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Biomedical subjects

D J Shewring

Publications and source records attributed to D J Shewring.

16 recordsLinked to original sources
PubMed2006

Collateral ligament avulsion fractures from the heads of the metacarpals of the fingers.

Nineteen patients with collateral ligament avulsion fractures from the metacarpal heads of the fingers were treated during a 6 year period. Seven undisplaced fractures were initially treated conservatively. Four united with full movement. Three required internal fixation for symptomatic non-union and healed without problems. Eleven patients with displaced fractures were treated by primary internal fixation using a single lag screw through a dorsal approach. Seven of these achieved a full range of movement of the injured digit by 3 months. Four patients failed to regain full flexion of the metacarpophalangeal joint. One patient with a displaced and comminuted fracture was treated with internal fixation at 8 weeks when the fragment had consolidated. As with similar fractures from the proximal phalangeal bases, these fractures are prone to non-union when treated conservatively, even when undisplaced. If fixation becomes necessary, the delay of a trial of conservative treatment does not appear to affect the outcome. Internal fixation of displaced fractures allows gentle mobilisation and facilitates union.

Adolescent↗
PubMed2003

Avulsion fractures from the base of the proximal phalanges of the fingers.

Thirty-three patients with avulsion fractures from the base of the proximal phalanges were treated during a 6-year period. All eight fractures treated conservatively failed to unite and subsequently required surgery. The remaining 25 patients were treated with primary internal fixation using a single lag screw through a palmar approach. Surgery gave excellent results in all cases and all patients achieved a full range of movement within 3 weeks.

Adolescent↗
PubMed1995

Vascularized pedicle graft of the lower trunk for reconstruction of the branchial plexus.

The middle trunk of an injured brachial plexus was reconstructed using a vascularized graft of the lower trunk, which was expendable because of irreparable damage to the C8 and T1 nerve roots. The graft was transferred on a vascular pedicle of mesoneurium. Useful recovery was achieved at 3 years. This technique helps to overcome the problems of limited supply and secondary sensory deficit of grafts from peripheral nerves, but is possible only if the plexus is explored early, before mobilization and transfer of nerve trunks is precluded by scarring.

Adult↗
PubMed1994

Experience of the early use of technetium 99 bone scintigraphy in wrist injury.

In a retrospective study, patients with suspected scaphoid fracture had an average of three sets of scaphoid radiographs prior to scintigraphy. Scans were performed an average of 3 months after injury and many were inconclusive because of disuse changes. A prospective analysis of early scintigraphy in 35 cases over 18 months was carried out. Scans were performed at an average of 15.5 days after injury in selected cases. Patients had an average of 1.28 sets of negative radiographs prior to scanning. There were no false negative scans and in 13 with focal uptake a wrist fracture was demonstrated. Diffuse uptake was thought to be indicative of ligamentous damage or reflex sympathetic dystrophy. Early scintigraphy was found to be a sensitive, reliable and cost-effective examination in cases of suspected significant wrist injury.

Adolescent↗
PubMed1993

Injuries to the hand in rugby union football.

Hand injuries are a common consequence of playing rugby. A prospective study of all rugby injuries referred to a hand clinic over the course of one season was carried out. 72 patients with such injuries were seen. There were 46 fractures and 26 soft tissue injuries. A substantial number were caused deliberately by opponents. One-third of the injuries were thought to be preventable.

Adult↗
PubMed1992

Fractures of the distal femur treated with the AO dynamic condylar screw.

We report the results of treatment with the dynamic condylar screw of 21 cases of supracondylar and intercondylar fractures of the femur in patients aged 22 to 91 years. There were two nonunions and no deaths. We found the device easy to use and the good fixation allowed early patient mobilisation.

Adult↗
PubMed1992

Long-term survival of a patient with malignant lymphoma of bone.

Malignant lymphoma of bone is an uncommon tumour. A number of studies have outlined the clinicopathological findings and overall favourable prognosis in adults. We report on a woman whose tumour was originally diagnosed as a secondary carcinoma of the upper femur. Twenty-three years later following proximal femoral replacement, the original histology was reviewed using immunohistochemical techniques and revised to B-cell malignant lymphoma of bone.

Adult↗
PubMed1991

Reversed dynamic slings: results of use in the treatment of post-traumatic flexion contractures of the elbow.

We report our experience with reversed dynamic slings used in the treatment of post-traumatic flexion contractures of the elbow. There were 21 patients treated for deformities ranging from 35 degrees to 70 degrees (average 55 degrees). The flexion deformity after treatment varied from 25 degrees to 45 degrees (average 34.8 degrees), giving an average increase in range of movement of 39.1 per cent.

Adolescent↗
PubMed1991

Rare intrathoracic complications in acute pancreatitis.

Ascites and pleural effusions may complicate pancreatitis but pericarditis with pericardial effusion and tamponade is rare and necrosis of mediastinal fat has not been described before. All these complications occurred in the case reported here.

Acute Disease↗