Biomedical subjects

A S Irwin

Publications and source records attributed to A S Irwin.

4 recordsLinked to original sources

PubMed1998

Achilles tendon rupture and sciatica: a possible correlation.

The association between Achilles tendon rupture and sciatica was investigated by questionnaire in 138 patients who underwent repair of an Achilles tendon rupture, and in a group of individuals nominated by the patients, matched for age, sex, and occupation. A total of 102 patients (74%) and 128 peer nominated controls (71%) replied to the questionnaire. Of the 102 respondent patients, 18 had an officebased job, 47 were involved in skilled nonmanual work, and 16 were retired. Back pain had been experienced by 63 of the patients who replied to the questionnaire, and by 91 (75%) of the individuals in the control group (difference not significant). In about 30% of both groups, the pain confined them to bed for at least two days, and resulted in absence from work. Thirteen of the patients and 16 of the controls had undergone thoracic, lumbar, or sacral radiography. One individual in each group had received surgery for back pain. However, 35 of 102 patients had experienced sciatic pain before Achilles tendon rupture. Pain of a similar nature had been experienced by only 15 individuals in the control group (12%) (p < 0.001). Using this study design, we found a highly significant association between Achilles tendon rupture and sciatica. We propose that this association could be due to impaired afferent signals from the lower leg, or to similar collagen or vascular anomalies of the vertebral disc and the Achilles tendon.

Achilles Tendon↗

PubMed1997

Assessment of late results of surgery in talipes equino-varus: a reliability study.

UNLABELLED: The variability of a method for clinical and functional assessment of the long-term results of surgical correction of idiopathic congenital talipes equino varus was studied in ten boys and four girls (average age: 19.1 (SD 2.3 years); 22 affected feet) with radiographical evidence of fusion of the foot and ankle ossification centres. Patients were measured twice, 1 week-1 month apart, by the same investigator and were assessed twice on each visit. Assessment included anthropometry, functional assessment and subjective functional evaluation. Calf circumference, skinfold thickness, foot length and width were highly reproducible. Foot length was not significantly influenced by the operation whereas calf circumference, skinfold thickness and foot width were. Although highly reproducible, hopping was not significantly affected by operation. Active and passive range of motion were significantly different. Each was highly reproducible and both were significantly affected by the operation. Patients reported a high and highly reproducible (within two points) functional level. CONCLUSION: An assistant-administered functional questionnaire together with measurement of active and passive range of motion allows easy, valid and reproducible assessment of long-term results of surgery for idiopathic congenital talipes equino-varus correction. A significant effect of the number and type of operation was evidenced.

Adolescent↗

PubMed1995

Scapho-trapezoid arthritis. A cause of residual pain after arthroplasty of the trapezio-metacarpal joint.

Scapho-trapezoid osteoarthritis may accompany osteoarthritis of the CM joint of the thumb. If the scapho-trapezoid joint is not excised when performing an excision of the trapezium with ligament reconstruction and interposition of the tendon of the FCR, the procedure may be unsuccessful. We describe three patients with four thumbs in which scapho-trapezoid osteoarthritis was associated with basal joint arthritis. In one patient, it was not recognized pre-operatively and persistent post-operative pain dictated further surgery. In the other patients, the scapho-trapezoid joint was excised primarily, with resolution of the pain. In the pre-operative assessment, the scapho-trapezoid joint should be carefully studied to prevent failure of the procedure.

Aged↗

PubMed1995

Traumatic dislocation of the lateral sesamoid of the great toe: nonoperative management.

A case of traumatic dislocation of the lateral sesamoid of flexor hallucis brevis tendon associated with metatarsal neck fractures due to a crush injury is reported. This patient was treated nonoperatively by elevation, application of plaster, and then free mobilisation. The patient has now fully recovered and remains completely asymptomatic despite residual sesamoid dislocation 1 year after the injury. The nonoperative management of this injury has not, to our knowledge, been reported previously.

Adult↗