PubMed HealthSearch

Biomedical subjects

D I Rowley

Publications and source records attributed to D I Rowley.

At least 19 recordsLinked to original sources

Energetics of paraplegic walking.

A group of 35 paraplegic subjects using reciprocating walking orthoses have been examined in order to gain an insight into the potential functional benefits of using such devices. Measurements have been made of walking speeds and of the energy costs of ambulation using an established technique based on heart rate recordings. It was found that orthotically aided walking for paraplegics was slow and energy costly compared with both normal walking and wheelchair propulsion and, as it additionally requires the use of a walking aid in both hands, cannot be considered to confer the functional benefits frequently claimed for it. Nevertheless, the majority of the subjects studied liked their orthosis and did well in it, with many subjectively reporting improvements in mobility and independence.

Adolescent

Surgeons and HIV.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome

Fixation is fun.

Explore the source record for details and available documents.

Fracture Fixation

Intertrochanteric fractures of the femur: a randomized prospective trial comparing the Pugh nail with the dynamic hip screw.

Over a 14-month period, 100 consecutive cases of intertrochanteric fracture were randomly allocated to be treated by either Pugh nail-plate or Dynamic Hip Screw (DHS) fixation. Although there were 11 cases of malreduction and/or suboptimal positioning of the fixation device in the femoral head, only two of these gave long-term problems. Despite the difference in configuration of the devices and a considerable disparity in price, patient satisfaction and the incidence of untoward radiological features at an average of 6 months after surgery were similar in the two groups. A trifin-ended device would thus appear to be a reliable alternative to the more commonly used hip screw systems for intertrochanteric fracture.

Aged

Treatment of Freiberg's disease. A new operative technique.

A method of treating Freiberg's disease of the metatarsal head by shortening the metatarsal bone is described. This operation has been performed in 15 patients (16 feet). Excellent relief of pain was obtained, although most patients had persistent stiffness of the metatarsophalangeal joint.

Adolescent

The importance of the valgus hindfoot in forefoot surgery in rheumatoid arthritis.

The relationship between hindfoot deformity and forefoot pressure was assessed in 28 rheumatoid patients who had undergone forefoot reconstruction four years previously. Patients with valgus hindfoot deformities tended to have high forefoot pressures whereas those with a normal hindfoot recorded normal pressures on the dynamic pedobarograph. All patients with residual forefoot pain recorded abnormal forefoot pressures. We believe that orthotic control of hindfoot deformities should be considered for those patients who require forefoot surgery as a combination of surgical and orthotic management may offer the best chance of success.

Adult

A prospective study of forefoot arthroplasty.

The Kates et al. metatarsal head resection arthroplasty has been modified and evaluated clinically and objectively using a dynamic pedobarograph in 35 adult rheumatoid arthritis patients. Preoperatively, all patients complained of severe forefoot pain, but only 70% recorded abnormal plantar pressure measurements. After a mean follow-up time of 36 months, 91% of the patients were satisfied with the result following surgery. Forty-two feet were pain-free, 16 feet still painful but less than preoperatively, and two feet worse. Thirteen of the 18 painful feet recorded abnormal pressure, but 16 additional feet with normal pressures were symptomatic. The clinical and pedobarographic results show that, in the majority of patients, the Kates et al. forefoot arthroplasty relieves pain, improves mobility, effectively decreases high abnormal plantar pressures, and should be considered when conservative methods of treatment have failed.

Adult

Orthotic compensation for non-functioning hip extensors.

Three point fixation to stabilise joints using a rigid orthosis is relatively simple. When movement is required in a single plane, a hinge can be incorporated preventing superfluous movement and consequent loss of stability and function. Alternatively the Reciprocating Gait Orthosis (RGO) which utilises a system of Bowden cables with a HKAFO to provide reciprocal flexion and extension forces at the hip joint may be used. Free standing is achieved in the RGO by trunk and arm movements, the cable tension effectively "locking" the hips in neutral. Force transfer through the cables also produces reciprocal gait. The upper limbs acting through external supports provide the initiating force, producing truncal extension and subsequent hip extension of the stance leg. The resulting flexion of the swing leg produces a forward step. Currently 40 patients have been fitted with the orthosis in Salford, of whom 22 are Spina Bifida patients (aged 3-34 years). Most have Thoraco-lumbar or upper Lumbar lesions. The device has performed well with 1 episode of "knee clash" and 3 patients have had structural failures. Functional walking has been achieved with the orthosis.

Adolescent