Orthopedics Commons^™

Operative Treatment Of Bilateral Hip Dislocation In Children With Arthrogryposis Multiplex Congenita, S Asif, Masood Umer, Rashid Baig

Department of Surgery Docs

Abstract

PURPOSE:

Arthrogryposis multiplex congenita (AMC) is a rare syndrome with multiple joint contractures. It is commonly believed that bilaterally dislocated hips associated with joint contractures should not be reduced, because movement is satisfactory, while open reduction leads to poor results. This report presents our experience with surgical management of bilateral dislocation of hips in children with AMC.

METHODS:

During the period 1990 to 2000, we performed open reduction on 8 hips of 4 children with AMC. The mean age at surgery was 23 months (range, 5-48 months). Open reduction and capsular plication without any bony procedure were performed in …

Passing The Boards: Can Usmle And Orthopaedic In-Training Examination Scores Predict Passage Of The Abos Part-I Examination?, Gregg R Klein, Matthew S Austin, Susan Randolph, Peter F Sharkey, Alan S Hilibrand

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.

An Experience With Free Scapular Flap For Reconstruction Of Lower Extremity Defects At Aga Khan University Hospital Karachi, Pervaiz Mehmood Hashmi

Section of Orthopaedic Surgery

Background: Reconstruction of large composite tissue defects with exposed vital structures and weight bearing surfaces are extremely difficult for reconstructive surgeons. Coverage of such difficult defects can be achieved with free tissue transfer provided microsurgical expertise is available. This study was carried out to determine the outcome of free scapular flaps performed for lower extremity defects.
Methods: Clinical records of the patients were reviewed and important variables included demographic data, etiology of soft tissue defects, site and size of defect, complications and percentage of wound coverage by flap. Patient satisfaction and objective assessment of flap coverage and motion of involved …

Septic Arthritis Of The Hip In Children: Aga Khan University Hospital Experience In Pakistan, Muhammad Umer, Pervaiz Hashmi, Tashfeen Ahmad, M Ahmed, Masood Umer

Section of Orthopaedic Surgery

Objective: To present clinical, radiological and bacteriological features and short term outcome of septic arthritis of the hip in children.
Methods: There were 23 male and 16 female children, including 6 neonates and 10 infants with a mean age of 3.9 years. Diagnosis of septic hip was made on clinical grounds, supplemented by X-rays, leukocyte count and the erythrocyte sedimentation rate (ESR). Thirty nine patients with 40 hips were followed for a mean time period of 76 weeks. All patients had a positive joint aspirate (pus) and underwent surgical decompression along with intravenous antibiotic therapy.
Results: Symptoms of pain, fever …

Effects Of Tensioning Errors In Split Transfers Of Tibialis Anterior And Posterior Tendons, Stephen J. Piazza, Matthew F. Moran, Neil A. Sharkey, Robert L. Adamson, James O. Sanders

All PTHMS Faculty Publications

Background: Split transfers of the tibialis anterior and posterior tendons are commonly performed to address hindfoot varus deformities in patients with cerebral palsy, stroke, or brain injury. Poor outcomes from these procedures are often attributed to a failure to tension the transferred tendon properly, but the mechanical effects of this aspect of the procedure have not been quantified, to our knowledge. The purpose of the present study was to use a cadaver model to examine changes in the actions of these muscles that occur when the tensions in the halves of the split tendon are intentionally balanced or unbalanced to …

Hyalgan® Has A Dose-Dependent Differential Effect On Macrophage Proliferation And Cell Death, Kyle M. Sheehan, Lindsey B. Delott, Susan M. Day, David H. Deheer

University Faculty Publications and Creative Works

The intra-articular injection of high molecular weight hyaluronic acid (HA) has been reported to be an effective treatment for pain of osteoarthritis of the knee. However, the mechanism by which HA exerts its effect is unknown. To explore HA's influence on the growth of U937 human macrophages, cells were incubated for 168 h with three concentrations, 1, 0.1 and 0.01 mg/mL, of Hyalgan®, a high molecular weight HA preparation. At 24-h increments, the cells were examined for proliferation, cell cycle distribution as well as the number of apoptotic and dead cells. Exposing macrophages to 1 mg/mL Hyalgan® significantly reduced the …

