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Biomedical subjects

A Axer

Publications and source records attributed to A Axer.

At least 19 recordsLinked to original sources
PubMed1984

Residual shortening after osteotomy for Perthes' disease. A comparative study.

The residual shortening of the affected limbs in 55 patients treated by subtrochanteric varus derotation osteotomy was compared with that in 71 patients treated with weight-relieving calipers. When last examined, 43 of the former group and 47 of the latter had reached complete or near-complete skeletal maturity. The average follow-up was 9.1 years in the osteotomised patients and 5.25 years in the conservatively treated group. The average residual shortening (0.9 cm) was identical in both groups. In most patients the initial shortening caused by the osteotomy gradually corrected as, over a period of several years, the postosteotomy angle gradually became less varus. Any residual shortening depended principally on the severity of inhibition of endochondral ossification at the proximal femoral growth plate. Less residual shortening was seen in children who were under seven years of age at the onset of symptoms (under eight at operation) in whom the open-wedge technique of osteotomy was employed and who had good anatomical results.

Adolescent↗
PubMed1984

A new technique for greater trochanteric hip arthroplasty.

This paper describes a new technique for greater trochanteric hip arthroplasty in which the femur is divided at the subtrochanteric level and the upper fragment rotated through 180 degrees to place the greater trochanter deeply in the acetabulum; with the lower limb in the weight-bearing position the fragments are then fixed with a short intramedullary nail. This operation was carried out in a boy aged 4 years 6 months in whom the femoral head and neck had been destroyed by septic arthritis. Ten years later leg-lengthening was performed. When reviewed at the age of 20, he had a stable hip, a satisfactory range of painless movement, and shortening of only 2.5 cm; he could walk and run for long distances with only a slight abductor lunch.

Arthritis, Infectious↗
PubMed1981

Unusual gas-forming infection with Escherichia coli.

Infections with non-clostridial gas-forming organisms are not often encountered in orthopaedic practice. We present here a case of gas-forming infection with Escherichia coli which occurred 10 months after internal fixation of a closed fracture of the femur in an 84-year-old diabetic woman who suffered from septic nephrolithiasis. The wound infection was considered to have arisen by spread from the organisms of the infected kidney.

Aged↗
PubMed1980

Simple reconstruction of anteromedial rotational knee stability.

A technically simple operation for the restoration of anteromedial rotational knee stability is described. It involves suturing under tension the posteromedial capsule of the knee joint to the semimembranosus tendon at its insertion into the tibia, with the leg held in full internal rotation and with the knee flexed to 60 degrees. This, in combination with the conservative treatment of meniscal injuries and with tightening of the soft tissue structures over the medial aspect of the knee, restored full or almost full anteromedial stability in the knee in 15 out of 16 young men, observed for an average of 19 months after the operation.

Adolescent↗
PubMed1980

Arthrography as an aid to diagnosis, prognosis and therapy in Legg-Calvé-Perthes' disease.

Measurements of head diameter and acetabulum-head quotient (AHQ) were made on the plain radiographs and corresponding arthrograms of 37 consecutive patients with unilateral Legg-Calvé-Perthes' Disease (L.C.P.D.). Although on plain radiographs the affected osseous femoral capital epiphysis was slightly larger (22) the same size (9) or smaller (6) than that on the normal side, on arthrography the osteochondral head was much larger in 34 and the same size in 3 instances. In 35 cases the arthrograms revealed flattening of the osteochondral head. The AHQ computed from the arthrograms was almost invariably less than that computed from the plain radiographs. Thus the AHQ computed on arthrograms more realistically assessed the almost invariably poor head coverage in L.C.P.D. This, together with signs of flattening, diagnoses the severity of the disease process and helps to differentiate the "head at risk" which requires treatment. During arthrography the degree of abduction-medial rotation of the leg necessary for containment of the flattened protruding head within the acetabulum can be determined, allowing accurate therapy to be planned, be it operative or orthotic.

Acetabulum↗
PubMed1979

Localized regressive articular cartilage changes in the hip joint of the rabbit following an induced synovitis.

A talcum induced synovitis in the hip joint of the rabbit, which is known to cause articular cartilage hyperplasia followed by femoral head protrusion and joint incongruency, has in the present experiment also been shown to lead to localized regressive articular cartilage changes. The articular cartilage of the hip joints in 40 rabbits was examined histologically, at intervals, following induction of such a talcum synovitis. Regressive changes in the form of loss of surface chondrocytes and glycosaminoglycans sometimes accompanied by fibrillation, were found in the area of the femoral head articular cartilage which had become flattened following the head protrusion. Chondrocyte cloning facilitated subsequent cartilage repair. The biomechanical disturbance in the joint following the induced synovitis is felt to have caused the regressive changes. The experiment is considered to have some significance in connection with Legg-Calvé-Perthes' Syndrome (L.C.P.S.) in children.

Animals↗
PubMed1978

Arthrographic findings in Legg-Calvé-Perthes disease and transient synovitis of the hip.

Bilateral arthrography of the hip was performed in thirty-seven patients with unilateral Legg-Calvé-Perthes disease. Measurements made on the plain roentgenograms and on the arthrograms of the diameter of the femoral head, the width of the medial joint space, and the thickness of the acetabular cartilage were compared. The acetabulum-head quotients also were calculated. When present, evidence of flattening of the femoral head cartilage and of pooling of the contrast material also was noted. These data showed that in the early stages of Legg-Calvé-Perthes disease the articular cartilage is thickened, and that the cartilaginous femoral head is deformed and protrudes from the acetabulum. Arthrograms made with the hip in different positions also indicated the extent and location of collapse of the (osteochondroal) femoral head and therefore proved useful as a means to determine the best therapeutic position of the hip to provide coverage of the head. In three patients with severe transient synovitis, thickening of the articular cartilage resembling that seen in Legg-Calvé-Perthes disease was demonstrated.

Cartilage, Articular↗