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At least 829 records · Page 46Linked to original sources
PubMed2005

Objective growth monitoring of the maxilla in full term infants.

OBJECTIVE: To develop a non-invasive method for longitudinal maxillary volume measurements and to provide first normative data. DESIGN: Thirty-four healthy infants served as a gold standard for a growing population sample. Alginate impressions were taken of the upper jaw within the first week after birth, and consecutively at different stages of development. The plaster casts were digitised by an optical scanner generating a high resolution polygon mesh of each object. The digital models were aligned to a reference coordinate system with an iterative, landmark-independent procedure. Biometric linear and volume measurements were obtained by using feature-dependent calculations independent of landmark placements. Intra-investigator reproducibility was tested by repeated alignments and measurements of 30 randomly selected casts. To assess the effect of mesh resolution, the reproducibility test was repeated with low resolution models. The method was proved to be valid on the defined gold standard consisting of 96 consecutive edentulous casts. RESULTS: Feature-dependent, linear distances are less error prone (0.56-2.66%) compared to subjectively determined measurements (0.88-3.65%). The same applies to feature-dependent volume calculations (4.34%) compared to subjectively determined volumes (4.95%). Mesh resolution shows an effect (p<or=0.001) only on two linear measurements: palatal depth and palatal length. Growth of the individuals in the population sample was evidently confirmed by the maxillary volume measurements (asymptotic pattern) and by comparisons of head circumference (proportional pattern). CONCLUSION: The described method is non-invasive, precise and without any risk for the infant. Maxillary volume calculation could serve as an important biometric measurement for bone growth evaluation.

Biometry↗
PubMed2005

The tryptophan hydroxylase activation inhibitor, AGN-2979, decreases regional 5-HT synthesis in the rat brain measured with alpha-[14C]methyl-L-tryptophan: an autoradiographic study.

Many experimental conditions are stressful for animals. It is well known that stress induces tryptophan hydroxylase (TPH) activation, resulting in increased serotonin (5-HT) synthesis. In our experimental procedure to measure 5-HT synthesis using alpha-[(14)C]methyl-L-tryptophan (alpha-MTrp) autoradiographic method, the hind limbs of animals are restrained using a loose-fitted plaster cast such that the forelimbs of the animal remain free. The objective of the present investigation was to evaluate the changes, if any, in 5-HT synthesis, after injecting these restrained rats with the TPH activation inhibitor AGN-2979. The effect on regional 5-HT synthesis was studied using the alpha-MTrp autoradiographic method. The hypothesis was that the TPH activation inhibitor would reduce 5-HT synthesis, if TPH activation was induced by this restraint. The rats received injection of AGN-2979 (10 mg/kg, i.p.) or distilled water vehicle (1 mL/kg, i.p.) 1 h prior to tracer administration. The free- and total tryptophan concentrations were not significantly different between the treatment and control groups. The results demonstrate that 5-HT synthesis in AGN-2979 treated rats is significantly decreased (-12 to -35%) in both the raphe nuclei and their terminal areas when compared to the control rats. These findings suggest that restrained conditions, such as those used in our experimental protocol, induce TPH activation resulting in an increased 5-HT synthesis throughout the brain. The reduction in 5-HT synthesis in the AGN-2979 group is not related to a change in the plasma tryptophan. Because there was no activation in the pineal body, the structure having a different isoform of TPH, we can propose that it is only the brain TPH that becomes activated with this specific restraint.

Analysis of Variance↗
PubMed2004

Driving whilst plastered: is it safe, is it legal? A survey of advice to patients given by orthopaedic surgeons, insurance companies and the police.