The Reliability Of Emg Normalization Procedures For Three Muscles Invol Ved In Knee Extension, Gerrik J. Schepel

Masters Theses

This retrospective study analyzed the three muscles involved in knee extension: vastus medialis, rectus femoris, and vastus lateralis. lt was conducted to determine the reliability of normalization procedures when evaluating the EMG response detected from a muscle. During a maximal voluntary isometric contraction {MVIC), the EMG response of the muscle was recorded and the iEMG moment per unit area was determined. The iEMG response ofthe quadriceps muscles during dynamic exercise was normalized using the MVIC. Subjects (N = 44) performed two consecutive MVICs with a 2-min rest between trials at 110°, 90°, 70°, 50°, and 30° of knee flexion, …

Impact Of Smoking On The Outcome Of Anterior Cervical Arthrodesis With Interbody Or Strut-Grafting., Alan Hilibrand, Mark A. Fye, Sanford E. Emery, Mark A. Palumbo, Henry H. Bohlman

Rothman Institute Papers

BACKGROUND: An increased rate of pseudarthrosis has been documented following posterolateral lumbar spine grafting in patients who smoke. This same relationship has been assumed for anterior cervical interbody grafting, but to our knowledge it has never been proven. This study compared the long-term radiographic and clinical results of smokers and nonsmokers who had undergone arthrodesis with autogenous bone graft following multi-level anterior cervical decompression for the treatment of cervical radiculopathy or myelopathy, or both.

METHODS: One hundred and ninety patients were followed clinically and radiographically for at least two years (range, two to fifteen years). Fifty-nine of the patients had …

Treatment Of Tibial Diaphyseal Fractures With Closed Flexible Intramedullary Ender Nails: 39 Fractures Followed For A Period Of Two To Seven Years, Hussain R. Usman, Muhammad A. Umer, Masood Umer

Department of Surgery Docs

Abstract

OBJECTIVE:

To assess the efficacy of flexible intramedullary Ender nails for the treatment of tibial diaphyseal.

MATERIALS AND METHODS:

This is a retrospective review of patients treated with the Ender Nail for both open and closed tibial shaft fractures. Between January 1989 and December 1994, 43 fractures were treated with these nails. The configuration of each fracture was determined using the Orthopedic Trauma Association classification and the extent of soft tissue damage was assessed using the Gustilo and Anderson's classification. Four patients were excluded from the study due to inadequate follow-up. There were 27 closed and 12 open fractures. …

Tibial Plateau Fractures: A New Classification Scheme, Raja Muhammad Shahzad Khan, Shuja Hassan Khan, Agha Jamil Ahmad, Muhammad Umar

Section of Orthopaedic Surgery

Fractures of the tibial plateaus are common injuries. Various classification schemes have been used to describe these injuries. Although each system has its own purpose, the simpler systems do not allow comparison with more complex divisions. The problem is compounded by the variable use of adjectives that describe these fractures. A comprehensive classification of tibial plateau fractures should group fractures that are similar in topography, morphology, and pathogenesis, requiring similar treatment, and having a similar prognosis. Fracture dislocations and standard tibial plateau fractures should be incorporated into a single classification to avoid the use of two complementary classifications. Any such …

Increased Matrix Synthesis Following Adenoviral Transfer Of A Transforming Growth Factor Beta1 Gene Into Articular Chondrocytes, Franklin D. Shuler Md, Phd, Helga I. Georgescu, Christopher Niyibizi, Rebecca K. Studer, Zhibao Mi, Brian Johnstone, Paul D. Robbins, Christopher H. Evans

