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Biomedical subjects

A G Jennings

Publications and source records attributed to A G Jennings.

11 recordsLinked to original sources
PubMed2004

Repair of acute rupture of the Achilles tendon: a new technique using polyester tape without external splintage.

INTRODUCTION: A new method of treating acute rupture of the Achilles tendon using polyester tape is reported. This requires no postoperative splintage, allows earlier mobilisation and prompt return to work and sport. PATIENTS AND METHODS: Thirty patients were reviewed prospectively and at a mean of 3 years from surgery. RESULTS: The average time of return to work, full weight-bearing and to driving was 40 days, 45 days and 49 days, respectively. The average time for return to sport was 122 days. Three patients required further surgery, two for infected wounds and one for scar release. There was one sural nerve injury. Twenty-two patients regained a normal range of ankle and subtalar movement, with the mean power of plantar flexion 84% of the opposite side. Of the 22 patients who played sport, 14 were still performing at the same or a higher level. There were no re-ruptures over this period. CONCLUSIONS: The technique is straightforward and avoids splintage. It also conveys other short- and long-term advantages over more established methods.

Achilles Tendon↗
PubMed2002

Chronic rupture of tendo Achillis. Long-term results of operative management using polyester tape.

We report the long-term results of the surgical treatment of chronic rupture of tendo Achillis using polyester tape. This requires minimal postoperative splintage and allows early mobilisation and a prompt return to work and sport. We reviewed 16 patients (10 women and 6 men) at a mean period of three years after surgery. The median time from injury to operation was 16.8 months (3.9 months to 13 years), and the median age of the patients was 52 years (27 to 78). The median time to full weight-bearing was 40 days and the median time for return to sport was 18 weeks (5.4 to 32). One patient required further surgery and one had numbness along the distribution of the sural nerve. After surgery only two patients had increased dorsiflexion of the ankle compared with the uninjured side. There were no cases of rerupture. We recommend this technique for the treatment of chronic rupture of tendo Achillis.

Achilles Tendon↗
PubMed1999

Should we operate on nonagenarians with hip fractures?

Studies on fractured necks of femurs usually have a cut off point at the age of 85. However, in view of an ageing populace it seems reasonable to look at the nature of hip fractures in the nonagenarians. In previous studies mortality and morbidity of 90-year-olds has been high. It has also been suggested that operating on the demented and institutionalised is not particularly effective. A 4-year review of 164 nonagenarian patients with hip fractures was therefore conducted at York district hospital. Access to the records of 136 (83%) patients was obtained with limited admission and mortality data from a further 28. Mortality rates at six months were 43% (24% in hospital) increasing to 46% at one year. Sixty-two patients had some complication of which 35 were dead within 6 months. Sixty-two per cent of patients returned to their pre admission residence. The mortality rates in this review are lower than in some previous studies and of those that survived 6 months 53% had no postoperative complications. It would therefore seem reasonable to operate on nonagenarians.

Aged↗
PubMed1999

Impact of the introduction of a daily trauma list on out-of-hours operating.

The British Orthopaedic Association have recommended that all hospitals should have daily, consultant-led, trauma lists. We have prospectively examined the introduction of a daily trauma list on the out-of-hours operating and the management of trauma in one district hospital. The data collected were compared with a corresponding 6-month period in 1996. It was found that the mean usage of the list was 2 h 38 min; 10% of lists were not used. There has been a significant reduction in the number of operations performed out-of-hours, and also a significant reduction in the amount of out-of-hours operating after midnight. More complex cases have also been operated on in normal working hours. The initial introduction of a daily trauma list has had a significant impact on the total amount of out-of-hours operating and has increased consultant supervision of the management of trauma, thereby increasing the quality of care for these patients.

Emergency Treatment↗
PubMed1995

134 tibial shaft fractures managed with the Dynamic Axial Fixator.

We have reviewed the results of 134 tibial shaft fractures treated with the Dynamic Axial Fixator. In 86 closed fractures, the average union time was 4 months. 76 fractures had united by 5 months; delayed union occurred in 7 cases. 3 closed fractures failed to unite. In 48 open fractures, the union time was related to the severity of soft tissue trauma. The average union time was 5 months for grade II and 6 months for grade III open fractures. 33 open fractures had united by 5 months and delayed union occurred in 11 fractures. 4 open fractures failed to unite. The commonest complication was minor pin site infection, which was seen in 34 percent. These responded rapidly to treatment and external fixation continued. Major pin site infections were uncommon (5 percent) and none led to any serious sequelae. We have found the Dynamic Axial Fixator a safe and reliable device for treating fractures of the tibial shaft.

Adolescent↗
PubMed1994

Research or re-search? Why we should read old and foreign literature.

