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Biomedical subjects

D E Cooper

Publications and source records attributed to D E Cooper.

16 recordsLinked to original sources
PubMed1992

Complete knee dislocation without posterior cruciate ligament disruption. A report of four cases and review of the literature.

Complete knee dislocation usually causes disruption of both the anterior and posterior cruciate ligaments. Four cases of complete knee dislocation without posterior cruciate ligament (PCL) disruption are reported. All cases involved either anterior or anteromedial dislocation with anterior cruciate ligament disruption and collateral ligament injury, but without posterior cruciate disruption. This is an uncommon finding in complete dislocation of the knee. The PCL may occasionally be spared significant injury in anterior type dislocations, however, thus favorably affecting treatment options.

Adolescent↗
PubMed1992

Anatomy, histology, and vascularity of the glenoid labrum. An anatomical study.

We studied the gross, histological, and vascular anatomy of the glenoid labrum in twenty-three fresh-frozen shoulders from cadavera to demonstrate its cross-sectional anatomy, its microvascularity, and its attachments. The superior and anterosuperior portions of the labrum are loosely attached to the glenoid, and the macro-anatomy of those portions is similar to that of the meniscus of the knee. The superior portion of the labrum also consistently inserts directly into the biceps tendon, while its inferior portion is firmly attached to the glenoid rim and appears as a fibrous, immobile extension of the articular cartilage. The arteries supplying the periphery of the glenoid labrum come from the suprascapular, circumflex scapular, and posterior circumflex humeral arteries. In general, the superior and anterosuperior parts of the labrum have less vascularity than do the posterosuperior and inferior parts, and the vascularity is limited to the periphery of the labrum. Vessels supplying the labrum originate from either capsular or periosteal vessels and not from the underlying bone.

Adult↗
PubMed1991

Contaminated patellar tendon grafts: incidence of positive cultures and efficacy of an antibiotic solution soak--an in vitro study.

The incidence of positive cultures after contamination of sterile patellar tendon grafts in an operating room environment was studied in 10 specimens. The grafts were dropped on the floor for 3 min and then cultured. Six of the 10 grafts (60%) had a positive culture at 10 days. To test the efficacy of an antibiotic solution on cleansing contaminated grafts, 10 additional grafts were dropped on the floor for 3 min. Before the grafts were cultured they were soaked in a sterile saline solution containing bacitracin (33.33 U/ml) and polymyxin B (333.33 U/ml) for 15 min. Thirty percent of these grafts (3 of 10) cultured positive at 10 days. In each case the bacterial contaminant was found to be sensitive to one of the antibiotic agents used in the cleansing solution. The results of this study suggest that although soaking contaminated grafts in this antibiotic solution for 15 min may reduce the incidence of positive cultures, it still results in a 30% incidence of nonsterile grafts.

Anterior Cruciate Ligament↗
PubMed1991

Extrusion of the medial meniscus.

Disruption of the anchoring points of the menisci of the knee has been hypothesized to result in subluxation of the affected meniscus from the articular surface. A case report of such an extrusion of the medial meniscus is presented. Medial subluxation of the meniscus from the tibiofemoral articulation occurred as a result of avulsion of the posterior horn with concomitant medial collateral and posterior cruciate ligament injuries.

Arthroscopy↗
PubMed1991

Meniscal repair.

Over the past several decades, scientific evidence has mounted to substantiate the vital role of the meniscus in the function of the knee. Total meniscectomy is rarely indicated and the pendulum of orthopedic popular opinion has swung toward new ways to preserve the injured meniscus. This article reviews the anatomy, blood supply, and function of the meniscus and also discusses the supporting scientific evidence, decision-making processes, and techniques for meniscal repair.

Arthroscopy↗
PubMed1991

Tests for posterolateral instability of the knee in normal subjects. Results of examination under anesthesia.

An apparently normal knee was examined in each of 100 subjects while they were under general or epidural anesthesia for an unrelated operation. The Lachman, anterior drawer, posterior drawer, and pivot-shift tests were negative in all knees. All knees were stable to varus and valgus stress at both 0 and 30 degrees of flexion. The external-rotation recurvatum test also was negative in all knees. A positive reversed pivot-shift sign was present in 35 per cent of the knees, suggesting that it may not signify abnormality, at least not without a negative test on the contralateral knee. The results of the posterolateral drawer test were variable, difficult to quantify, and did not always have a firm end-point. The amount of maximum external rotation of the tibia, measured from the reference line of the medial border of the foot, was extremely variable at both 30 and 90 degrees of flexion of the knee. External rotation, as determined by this reference, was slightly greater (averaging 9 degrees) at 90 than at 30 degrees of flexion. The normal range of maximum external rotation of the foot was 10 to 45 degrees at 30 degrees of flexion of the knee and 15 to 70 degrees at 90 degrees of flexion. The presence of a large angle of external rotation and a positive reversed pivot-shift sign correlated strongly with increased ligamentous laxity and mild varus alignment of the knee.