Many patients, immobilised in a plaster cast after a fracture of the upper or lower limb, wish to drive. They frequently ask permission to do so from the treating surgeon. Insurance companies are apparently willing to insure these patients to drive if they obtain their doctors permission. The DVLA guidelines are unhelpful in these circumstances. We therefore established current practice within the south west region by canvassing 126 consultant orthopaedic surgeons, 27 insurance companies and the 6 regional police constabularies, sending them specific clinical scenarios and asking how they would advise these patients regarding safety to drive. The results were as follows: sixty-seven (53%) of surgeons responded of which 97% gave specific advice regarding safety to drive. The insurance companies were generally unwilling to respond and a national response was received from the Association of Chief Constables, which specifically stated that safety to drive was for the individual patient to decide and the doctor should not give advice. We consider this to be unsatisfactory for all parties and suggest how this situation could be improved for both the patient and other road users welfare.

Automobile Driving↗
PubMed2005

Which Colles' fractures should be manipulated?

Ninety-two patients with displaced Colles' fractures were followed prospectively after manipulation under regional anaesthesia. Radiographs were taken before and after manipulation and after 3 months when a functional assessment was also made. A correlation was sought between outcome and radiological measurements. Final radial shortening of 3mm or more was associated with a significantly worse functional outcome after 3 months (P < 0.001). Where the initial radial shortening was 3 mm or more, the probability of malunion was 65% whereas with less than 3mm, the probability of malunion was 28% (P < 0.001). With 5 mm or more of radial shortening at presentation, the probability of malunion was 73% (P < 0.01). The decision to manipulate remains a matter of judgement but a high failure rate renders simple manipulation and plaster cast fixation a poor treatment option in fractures with 5mm or more of radial shortening at presentation.

Colles' Fracture↗
PubMed2003

Nasolabial and alveolar morphology following presurgical orthopaedic treatment in complete unilateral clefts of lip, alveolus and palate.

INTRODUCTION: The purpose of this study was to assess the three-dimensional (3-D) facial and alveolar morphology of patients with unilateral clefts of lip, alveolus and palate by means of a computer-aided diagnosis system. PATIENTS AND METHODS: Maxillary orthopaedic treatment was performed using soft/hard acrylic plates (Hotz's) within 2 weeks of birth. The nasolabial and alveolar morphology of 15 patients was evaluated before orthopaedic treatment (2 weeks of age) and before cheiloplasty (3 months of age). Nasolabial form was measured using a 3-D optical scanner. Twenty-one landmarks were extracted from the data and analysed linearly and angularly. Alveolar forms were measured with a high-accuracy contact-type 3-D digitizer on plaster casts. Seven landmarks were digitized and analysed linearly and angularly. RESULTS: Some growth was observed in the intercanthal distance, alar width, intercommissural width, and height of the lip. There was little change in the width of the cleft lip or displacement of the columella base, while the alveolar cleft narrowed. CONCLUSION: Presurgical orthopaedics reduces cleft width and makes subsequent surgery easier.

Acrylic Resins↗
PubMed2006

The influence of two different types of foot orthoses on first metatarsophalangeal joint kinematics during gait in a single subject.

OBJECTIVE: To quantify the effect of two distinct foot orthotic designs on in vivo multisegment foot and leg motion; in particular, the first metatarsal and first metatarsophalangeal (MTP) joint during gait. METHODS: A 23-year-old man had an excessively pronated foot structure as measured during a clinical orthopedic examination. The Optotrak Motion Analysis System was used to collect three-dimensional position and orientation data from four modeled rigid body segments (hallux, first metatarsal, calcaneus, and tibia) during the stance phase of walking. The subject walked at a self-selected comfortable walking speed, and a minimum of five trials were collected under three different test conditions: no orthosis, semirigid orthosis with a varus post, and a semirigid orthosis with a varus post and a large medial flange. Data were normalized to the stance period, and descriptive statistics were calculated for dependent variables. RESULTS: Both orthotic interventions equally modified first MTP joint motion when compared with the no orthotic condition. First MTP joint dorsiflexion was decreased (>2 SD) with the orthosis during terminal stance phase. This decrease was associated with a concomitant increase in first metatarsal plantar flexion. CONCLUSION: A custom-made semirigid orthosis posted medially and made from a neutral position off-weight-bearing plaster cast can alter motion in the forefoot during the propulsive period by increasing first metatarsal plantar flexion and decreasing excessive first MTP joint dorsiflexion.

