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Biomedical subjects

D F Bovill

Publications and source records attributed to D F Bovill.

4 recordsLinked to original sources

Unicameral bone cysts. A comparison of treatment options.

Thirty-two unicameral bone cyst cases from various hospital centers in the San Francisco Bay Area were reviewed in order to compare the results of different treatment methods. Thirteen of the 32 cysts were latent and 19 were active, judged by their proximity to the growth plate. The average age at presentation was 8.9 years, and average follow-up was 5.6 years. Fifteen patients were treated surgically, 12 were given steroid injections, and five were treated nonoperatively. Comparative analysis of these methods supports previous studies which show that steroid injections are as effective as surgical intervention while having lower morbidity.

Adolescent↗

The efficacy of intraoperative autologous transfusion in major shoulder surgery.

Perioperative blood loss associated with 36 cases of major shoulder surgery in which an intraoperative autologous transfusion device was used was compared with a control group of 36 shoulder surgery patients to determine the effectiveness of intraoperative autologous transfusion (IAT). Total blood loss in this retrospective review was evaluated by assessing the volume of transfused banked blood and the change in hematocrit. All surgical cases were performed by the same surgeon. The procedures considered in the study were humeral head and total shoulder replacement. Use of an intraoperative autotransfusion device was associated with fewer units of transfused banked blood and similar or smaller drops in hematocrit. While shoulder surgery can involve substantial blood loss, the authors recommend intraoperative autologous transfusion for revision of failed shoulder surgery, arthrodesis, joint replacement, or repairs of massive cuff tears when mobilization and tendon transfers are anticipated. The risk of disease transmission through banked blood, especially of acquired immune deficiency syndrome (AIDS) and hepatitis viruses, has increased the need for a heightened awareness and use of alternative blood sources such as IAT.

Acquired Immunodeficiency Syndrome↗

The efficacy of intraoperative autologous transfusion in major orthopedic surgery: a regression analysis.

Perioperative blood loss associated with 89 cases of major orthopedic surgery was compared with that of a control group of 89 to determine the effectiveness of intraoperative autologous transfusion. Volume of banked blood transfused and hematocrit change were used to determine total blood loss. The orthopedic cases consisted of cemented "virgin" total hip replacement, cemented virgin tricompartmental knee replacement, and spine fusion. Use of an autotransfusion device (Cell Saver) intraoperatively was associated with significantly smaller volumes of transfused banked blood and significantly smaller hematocrit drops in the groups of patients who underwent total hip replacement or spine fusion, but not in the group of patients who underwent total knee replacement. One potential source of bias in the study stems from the fact that four days were allotted for equilibrium from perioperative blood loss in the hip and knee replacement groups, while, for reasons of data availability, equilibrium time in the spine fusion groups was two days.

Adult↗

Persistent brachial plexus birth palsies.

Sixty-six brachial plexus palsies in 64 patients were retrospectively reviewed at the San Francisco Unit of the Shriners Hospital system in a 15-year period from 1973 to 1988. All patients were referred with persistent brachial plexus palsies caused by birth trauma. The distribution of palsies at birth included 34 upper palsies, three lower palsies, and 29 mixed (or global) palsies. At final follow-up, the distribution of palsies had shifted and included 42 upper palsies, 6 lower palsies, and 14 mixed (or global) palsies. One patient had a persistent flail upper extremity. Many previously documented obstetrical risk factors were confirmed. Time to resolution or plateau averaged 4.5 months (range 3 weeks to 18 months). Only two palsies (one patient) resolved completely with time.

Birth Injuries↗