Adolescent↗
PubMed1990

Arthroscopic meniscal repair.

The advent of arthroscopy and advanced arthroscopic techniques has made meniscal repair the preferred approach for many meniscal tears. This article reviews the blood supply of the meniscus and discusses the supporting scientific evidence, decision making, and techniques for meniscal repair.

Arthroscopy↗
PubMed1989

The heel of achilles: calcaneal avulsion fracture from a gunshot wound.

Greek mythology relates that the legendary warrior Achilles was made invincible by his mother Thetis, who dipped him in the River Styx while holding him by his heel. Because his heel was never immersed, it remained his one area of vulnerability. After the fall of Troy, Achilles met his demise when he was shot in the heel by Paris, whose arrow was guided by the Greek god Apollo. This is the derivation of the term "Achilles tendon." Avulsion fractures of the tuberosity of the calcaneus are rare injuries. Schonbauer reviewed a series of 870,000 accident cases treated at the Vienna Trauma Hospital and found only four such cases in addition to 151 cases of subcutaneous Achilles tendon rupture. In Bohler's series of 182 calcaneal fractures, avulsion of the calcaneal tuberosity accounted for less than 1% of these injuries. Rowe reported four Achilles avulsion fractures in his series of 154 calcaneal fractures. Three basic mechanisms of injury have been described: (1) dorsiflexion violence against the maximally plantarflexed foot, typically occurring in a fall from a height; (2) powerful contraction of the triceps surae muscle with simultaneous extension of the knee such as when a person is about to sprint in a race; (3) a direct blunt blow to the hindfoot. We are describing a case of avulsion of the calcaneal tuberosity due to direct penetrating trauma from a gunshot wound, a mechanism not previously reported.

Adult↗
PubMed1989

Reflex sympathetic dystrophy of the knee. Treatment using continuous epidural anesthesia.

We retrospectively reviewed the cases of fourteen patients who had reflex sympathetic dystrophy of the knee. All fourteen were hospitalized, and epidural block anesthesia was instituted with an indwelling catheter for an average of four days, during which continuous passive motion, manipulation (as necessary), stimulation of muscles, and alternating hot and cold soaks were used. The average length of follow-up was thirty-two months. Eleven patients had complete resolution of the symptoms, two had sufficient intermittent aching with changes in the weather to need medication, and one had no relief. The diagnosis was confirmed if the symptoms were relieved by a lumbar sympathetic block. Pain that was out of proportion to the severity of the injury was the most consistent finding, being present in all fourteen patients. However, variation in clinical severity is characteristic of the syndrome. Eleven of the fourteen patients had had a previous patellar operation. After the onset of the symptoms, nine patients had two or more arthroscopic examinations, without notable findings. All fourteen patients had had extensive physical therapy and medical treatment before the epidural block was performed.

Adult↗
PubMed1988

The prevention of injuries of the brachial plexus secondary to malposition of the patient during surgery.

Brachial plexus injuries that occur secondary to malposition of the patient during general anesthesia have been described in the medical literature for nearly a century. However, little can be found in the orthopedic literature. Of the peripheral nerve groups, the brachial plexus may be the most vulnerable to injury from malpositioning. This study presents three such cases of brachial plexus injury and reviews the literature concerning the subject. Pertinent anatomy, etiology, and pathogenesis of injury to the brachial plexus reveal that injury can occur from stretch or compression of nerves and is usually caused by a combination of the two. With awareness of risk factors and the positions which are likely to cause injury to the brachial plexus, careful positioning of the upper extremity can prevent injury and potential disability to the patient.

Aged↗
PubMed1987

The role of group psychotherapy in the treatment of substance abusers.

A psychological model portrays substance abuse as the result of efforts to self-medicate for particularly painful affect states. Long-term psychotherapy is the treatment of choice for the hypersensitization to affects. The important role of group psychotherapy in substance-abuse treatment is discussed in light of clinical results.

Acting Out↗
PubMed1985

Trust.

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Complementary Therapies↗