Adult↗
PubMed2005

The vacuum chest wall lifter: an innovative, nonsurgical addition to the management of pectus excavatum.

PURPOSE: This report describes the authors' experience using a vacuum to pull the abnormal chest wall outward in patients with pectus excavatum. METHODS: A suction cup was used to create a vacuum at the chest wall. A patient-activated hand pump was used to reduce pressure up to 15% below atmospheric pressure. The device was used by 60 patients (56 males, 4 females), aged 6.1 to 34.9 years (median, 14.8 years), for a minimum of 30 minutes, twice a day, up to 5 hours per day (median, 90 minutes). Patient progress was documented using photography, radiography, and plaster casts of the defect. In 14 children this method was used during the Nuss procedure to enlarge the retrosternal space for safer passage of the introducer. RESULTS: Follow-up occurred between 2 and 18 months (median, 10 months). Computed tomographic scans showed that the device lifted the sternum and ribs within 1 to 2 minutes; this was confirmed thoracoscopically during the Nuss procedure. The suction cup enlarged the retrosternal space for safer passage of the introducer. Initially, the sternum sank back after few minutes. After 1 month, an elevation of 1 cm was noted in 85% of the patients. After 5 months, the sternum was lifted to a normal level in 12 patients (20%) when evaluated immediately after using the suction cup. All patients exhibited moderate subcutaneous hematoma, although the skin was not injured. One patient suffered from transient paresthesis in the right arm and leg. Two patients experienced orthostatic disturbances during the first application of the suction cup. There were no other complications. DISCUSSION: In patients with pectus excavatum, application of a vacuum effectively pulled the depressed anterior chest wall forward. The initial results proved dramatic, although it is not yet known how much time is required for long-term correction. CONCLUSIONS: This vacuum method holds promise as a valuable adjunct treatment in both surgical and nonsurgical correction of pectus excavatum.

Adolescent↗
PubMed2005

3D reconstruction of the structure of a residual limb for customising the design of a prosthetic socket.

Aiming at overcoming the limitations of the plaster-casting method in traditional prosthetic socket fabrication, the idea of reconstructing the 3D models for bones and skin of the residual limb is proposed. Given the two-dimensional obtained image through CT scanning, using image processing and reverse engineering techniques, the 3D solid model of the residual limb can be successfully reconstructed. The new approach can reproduce both the internal and the external structure of the residual limb. It can moreover avoid making a positive mould by the way of manual modifications. In addition to this, it can provide a scientific basis for the individualization of prosthetic socket design.

Artificial Limbs↗
PubMed1984

Mandibular incisor dimensions and crowding.

Previous authors have suggested that well-aligned mandibular incisors are narrower mesiodistally than incisors which crowd and that reducing mesiodistal dimensions of the mandibular incisors to fit a specific size range will prevent future malalignment. This study examined 164 cases from the records of the University of Washington Department of Orthodontics, 134 of which had been orthodontically treated and were a minimum of 10 years postretention. Measurements were made from the postretention plaster casts and from serial cephalometric head films. Statistical tests showed that there was a weak association between incisor widths or MD/FL dimensions ratio and irregular alignment over the long term. Mean dimensional differences between crowded and uncrowded incisors were small in the few pooled or segregated groups in which statistically significant differences were found. When incisor dimensions were combined with pretreatment, posttreatment, or long-term cephalometric and cast measurements, only weak and not clinically useful associations were found with long-term incisor alignment. While there was a weak tendency for narrower incisors to be associated with better alignment in some instances, narrower mesiodistal widths of mandibular incisors did not ensure long-term stability in orthodontically treated cases.

Adult↗
PubMed1997

Non-metric tooth crown traits of the Thai, Aka and Yao tribes of northern Thailand.