Orthopaedics

Monolayer cultures of lapine articular chondrocytes were transduced with first-generation adenoviral vectors carrying lacZ or transforming growth factor β₁ genes under the transcriptional control of the human cytomegalovirus early promoter. High concentrations of transforming growth factor β₁ were produced by chondrocytes following transfer of the transforming growth factor β₁ gene but not the lacZ gene. Transduced chondrocytes responded to the elevated endogenous production of transforming growth factor β₁ by increasing their synthesis of proteoglycan, collagen, and noncollagenous proteins in a dose-dependent fashion. The increases in collagen synthesis were not accompanied by alterations in the collagen phenotype; …

Transfer Of Lacz Marker Gene To The Meniscus, Hideyuki Goto Md, Franklin D. Shuler Md, Phd, Chanin Lamsam Md, Hans D. Moller Md, Christopher Niyibizi Phd, Freddie H. Fu Md, Paul D. Robbins Phd, Christopher H. Evans Phd

Orthopaedics

Background: Lesions in the avascular two-thirds of the meniscus do not heal well and are of concern clinically. Various growth factors promote the synthesis of matrix by meniscal cells and thus have the potential to augment healing. However, their clinical application is severely hindered by problems with delivery. An attractive approach to overcoming such problems is to transfer genes that encode the growth factors in question to the site of the injury. As a prelude to this, we evaluated methods for delivering genes to the meniscus.

Methods: Gene transfer was evaluated in vitro and in vivo with a lacZ marker …

Clinico-Morphological Pattern And Frequency Of Bone Cancer, Sajid H. Shah, Suhail Muzaffar, Irshad N. Soomro, Shahid Pervez, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Objective:

The present study was done to find out the frequency of malignant tumors of bone and to categorize the prevelence of various histological types of osseous malignancies with respect to age, sex and site of origin.

Setting:

This study included consecutive cases of malignant bone tumors, which were diagnosed in the department of pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997).

Methods:

These tumors were initially evaluated on H & E stained section from paraffin embedded tissue blocks. Special stains and immunohistochemical analysis was performed whenever required.

Results:

A total of 169 …

Radiculopathy And Myelopathy At Segments Adjacent To The Site Of A Previous Anterior Cervical Arthrodesis., Alan S. Hilibrand, Gregory D. Carlson, M A Palumbo, P K Jones, H H Bohlman

Rothman Institute Papers

BACKGROUND: We studied the incidence, prevalence, and radiographic progression of symptomatic adjacent-segment disease, which we defined as the development of new radiculopathy or myelopathy referable to a motion segment adjacent to the site of a previous anterior arthrodesis of the cervical spine.

METHODS: A consecutive series of 374 patients who had a total of 409 anterior cervical arthrodeses for the treatment of cervical spondylosis with radiculopathy or myelopathy, or both, were followed for a maximum of twenty-one years after the operation. The annual incidence of symptomatic adjacent-segment disease was defined as the percentage of patients who had been disease-free at …

Well Differentiated Hepatocellular Carcinoma Metastasizing To Jaw And Oral Cavity Within Six Months Of Primary Diagnosis., Nazma Afroze, Irshad N. Soomro, Shahid Pervez, Naila Kayani, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Acquired Arterio-Venous Fistula With Mycetoma: Two Entities Coinciding: A Case Report, Saldar Nasim Khan, Nabil Wasif, Masood Umar, Mohamrnad Umar

Section of Orthopaedic Surgery

No abstract provided.

Ambulatory Arthroscopic Knee Surgery Results Of Partial Meniscectomy, Muhammad Umar

Section of Orthopaedic Surgery

In an open prospective study the results of arthroscopic partial meniscectomy were reviewed in 188 knees. Group I comprised of 139 (65%) knees with pure meniscus lesions without any ligament laxity, the remaining 49 (35%) knees in group II had anterior cruciate ligament (ACL) deficiency in addition to meniscus lesions. In group I, 93% had excellent to good and 7% had fair results by criteria of Tapper and Hoover. In group II, 75% had excellent to good and 25% had fair results. Arthroscopic knee surgery was a good method of identifying patients in group II who required anterior cruciate reconstruction. …

Patellofemoral Pain In Female Ballet Dancers: Correlation With Iliotibial Band Tightness And Tibial External Rotation, John Winslow, Evangeline Yoder