The recent availability of MEDLINE has made literature searches easier but, as a result, historic papers and those from foreign language journals may be overlooked. One hundred papers were reviewed and it was found that there was a 5% incidence of failure to acknowledge papers published in either pre-second world war literature or papers published in French. It is important to read historic and foreign language literature in order that the wheel is not reinvented.

Anterior Cruciate Ligament Injuries↗
PubMed1994

Proprioception in the knee and reflex hamstring contraction latency.

There are various methods of measuring proprioception at the knee. Beard et al (1993) have described a delay in reflex hamstring contraction in anterior cruciate deficient knees. We have repeated their experiment and were unable to detect any significant difference in reflex hamstring contraction between the injured and uninjured legs. We discuss possible neurophysiological and biomechanical causes for the conflicting results and conclude that this method may not be a valid measure of proprioception.

Adult↗
PubMed1991

Expression of the cell adhesion molecules, L-CAM and N-CAM during avian scale development.

To examine the involvement of cell adhesion molecules in the inductive epithelial-mesenchymal interactions during avian scale development, a study of the spatiotemporal distribution of L-CAM and N-CAM was undertaken. During scutate scale development, L-CAM and N-CAM are expressed together in cells of the transient embryonic layers destined to be lost at hatching. The ongoing linkage of the cells of these layers by both CAMs sets them apart, early in development, as unique cell populations. L-CAM and N-CAM were also expressed simultaneously at the basal surface of the early germinative cells where signal transduction is presumed to occur. In spite of the differences in cell shape, adhesion, density and proliferative state between populations of epidermal placode and interplacode cells, the expression of L-CAM and N-CAM appeared to be uniform and nondiscriminating for these discrete cell lineages. The same pattern of L-CAM and N-CAM expression was observed during morphogenesis of reticulate scales that develop without placode formation. While L-CAM and N-CAM are present during the early stages of scale development and most likely function in cell adhesion, the data do not support a role for these adhesion molecules in the formation of the morphogenetically critical placode and interplacode cell populations. In both scale types, L-CAM became predominantly epithelial, and N-CAM became predominantly dermal as histogenesis occurred. Initially, N-CAM was concentrated near the basal lamina where it may be involved in the reciprocal epidermal-dermal interactions required for morphogenesis. However, as development of the scales progressed, N-CAM disappeared from the tissues. L-CAM expression continued in the epidermis and was intense on all suprabasal cells undergoing differentiation into either an alpha-stratum or beta-stratum. However, L-CAM was more prevalent on the basal cells of alpha-keratinizing regions than on the basal cells of beta-keratinizing regions.

Animals↗
PubMed1991

The initial expression and patterned appearance of tenascin in scutate scales is absent from the dermis of the scaleless (sc/sc) chicken.

Morphogenesis of the anterior metatarsal skin (scutate scale region), from 9.5 to 12 days of development, results in the formation of orderly patterned scale ridges. It is after the initial formation of the Definitive Scale Ridge that the characteristic outer and inner epidermal surfaces differentiate. The hard, plate-like beta stratum, with its unique beta keratins, characterizes the epidermis of the outer surface, while the epidermis of the inner surface elaborates an alpha stratum. The anterior metatarsal region of the scaleless mutant does not undergo scale morphogenesis. Therefore, scale ridges do not form nor do the outer and inner epidermal surfaces with their characteristic beta and alpha strata. We have found that the extracellular matrix molecule, tenascin, first appears in the scutate scale dermis at 12 days of development when the scale ridge is established. Tenascin is found in the dermis only under the scale ridge and is not associated with the dermal-epidermal junction. Tenascin is not found in scaleless anterior metatarsal dermis at this time. As outgrowth of the Definitive Scale Ridge takes place, tenascin distribution correlates closely with the formation of the outer epidermal surface of each scale ridge. By 16 days of development tenascin is also found in close association with the dermal-epidermal junction. Tenascin does not appear in scaleless anterior metatarsal dermis until 16 days of development and then it is randomly and sparsely distributed at the dermal-epidermal junction. Tenascin's initial appearance and pattern of distribution in the scutate scale dermis and its abnormal expression in the scaleless dermis suggest that morphogenesis plays a significant role in regulation of its expression.

Animals↗
PubMedDate not supplied

Ego development in women with histories of sexual abuse.

As many as a third of the women in this culture experience sexual abuse prior to reaching age 18. Recent literature and research have presented divergent views related to the impact of early abuse on ego development, with arguments supporting both ego fragmentation and ego acceleration. This preliminary study compared the level of ego development, as measured by Loevinger's Washington University Sentence Completion Test (SCT), of 30 women with histories of childhood sexual victimization, and 30 women with no history of abuse. Results indicated no significant difference between the ego levels of the sexually abused and nonabused groups, with a slight trend toward higher ego development in the abused group. Factors contributing to these findings are discussed and recommendations for future research are suggested.

Adolescent↗