Biomedical subjects

A P Henry

Publications and source records attributed to A P Henry.

11 recordsLinked to original sources

PubMed1996

Pelvic insufficiency fractures after irradiation: diagnosis, management, and rehabilitation.

Insufficiency fractures of the pelvis are commonly overlooked as causes of severe hip and low back pain. Predisposing factors include postmenopausal osteoporosis, corticosteroids, and local irradiation. Differential diagnosis includes metastatic disease to bone. We present the case of a 65-year-old woman who had a two-month history of low back pain and left groin pain. Her medical history included osteoporosis and endometrial cancer that was treated with radiation therapy to the pelvis 1 year prior to presentation. Despite bed rest, analgesics, and therapeutic modalities, her pain remained intractable and prevented ambulation. Plain radiographs showed no fracture. Computed tomography (CT) and magnetic resonance imaging showed fractures of the pelvis but were suggestive of malignancy. CT-guided bone biopsy was consistent with radiation osteonecrosis. After diagnosis and continued therapy, the patient progressed to ambulation with moderate discomfort. Failure to diagnose insufficiency fractures could lead to further pelvic irradiation, compromising already weakened bones and causing prolonged disability.

Aged↗

PubMed1996

Tibial reconstruction by ipsilateral vascularized fibular transfer.

Between 1979 and 1991 ipsilateral vascularized fibular transposition was performed on eight patients with segmental tibial defects following injury. We report these cases with a minimum follow-up of 2.5 years. All the tibial defects were the result of severe open fractures (Gustilo Grade III) and either bone loss or infected non-union, and ranged in size from 1 to 12 cm. The patients had an average of seven procedures and a delay of 33 months before fibular transfer. The procedure was successful in achieving fracture union in all cases, with an average time to union of 15 months (range, 5-33 months). Shortening of up to 3 cm and some residual ankle stiffness was found, but all patients were ambulating bearing full weight and six had returned to their previous occupation by their final follow-up. Only one patient had significant pain affecting function. This is a successful and relatively simple technique compared to microvascular and bone transport procedures for reconstructing segmental tibial defects with relatively avascular graft beds.

Adolescent↗

PubMed1994

Treatment of femoral fracture above a knee prosthesis. 18 cases followed 0.5-14 years.

We reviewed 16 patients who sustained 18 fractures above a total knee prosthesis. 5 fractures were undisplaced and were treated with either skeletal traction or a plaster cylinder. 3 did well, 1 patient suffered a cerebral vascular accident while still in plaster and 1 patient died of heart failure while on skeletal traction. 7 displaced fractures were treated initially with skeletal traction. 1 patient had a nonunion of the fracture and 2 a malunion and malfunction of the knee. 4 underwent various operations later because of malalignment and nonunion of the fracture with poor functional results. 6 displaced fractures were treated with immediate internal fixation. 5 recovered well and returned to pre-fracture activities. 1 patient's plate broke and further surgery was needed. We conclude that displaced fractures above a knee prosthesis should be treated with immediate stable internal fixation and early mobilization. Nonoperative treatment was satisfactory only for minor undisplaced fractures.

Aged↗

PubMed1986

The results and morbidity of varus osteotomy for Perthes' disease.

The results of varus proximal femoral osteotomy in 55 hips in 52 patients were analyzed by Harrison's radiologic autoassessment method. Excluding operations upon Catterall Grade 1 hips, 75.6% were either therapeutic successes or unchanged; 24.4% were therapeutic failures. These results are compared with and shown to be similar to those of patients treated conservatively by the Birmingham splint. In ten children with Catterall Grade 1 disease, seven were unchanged but three were therapeutic failures. Improved end results occurred in hips with greater surgical varus than those in which the end result worsened, but the statistical significance was questionable. The bone remodelling in response to surgical varus was unpredictable, but the greater the surgical varus the less the correction of the neck shaft angle at follow-up evaluation. Chronologic age cannot be used to predict such bone remodelling as may be impaired by the disease process. An analysis of the incidence and significance of leg shortening, limping, and abductor lurch is presented and some observations made on trochanteric overgrowth and the effect of surgery on the rate of femoral head reconstitution. New attempts to achieve containment of the hip by high-femoral osteotomy may determine the effects of a combination of varus and selective rotation osteotomy using ultrasound scans to measure femoral torsion before operation.

Child↗

PubMed1983

Closed vertebral biopsy.

A study of cadaveric vertebral biopsy and a review of 100 clinical biopsies has shown that needles and trephines producing tissue specimens of two millimetres or more in diameter can be expected to give a high degree of diagnostic accuracy. The erythrocyte sedimentation rate was a more useful screening investigation than were estimations of serum alkaline phosphatase. The complications are described. It is suggested that patients with painful thoracic metastases and evidence of progressive cord compression should have early decompression after open biopsy if further neurological compromise is to be prevented.

Aged↗

PubMed1975

The use of footprints in assessing the results of operations for hallux valgus. A comparison of Keller's operation and arthrodesis.

One hundred and seventy feet have been reviewed after operations for hallux valgus; eighty-five had had arthrodesis of the first metatarso-phalangeal joint and eighty-five had had Keller's operation. Footprints were made in order to assess the patterns of weight-bearing on the big toe and on the lesser metatarsal heads. After arthodesis the big toe bore weight in 80 per cent compared with 40 per cent after Keller's operation. The ability to bear weight on the big toe is related to the presence of metatarsalgia and excessive weight-bearing on the lesser metatarsal heads. These complicaitons were seen more commonly after Keller's operation (particularly when more than one-third of the phalanx had been excised) than after arthrodesis.

Arthrodesis↗

PubMed1974