Rehabilitation Sciences Faculty Publications

Review of the literature reveals that ballet dancers have a high incidence of idiopathic patellofemoral pain. Twenty-four female ballet dancers were subjects in a study of the relationship between: 1) iliotibial band (ITB) tightness and patellofemoral pain, and 2) ITB tightness and degrees of tibial external rotation used in the dance demi-plie. Dancers were initially assessed by questionnaire to determine if any had knee pain. Twelve subjects mel the study criteria for patellofemoral pain, and 12 dancers without knee pain served as controls for the study. Iliotibial band tightness was measured (Ober test), and degrees of tibial external rotation used …

The Ring Butterfly Fragment, Philippe D`Sousa, Masood Umer, Riaz Hussain Lakdawala

Department of Surgery Docs

No abstract provided.

The Effects Of Orthopaedic Surgery And Dorsal Rhizotomy On Selected Gait Characteristics Of Cerebral Palsy Children, Danielle M. Lanoue

Rehabilitation Sciences Theses & Dissertations

Surgical management of cerebral palsy children typically involves multiple orthopaedic surgeries in order to achieve and maintain the maximum functional level of ambulation. Orthopaedic intervention to address lower extremity spasticity often includes: muscle lengthenings, muscle releases and tendon transfers. The most recent advance in management of lower extremity spasticity has been through a neurosurgical approach; selective dorsal rhizotomy. The long term effects of dorsal rhizotomy are still being investigated. Through the use of instrumented gait analysis, the specific objective results of both of these types of surgeries can be investigated. The purpose of this retrospective study was to examine the …

A Descriptive Study Of Bone Health Risk Factors In Females Ages 13 To 16 Years, Anita M. Johnson

Dissertations and Theses @ UNI

The purpose of this study was to describe the known risk factor profile for bone health in an apparently healthy female adolescent population. A risk profile of nine factors, compiled from the current research literature included the following risks: (a) Female gender, (b) family history of osteoporosis, (c) Caucasian or Oriental race, (d) slender body frame/underweight, (e) dietary intake less than 1500 mg calcium/day, (f) weight-bearing physical activity less than 60 minutes three times a week, (g) amenorrhea or irregular menses associated with strenuous physical training, (h) smoking, and (i) alcohol use.

A three-day diet record was used to determine …

Spinal Disease Presenting As Acute Abdominal Pain, M J. Torrens, Rashid Jooma

Section of Neurosurgery

No abstract provided.

Spinal Disease Presenting As Acute Abdominal Pain: Report Of Two Cases, Rashid Jooma, M J. Torrens, R J. Veerapen, H B. Griffith

Section of Neurosurgery

No abstract provided.

The Effects Of Systematic Relaxation On The Number Of Times Pain Medication Was Administered To Immobilized Traction Patients, Brenda Carol Armstrong

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract Not Included]

Guided Abduction In The Treatment Of Congenital Hip Dislocations, Alfred B. Webber

Loma Linda University Electronic Theses, Dissertations & Projects

Guided abduction has been well accepted in Southern California as an effective method in the initial treatment of congenital hip dislocation. Since 1953, when this procedure was first instituted, no report has been made in the world literature describing its application and the results obtained. One of the purposes of this communication has been to outline the stages in treatment and show some of the results obtained.

The early group of congenital hip dislocations represents a difficult problem. It has been shown as a result of this study that guided abduction is an effective way to control the reduction of …

Tendon Transplantation In The Treatment Of Paralytic Equinus, George J. Wiessman

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract Not Included, Preface Follows]

With the continued high incidence of paralytic poliomyelitis the crippling after effects of this disease will be seen for many years to come even if the number of new cases gradually decrease as effective immunization techniques are developed. Because of the high incidence of lower extremity involvement and the disproportionately high percentage of anterior tibial paralysis, it is of interest to review the methods of treatment used, in paralytic equinus heretofore and draw lessons from these cases to guide us in the management of future problems.

It is recognized that the isolated instances of paralytic …