Lateral femoral split: an alternative for uncemented femoral stem revision surgery.
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Bone Cements↗
Biomedical subjects
C Crawshaw
Publications and source records attributed to C Crawshaw.
Influence of induced hypotension and spinal distraction on feline spinal somatosensory evoked potentials.
Spinal cord injury may occur during surgical correction of spinal deformity, which is performed frequently under hypotensive anaesthesia. We have investigated the interaction between pharmacologically induced hypotension and distraction on feline spinal cord function. Twelve anaesthetized cats were subjected to hypotension (mean arterial pressure (MAP) 60 mm Hg) using a mixture of sodium nitroprusside and trimetaphan (1:5). No significant changes were observed in somatosensory evoked potentials recorded at T11. In six cats distraction was applied at L2-3 in 2.5-mm increments up to 1 cm, while MAP was maintained at 100 mm Hg (normotensive group). The remaining cats were subjected to the same distraction procedure at an MAP of 60 mm Hg (hypotensive group). In the hypotensive group, a reduction in amplitude of evoked response occurred at significantly less distraction than in the normotensive group. These data indicate that the feline spinal cord is more sensitive to spinal distraction under hypotensive conditions.
Animals↗
Discitis following lumbar surgery.
Although well described in the orthopaedic literature and some orthopaedic textbooks, postoperative discitis is regularly missed or diagnosed late. Six cases of discitis were studied in detail with special reference to the clinical presentation. All patients with discitis had an erythrocyte sedimentation rate (ESR) greater than 50 at 2 or more weeks after surgery. A prospective study of 26 patients undergoing uncomplicated discectomy or fusion was made. ESRs were measured preoperatively and at 1,2, and 6 weeks after operation. Any patient with increasing back pain and an ESR greater than 52 or more weeks after surgery should be considered to have discitis until proven otherwise. If the ESR is measured routinely preoperatively and at 2 weeks postoperatively, this condition should not be missed.
Blood Sedimentation↗
A comparison of surgery and chemonucleolysis in the treatment of sciatica. A prospective randomized trial.
Fifty-two patients with unilateral sciatica caused by intervertebral disc herniation were selected on strict clinical and radiological criteria. All patients had failed to respond to conservative measures. Patients in this trial group randomly were allocated surgery or Chymopapain. During the same period, a further 71 patients, who were put forward for the trial, and did not fulfill the trial criteria, were offered Chymopapain as an alternative to surgery. Both groups were assessed at one month, three months, and one year--progress being recorded by clinical examination and visual analogs. The failure rate in the two Chymopapain groups were comparable, with 52% and 47%, but were significantly higher than the surgical group (11%). Surgery in the failed Chymopapain group frequently was delayed and unrewarding. Failures can be predicted at one month posttreatment, and early surgery may be indicated to prevent chronic scarring.
Adolescent↗
The use of nuclear magnetic resonance in the diagnosis of lateral canal entrapment.
The use of nuclear magnetic resonance (NMR) in the diagnosis of radicular pain due to lateral canal stenosis in 21 patients is reported. NMR was able to distinguish normal intervertebral discs from degenerate discs, and NMR evidence of reduction of epidural fat was more reliable than radiculography in identifying lateral root entrapment. NMR is an important advance in the investigation of lumbar radiculopathies.
Adult↗
Splinting in rheumatoid arthritis: I. Factors affecting patient compliance.
Fifty-four patients with rheumatoid arthritis were fitted with either unilateral or bilateral hand and wrist splints. Of 36 patients available for evaluation, 29 (greater than 80%) reported wearing their splints more frequently for activities requiring greater strength than dexterity. Patients also reported pain relief from wearing their splints, but did not report donning them for this purpose. We feel that a vigorous educational effort should be promoted to encourage patients to wear splints for diminution of inflammation and relief of pain as well as for support during heavier activities.
Activities of Daily Living↗
Splinting in rheumatoid arthritis: II. Evaluation of Lightcast fiberglass polymer splints.
Fifty-four patients with rheumatoid arthritis were fitted with fiberglass polymer Lightcast II hand and wrist splints. When patients were questioned after having worn the splints for 9 to 12 months, the majority responded that the splints were durable, cosmetically acceptable, and for the most part comfortable. The splints were staff manufactured at 1 sitting in less than an hour each.
Arthritis, Rheumatoid↗