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Biomedical subjects

A J Espley

Publications and source records attributed to A J Espley.

12 recordsLinked to original sources
PubMed2002

Perioperative ulnar neuropathy in orthopaedics: association with tilting the patient.

The incidence and causes of perioperative ulnar neuropathy in a prospective series of 203 consecutive patients were examined. Three percent of patients had ulnar neuropathy develop in the entire prospective series. The incidence was 6% in patients having total hip arthroplasty. There was a highly significant association between a tilted body position on the operating table and development of ulnar neuropathy on the contralateral side. This position rotates the arm internally and places the ulnar nerve at risk for direct compression.

Adolescent↗
PubMed1999

Effect of activity levels on polyethylene wear in Charnley low-friction arthroplasty.

Polyethylene wear debri has been implicated as a major cause of aseptic loosening following total hip replacement. The purpose of this study is to classify patient activity levels following total hip replacement and determine if it has an effect on radiographic wear of the socket. 97 patients (115 hips) with osteoarthritis who underwent Charnley low-friction arthroplasty with a minimum of 10 year follow-up were selected. Nine patients had died. Eighty-eight questionnaires were sent of which 59 replied. However, only 40 patients (45 hips) with a complete set of x-rays were finally studied. Activity levels were classified according to post-operative occupation and activities into 'active' and 'less active' groups. Radiographic wear was measured by studying the post-operative and the 10-year review radiograph. There was a significant difference in acetabular wear between the active and the less active group (p = 0.024). No correlation was found between weight and acetabular wear (p = 0.475) or between age and acetabular wear (p = 0.278). It was concluded, therefore, that surgeons who advise their patients to avoid heavy or high intensity activities for prolonged periods, after Charnley low-friction arthroplasty, are justified in this approach.

Acetabulum↗
PubMed1988

Fractures of the metatarsals: management of complicated injuries with a simple traction system.

A simple method of skeletal traction is described to facilitate management of complicated multiple fractures of the metatarsals following crush injuries of the foot. The system uses Brock's pins and a modified Nissen loop to achieve either balanced traction or fixed traction. Satisfactory alignment of the fractures can be maintained whilst soft tissue disorders are dealt with.

Fractures, Bone↗
PubMed1987

The Pugh nail-plate--a low incidence of device failure.

A consecutive series of 118 patients with fracture of the proximal end of the femur treated by the Pugh nail-plate, is reported. The contribution of failure of the device to failure of fixation is analysed. Fifteen subjects had a failure of fixation either requiring removal of the implant or resulting in malunion of the fracture. In only 2 of the fractures for which the nail-plate was designed could failure be directly attributed to the device alone. In the remaining failures of fixation the device was inappropriately used or inserted.

Aged↗
PubMed1979

Hip fracture after hemiplegia.

In a series of 57 hemiplegic patients who subsequently fractured their hips, it was found that hip fracture occurred significantly more often on the hemiplegic side. Hip fracture was equally common in right- and left-sided hemiplegia, and often occurred within one year of the stroke. Two factors seem to be important in the genesis of hip fractures in hemiplegic patients: the tendency of stroke patients to fall to the affected side as a result of impaired locomotor function, and the development of disuse osteoporosis in the hemiplegic limb.

Aged↗