Biomedical subjects
Publications and source records attributed to B Romanus.
Fifteen cases of crural hematoma in which phlebography had been performed were revised. A phlebography was often normal in an early stage of hematoma. In major crural hematoma compression, displacement and occlusion of the deep venous system occurred. Non-filling of deep veins occurred in 6 cases, and venous thrombosis should therefore only be diagnosed on the basis of constant filling defects.
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Major sacral resections up to the level of S 1 and even higher have been performed. This has raised the question of the degree to which such operations weaken the pelvic ring. Fifteen cadaver pelves, including the fifth lumbar vertebra, were loaded to failure, five unresected, five after resection of the sacrum between S 1 and S 2, and five after resection about 1 cm below the promontory. The weakening of the pelvic ring amounted to approximately 30 per cent with the former type of resection and 50 per cent with the latter. Taking into consideration the calculated normal load on L 5 in upright standing it seems safe from this study to allow patients to stand with full weight-bearing at an early stage postoperatively after submaximal resection of the sacrum.
A chemical analysis has been carried out on specimens from the subchondral weightbearing area of the medial tibial condyle from 22 normal individuals, 14 individuals with osteoarthritis and 12 individuals with rheumatoid arthritis. In the normal group there was a decrease in density with advancing age. Over the age of 50 there was no significant difference between the groups. The content of collagen, calcium, phosphorus and magnesium in each bone specimen was calculated. When expressed in per cent of dry fat free bone there was no significant difference between the three groups. When calculations were made on the basis of content per volume tissue wet bone some differences were found. There was a tendency for a higher content of collagen in rheumatoid bone than in normal and osteoarthritic bone. The content of calcium was significantly higher in rheumatoid arthritis than in osteoarthritis; the same result was found in the analysis of phosphorus. In the normal group there was a decrease in phosphorus content with advancing age, this was also seen in the magnesium analysis.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A cartilage-viewing technique was developed to overcome the shortcoming of not seeing the cartilaginous components, believed to play more important role than the osseous components in children's hips, with computed tomography. This technique was applied to 25 dysplastic hips in children younger than 10 years to evaluate their global and local deficiencies. The findings helped us to understand more about their individual problems. To quantify the three-dimensional (3-D) parameters of acetabular anatomy and femoral head coverage, a measuring technique was developed based on digitization of the 3-D coordinates and fitting of every component of the hip. The improved images and the quantified parameters were expected to aid the planning, formulation, and even simulation of individualized surgical treatment for children with developmental dysplasia of the hip.
Patients with bladder exstrophy demonstrate pubic diastasis with external rotation of the ilia and posterolateral orientation of the acetabula. Iliac osteotomy is performed to approximate the pubis and thus facilitate the genitourinary repair. The role of iliac osteotomy in the correction of gait abnormalities is controversial. Our goals in this study were to define the presence of hip pathology and gait abnormalities in patients treated for bladder exstrophy and to evaluate the effect of iliac osteotomy. We reviewed pelvic radiographs and gait studies in 15 children. The treatment included bilateral iliac osteotomy in nine of 15 of these patients. We found minor hip dysplasia in two patients, but we saw no evidence of subluxation or dislocation. Pubic diastasis increased with age and was not related to osteotomy. Patients had slightly less passive hip internal rotation than age-matched controls. There was no correlation between the restriction of hip internal rotation and the amount of pubic diastasis. Two thirds (10 of 15) of the patients exhibited increased lower extremity external rotation during gait. None of the subjects demonstrated a waddling gait (gluteus medius lurch) described in the literature. Based on our results, iliac osteotomy does not affect gait patterns in children with bladder exstrophy. However, we believe that it is indicated to improve the results of genitourinary repair.
Tibial traction for distal femoral fractures, followed after four to eight weeks by plaster, is the common treatment. Because of improved methodology, the proportion of surgically treated fractures had increased. Stable osteosynthesis with different plates is an established therapy for distal femoral fractures. In elderly or other patients with bone fragility, however, these operations often fail. The majority of the distal femoral fractures occur in such patients, and traction in bed is therefore often used. A less rigid device was constructed to meet the special circumstances with bone fragility. This device consists of two Ender's nails: one is inserted from each condyle, and each is connected to two cancellous screws traversing both condyles. The strength of this semielastic osteosynthesis was compared with four existing devices (AO, Rush, Zickel, Ender). Fixation was carried out in 17 pairs of osteotomized postmortem preparations from patients older than 60 years of age. The specimens were submitted to constant bending rate, and the load deformation was registered. The fixation with the condylar plate was strongest and showed the lowest flexibility. The Ender's nails and the Rush pins showed a tendency to lose their Condylar stabilization early. This was less pronounced with the Zickel nail, which, however, tended to displace at the osteotomy site during insertion and fracture the proximal fragment due to the limited bending ability of the blade construction. The new, semielastic device (ECS) was constructed to meet the special circumstances with bone fragility. It consists of two cancellous screws traversing both condyles. It combined easy insertion with moderate flexibility and high residual strength. In extension, it deflected 40 degrees without influencing residual stability. It is an interesting alternative to rigid internal fixation or traction in bed for osteoporotic patients with distal femoral fractures. In combines rigid screw fixation in the condylar part with an elastic adjustment in the femoral shaft above.