A survey was made of Thai tribe members, who cultivate rice paddies in the flatlands of northern Thailand, and of the Aka and Yao tribes, who farm with the slash-and-burn method in a mountainous region of northern Thailand. Plaster casts of the upper and lower jaws of tribe members were taken. Seventeen non-metric traits of their tooth crowns were classified and compared with other Mongoloid populations in various regions and periods. It was observed that the Thai tribe had the Sundadont characteristics, typical of South-East Asians, but the Aka and Yao tribe had more Sinodont than Sundadont characteristics, typical of North-East Asians. The regional and temporal variations of crown morphology in South-East Asia suggest earlier setting of the Thai tribe than the Aka and Yao tribes in this region. Moreover, comparison of the tooth morphological and linguistic classifications contradicts the traditional theory of the genealogy of the Thai language family. On the subject of the origin of modern South-East Asians, it is suggested that there has not been a gene flow of Sinodonty into Sundadonty of the principal ethnic groups in Neolithic South-East Asia.

Asian People↗
PubMed1978

The phlebographic demonstration of venous thrombosis occurring during the treatment of scoliosis.

The application of plaster casts to the trunk plays an important part in the management of severe scoliosis. The edge of these casts may impair venous drainage from the limbs and predispose to thrombosis, as in the three illustrative cases. A further case shows the possibility of a pelvic halo ring device causing similar venous compression. Steps should be taken to prevent this venous impingement from occurring, both at the time of case application and afterwards.

Adolescent↗
PubMed2000

Proto-oncogene expression during fracture repair.

The possibility that proto-oncogenes play a role in fracture repair has been investigated in this study. Closed fractures were created in the tibiae of NZW rabbits and treated with a plaster cast. At intervals of 1 and 2 weeks, sections of the fracture callus were obtained and stained using an immunocytochemical technique which localised c-myc and c-jun. Osteogenic cells of the periosteum, endosteum, Haversian canal and new bone trabeculae expressed proto-oncogenes while hypertrophic chondrocytes were generally immunoreactive negative. The results suggest that proto-oncogene expression may be involved in post-fracture osteogenesis but not in the chondrogenic processes which precede endochondral bone formation. This could be used as a tool for diagnosing slow healing in the early stages of fracture repair.

Animals↗
PubMed2000

The treatment of isolated ulnar fractures in adults: a systematic review.

The treatment of isolated ulnar fractures remains controversial, with different authors recommending both surgical and non-surgical management. We undertook a systematic review of the current literature in order to assess whether any conclusions can be drawn. A total of 33 series involving 1876 patients were identified as suitable for analysis. Data from these papers were combined by method of treatment. The results of the non-operative treatment of minimally displaced ulnar fractures with a stable configuration were uniformly good. Below elbow plaster cast, functional brace and early mobilisation all produced similar results. An above elbow cast was unnecessarily restrictive. To preserve forearm rotation, widely displaced or unstable fractures are best treated by open reduction and internal fixation. Guidelines based on cadaveric and clinical studies exist to predict fracture stability and the extent of acceptable displacement. However, these have not been verified in clinical studies. Compression plate fixation gave reliable results in these cases. Other methods lacked sufficient published data to be recommended.

Adult↗
PubMed2003

The presentation of scaphoid non-union.

A retrospective study of 30 patients presenting with scaphoid non-union was performed. The results showed that eight had been treated in plaster for a mean of 6 weeks and discharged from follow-up. They presented with established non-union at a mean of 60.3 months after the original fracture. Three of these cases have resulted in litigation against the surgeon. A total of 27 patients underwent bone grafting and Herbert's screw fixation achieving in union in 24. The natural history of scaphoid non-union has been examined in some detail in the literature. These studies have shown that scaphoid non-union is inevitably associated with arthritic changes that become worse with time and that freedom from symptoms is not protective from these changes. Therefore, prompt diagnosis and treatment of scaphoid non-union is vital, whether symptomatic or not, to prevent osteoarthritis developing in the future. Inadequate follow-up of treated scaphoid fractures will result in delayed diagnosis and treatment of non-union with a potentially impaired outcome and even litigation against the surgeon. It is the authors' advice that all scaphoid fractures treated in a plaster cast are reassessed clinically and radiologically 6 months post-injury.

