is drawn to the importance of understanding the basic biomechanical function of the foot and how it may affect the development of fatigue fractures. A distinction is drawn between the distal fractures of the second and third metatarsal shafts and those occurring in the proximal shafts of any of the metatarsals which have a different aetiology. Following conventional management in a plaster cast, it is suggested that any biomechanical anomaly which is present is compensated appropriately with an orthotic insole.

Foot Injuries↗
PubMed1990

Management of open fractures of the ankle joint.

A total of 64 patients with open fractures of the ankle were reviewed to assess the benefits of rigid primary internal fixation. Of these, 27 patients were treated by rigid primary internal fixation; the remainder were treated by a combination of internal splintage with K-wires and plaster casting. Patients who were treated by rigid primary fixation fared better in terms of joint mobility, maintenance of reduction and reduced sepsis rate. An interesting observation, in some of the displaced fractures, was the presence of débris far removed from the site of the wound. This was obviously sucked in during the mechanism of the injury. This has not been described previously. A method of decontaminating such wounds is discussed.

Adolescent↗
PubMed1992

Does plaster immobilization predispose to pulmonary embolism?

Over a 5-year study period, 22 patients with isolated lower limb injuries who were immobilized in a plaster cast developed a pulmonary embolus. This information was not available from orthopaedic audit. Better cross-specialty accounting is required if complications that span different hospital specialties are to be fully elucidated. This problem was heightened by the number of emboli occurring while the patient was being treated as an outpatient.

Adult↗
PubMed1992

Isolated tibial fractures in children.

In a review of 65 tibial fractures in children of which 25 were isolated and not associated with a fracture of the fibula, we found that isolated tibial fractures were not uncommon, and accounted for one-third of all tibial fractures in children under 11 years of age. They occur after two types of force, the most common being indirect violence involving a torsional injury. Isolated fractures unite easily without delayed union. Isolated transverse fractures never displace, and consequently do not require further radiographs following the initial check radiograph after the application of the plaster cast. In seven of the 25, the fracture was spiral or oblique and displacement into varus occurred for up to 2 weeks after the initial injury. These need careful follow-up, with weekly radiographs for the first 2 weeks. If the varus displacement is greater than 5 degrees we recommend manipulation in that period. After this time the fracture site is sticky, and manipulation will fail. Non-operative treatment is recommended for this fracture.

Casts, Surgical↗
PubMed1996

Dynamic external fixation versus non-operative treatment of severe distal radial fractures.

Severe distal radius fractures often lead to impairment of wrist function, particularly in younger patients. This paper reports 55 consecutive patients younger than 65 years with displaced intra-articular fractures of the distal radius. Twenty-nine were treated with dynamic external fixation, and 26 with closed reduction and plaster cast immobilization. At least 1 year after the injury the anatomical and functional results were assessed using the scoring system of Lidstrom. In a retrospective analysis, both the anatomical and functional end score were significantly better in the dynamic external fixation group than in the group treated non-operatively (0.02 P < 0.05 using chi 2 analysis with Yates' correction). We conclude that dynamic external fixation is a good alternative for non-operative treatment in younger patients with severe distal radial fractures. Prospective evaluation of this subject is necessary.

External Fixators↗
PubMed1986

Changes in exopeptidase activities in skeletal muscles during disuse.

Some aminopeptidase activities, dipeptidase-, tripeptidase-, and carboxypeptidase activities were measured in two different types of skeletal muscle in rabbit soleus muscle as a slow oxidative, and gastrocnemius muscle as a fast glycolytic type after immobilization in full extension with a plaster cast for 1, 2, 4, 7, 14 or 28 days. In correlation to the higher protein turnover in red muscles, the activities except of leucine and alanine aminopeptidase were higher in the normal soleus muscle than in the gastrocnemius muscle. Much higher activities of the tested enzymes were obtained in the immobilized soleus muscle than in the normal one after 2 weeks of immobilization. In the gastrocnemius muscle the tested enzyme activities generally did not change or decrease. The results demonstrate that the peptidases play a role in the process of protein breakdown in normal and disused skeletal muscles.

Animals↗
PubMed1979

Decrease of muscle extensibility and reduction of sarcomere number in soleus muscle following a local injection of tetanus toxin.

Slow soleus muscle in guinea pig developed within 4--6 days after local injection of a sublethal dose of tetanus toxin and 2--4 days after the first signs of local tetanus, a myostatic contracture characterized by a change in the passive tension--lengthening curve associated with a considerable decrease of the sarcomere number. It was demonstrated by clinical and EMG investigations that the soleus did have a tetanic spasm at least within the 2--4 day period of observation. When local tetanus was confined to slow soleus by functional suppression of rapid gastrocnemius and ankle flexor muscles, the decrease of the sarcomere number still persisted. This decrease failed to occur after section of the nerve supplying the soleus when associated with an injection of the tetanus toxin, and was much greater than when the soleus was passively shortened for the same period of time by plaster cast.

Animals↗
PubMed1984

Core myofibers and related alterations induced in rats' soleus muscle by immobilization in shortened position.

Experimental induction of core myofibers by tenotomy or local tetanus suggests that mechanical factors such as muscle tension loss, shortening or immobilization may play a role in core fiber formation. To test this hypothesis, we investigated the morphologic alterations induced in soleus (SOL) and extensor digitorum longus (EDL) muscles following immobilization of rats' hindlimb in various positions. The SOL and EDL muscles were immobilized in either shortened or lengthened state by applying wire-meshed plaster cast for 1, 2 and 3 weeks. The muscles were dissected out, measured, weighed and examined by histochemistry and electron microscopy. Gross atrophy was noted in all muscles but was greatest in shortened SOL. The SOL atrophy was diffuse and associated with relative increase in type 2 fibers. In EDL, the atrophy selectively involved fibers with low oxidative enzyme activity. Core myofibers were seen mainly in shortened SOL and consisted of myofibrillar derangement, loss of myofilaments and streaming of Z bands. The preferential involvement of shortened SOL (tonic, fatigue-resistant, slow-twitch muscle) suggests that the functional length, loss of tension subsequent to shortening and intrinsic biochemical properties of the muscle are important in core fiber formation.

Animals↗