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Biomedical subjects

D E Hastings

Publications and source records attributed to D E Hastings.

18 recordsLinked to original sources
PubMed1992

Osteoid osteoma of the elbow: a report of six cases.

We report six cases of osteoid osteoma of the elbow. Elbow pain was the presenting complaint in all of these young adult patients. A variety of diagnoses were entertained, and four patients underwent surgical procedures that were not helpful. Although an abnormality was identified on plain x-ray films, tomograms and a bone scan were helpful in isolating the lesion. A CT scan proved valuable in two cases. Complete en bloc excision relieved pain and improved function in each case.

Adolescent↗
PubMed1990

Listeria monocytogenes--an unusual cause of late infection in a prosthetic hip joint.

As the scope of patients having arthroplasty with compromised immune systems expands, the incidence of late prosthetic infections will increase and the variety of infecting organisms will broaden. The role of prophylactic antibiotics for such patients undergoing procedures known to cause a transient bacteremia is currently unknown. Their use is not universal and many patients undergo procedures frequently without any form of protection. The following case report outlines an unusual organism causing late hip arthroplasty infection in an immunocompromised host and examines the role of prophylactic antibiotics in preventing such complications.

Aged↗
PubMed1989

The 'occult' compartment syndrome.

Two cases of compartment syndromes after tibial fractures are presented in patients who had no sensation in the involved compartments. The absence of any clinical symptoms in these patients emphasizes the need for routine monitoring of intra-compartmental pressure in this select group of patients.

Adult↗
PubMed1986

Case report 398.

Explore the source record for details and available documents.

Adult↗
PubMed1986

Knee ligament instability--a rational anatomical classification.

In the management of a number of acute and chronic knee ligament injuries it was noted that the patterns of displacement could be explained on a translational basis in one of two planes. The displacement could be predicted by the anatomical structures that were torn. Rotation, while present in some cases, was not the major pattern of instability. It is therefore logical to classify knee ligament injuries on an anatomical basis. The injury or combination of injuries produces a predictable pattern of instability. Anatomical classification based on patterns of instability is less confusing than some methods of classification currently in use and may aid in clinical management.

Humans↗
PubMed1979

Acetabular reinforcement in total hip replacement.

In conclusion, based on our experimental and clinical material and analysis of failures, we recommend wire mesh reinforcement and bone graft for patients with mild to moderate protrusio. If the floor is strong but the pillars deficient, then the Eichler ring alone is the best implant. The combined system of wire mesh and Eichler ring should be used in cases of protrusion with a large deficiency of the acetabular floor and for protrusio with pillar weakness. Furthermore a bone graft should be used to reinforce the acetabular floor in addition to any prosthetic device.

Acetabulum↗
PubMed1978

The lupus hand: a new surgical approach.

Three patients with lupus erythematosus developed severe hand deformities which, over the course of a year, went on to fixed volar subluxation of the proximal phalanges with some ulnar drift. The flexion deformity at the metacarpophalangeal joints of nearly 90 degrees was not correctable passively, and the palmar skin became macerated. The articular cartilage of the metacarpal heads and proximal phalanges was well preserved and replacement arthroplasty was not justified. Contracture not only in the intrinsics but also in the long flexors was not relieved by operation on the soft tissues. A step-cut metacarpal shortening did correct the remaining intrinsic and long flexor contracture, corrected the volar dislocation, restored full metacarpophalangeal extension, and maintained a full range of flexion. Position of the bones was maintained by intramedullary Steinmann pins and crossed Kirschner wires and, in one patient, by a small screw. No recurrences developed in the follow up period of 18 to 96 months.

Arthritis↗
PubMed1977

Swan neck deformity in rheumatoid arthritis of the hand.

Swan neck deformity is not a single entity. Significantly different types of swan neck deformity are found, each demanding careful clinical evaluation and specialised treatment. This paper discusses the pathomechanics of swan neck deformity and presents a classification upon which rational treatment can be based. The surgical treatment of each variant is briefly outlined.

Arthritis, Rheumatoid↗
PubMed1977

The fixed lupus hand deformity and its surgical correction.

In a prospective study of 125 patients with SLE, three females developed fixed hand deformities. All had arthritis for more than 10 years, and had been treated with a mean daily dose of 15 mg of prednisone. The hand deformities consisted of irreducible metacarpophalangeal (MCP) subluxation and/or dislocation without erosion or destruction of the MCP joints, resulting in hyperflexion of the fingers in the palm. Two patients had dislocation of the carpometacarpal joints in both hands. On patient developed reducible swan-neck deformities in the second to fifth fingers of both hands and a second patient developed Boutonniere deformities in two fingers of one hand and clinodactyly of both fifth fingers. Because the deformity at the MCP joints resulted from soft tissue contractures in the intrinsics and long flexors, and because the cartilage of the MCP joint was preserved, a joint replacement was not considered. Metacarpal osteotomy and shortening was performed to decompress the contracted soft tissues. At follow-up (18-96 months), the hands remained corrected and all patients were able to perform normal activities.

Adult↗
PubMed1975

Protrusio acetabuli in rheumatoid arthritis.

Protrusio acetabuli is common is rheumatoid arthritis. Progression of this deformity can be measured by serial roentgenograms. The inward progression of the femoral head is the result of upward migration of the acetabular roof and collapse of the femoral head which appears to occur in a ratio of approximately two to one. Adrenal cortical steroids may play a significant role in the etiology of this condition in rheumatoid arthritis. This complication of intrapelvic protrusion of the prosthetic acetabulum following total hip replacement has been presented and suggestions made to overcome this problem. Early operation on those patients showing rapid development of protrusio may prevent complications.

Acetabulum↗
PubMed1975

Rheumatoid wrist deformities and their relation to ulnar drift.

With a new technique of roentgenography to reveal more accurately the degree of ulnar drift and radial deviation in hands of patients with rheumatoid arthritis, it was shown that the radial deviation was less marked than would be ascertained with conventional roentgenograms. Therefore radial deviation probably does not constitute a cause for ulnar drift. The study led to clinical implications as regards the position of splinting (with the wrist in ulnar deviation) and as regards operations to correct deformities of the wrist due to rheumatoid arthritis.

Adult↗
PubMed1975

Iatrogenic subcapital fracture of the hip: a new complication of intertrochanteric fractures.

A recently recognized complication of intertrochanteric fracture is a subcapital fracture occurring at the tip of the blade of an intertrochanteric fracture fixation blade plate. Histological examination reveals that this is not a fatigue fracture but is the result of stress concentration effects of a stiff metalic device. This fracture may be prevented by using a blade plate with a long blade which is well seated in the head, and by removing the metallic device as soon as it is safe to do so. Ultimate prevention lies in using a more compatible material for the internal fixation of fractures.

Aged↗