Adolescent↗
PubMed2003

Immediate full-weight-bearing mobilisation for repaired Achilles tendon ruptures: a pilot study.

Recent experimental and clinical evidence suggests that early loading and mobilisation for Achilles tendon ruptures may improve functional outcomes. This paper presents the results of a pilot study designed to assess the safety of immediate weight-bearing mobilisation. Twenty-eight operatively repaired patients were randomised to either immediate loading in an orthosis or traditional serial plaster casting. An independent observer, blinded to treatment, assessed the results. Improved clinical, anthropometric, and functional outcomes were noted in the immediate loading group. Ultrasound assessment confirmed no deleterious effects upon the tenodesis. There was one re-rupture of the tendon at a minimum follow-up of 1 year.

Achilles Tendon↗
PubMed2003

Diagnostic scanning for suspected scaphoid fractures: an economic evaluation based on cost-minimisation models.

OBJECTIVE: To compare, the costs of diagnosing suspected scaphoid fractures using various protocols with various scanning techniques. DESIGN: Analysis of the cost-minimisation models. The models were prepared after an audit of the existing protocol for suspected scaphoid fractures. SETTING: Departments of Accident and Emergency and Orthopaedics, Leighton General Hospital, Crew, Cheshire, UK. SUBJECTS: A total of 124 patients presenting to A&E with suspected scaphoid fractures between 1 December 1999 and 1 May 2000. MAIN OUTCOME MEASURES: Costs to the hospital budget in ruling out or diagnosing scaphoid fractures in these patients. RESULTS: The cost using an existing protocol that does not routinely involve scanning was pounds 15,554. Projected costs for many (but not all) of the alternative protocols involving routine use of scanning procedures were found to be lower or comparable. CONCLUSIONS: Protocols based on diagnostic scanning for suspected scaphoid fractures can be comparable to a protocol which does not rely on scanning techniques because they can avoid repeated radiographs, clinical appointments and plaster cast changes. However, any such protocol must be tailored on the basis of the workload, and the availability of resources.

Cost-Benefit Analysis↗
PubMed2004

A traction jig for reduction of distal radial fractures.

A traction jig is described which facilitates the closed reduction of extra-articular distal radial fractures and which maintains the reduction whilst a plaster cast is applied. The jig is suitable for use by a single operator in an Accident and Emergency department setting.

Adult↗
PubMed2003

An outcomes assessment of intra-articular calcaneal fractures, using patient and physician's assessment profiles.

Thirty-six patients with intra-articular displaced calcaneal fractures were examined to determine both physician- and patient-based outcomes. Three groups were selected. Group A was treated with open reduction and internal fixation, group B was treated with open reduction internal fixation and supplemental bone graft augmentation and the patients in group C were treated with plaster cast immobilisation and no formal operative treatment. All cohorts were well matched for age, sex and severity of injury. Patients were evaluated using both the American Foot and Ankle Society Scoring System (AFASS) and the short form 36 (SF-36). Minimum time to follow up was 4 years. No significant difference was observed between the three groups with regards to pain and functional outcomes using the AFASS score (P>0.05). No difference was observed between the three groups using the SF-36 score (P>0.1). A statistically significant difference was observed, using radiological criteria, between both groups A and B when compared to the non-operative group C. The rate of wound infection in groups A and B was 31.5%. No correlation was found between the SF-36 score and the AFASS score. No correlation was found between the radiological score and either the SF-36 or the AFASS score. This study has found that the conservative treatment of calcaneal fractures can produce satisfactory outcomes with lower morbidity than surgically treated fractures.

Adolescent↗