Biomedical subjects

D M Kaulesar Sukul

Publications and source records attributed to D M Kaulesar Sukul.

10 recordsLinked to original sources

PubMed1994

High-energy shock waves for the treatment of nonunions: an experiment on dogs.

Several surgical as well as nonsurgical modes of treatment of nonunions have been advocated in the literature. In an effort to achieve bony union in a new noninvasive way, we experimentally investigated the treatment of nonunions with extracorporeally induced high-energy shock waves. With use of a modified canine nonunion model, two randomized groups of five dogs each were set up to obtain a treatment and a control group. Shock waves were applied with the Osteostar (Siemens A.G., Germany), a specially designed, experimental, transportable, high-energy shock wave apparatus. Each of the dogs in the treatment group received 4000 shock waves of 0.54 mJ/mm2 (14.5 kV), which were applied at four preselected sites, lying symmetrically on the dorsal and ventral sides of the nonunion. During the course of the experiments, the dogs were monitored radiographically. Immediately after the shock wave treatments no radiographic changes could be detected. All of the treatment group dogs reached radiographically observable bony union 12 weeks after the shock wave treatment. In the control group, four dogs had radiographically persistent nonunions at termination of the study. Statistical analysis with Fisher's exact test (two-sided; P < or = 0.05) demonstrated the significance in outcome between the two groups. We conclude that hypertrophic nonunions in dogs can be treated successfully with extracorporeally induced high-energy shock waves. The results of this study may justify the application of shock waves for the treatment of certain types of nonunions, provided a specially designed shock wave apparatus is used for this purpose. We think that it may become a reliable, nonsurgical, alternative for the treatment of certain types of nonunions.

Animals↗

PubMed1994

Lowered motor conduction velocity of the peroneal nerve after inversion trauma.

To analyze the effect of inversion trauma on peroneal nerve function, motor conduction velocity was measured in 22 patients. In the injured leg, 4-8 d post trauma motor nerve conduction velocity in the knee-caput fibulae segment of the superficial peroneal nerve was significantly smaller when compared with the contralateral leg and the control group. Five weeks post trauma these values were normal again. For three segments of the deep peroneal nerve, the motor conduction velocity was significantly reduced, 4-8 d post trauma, when compared with the control group. In the caput-ankle and knee-ankle segment, motor conduction velocity was still significantly lowered 5 wk post trauma. Lowered amplitudes of the Compound Motor Action Potentials of the extensor digitorum brevis muscle were found 4-8 d post trauma. No correlation was found between motor nerve conduction velocities and subjective clinical tests (anterior drawer sign and (manually performed) talar tilt test). The results of this study support the hypothesis that inversion trauma is frequently accompanied by lesions of the peroneal nerve. Motor conduction velocity measurements can be a valuable tool in assessing more objectively functional instability of the ankle joint induced by inversion trauma.

Adolescent↗

PubMed1993

The effect of high energy shock waves focused on cortical bone: an in vitro study.

Extracorporeal shock wave lithotripsy has become an accepted alternative for the management of nephrolithiasis and cholelithiasis. Direct impact of shock waves cause tear and shear forces at transition sites between tissues with divergent acoustic impedances leading to stone fragmentation. The aim of this study was to determine whether shock waves can cause cortical bone damage at all and, if so, what the relationship is, if any, between the energy density of the shock waves, the number of shock waves applied, and the resulting cortical bone damage. With the Siemens Lithostar Plus with overhead module, electromagnetic shock waves, generated under water with energy densities of 0.23, 0.33, 0.42, or 0.54 mJ/mm2, corresponding with power settings 2, 4, 6, and 8, were applied to bone specimens, i.e., of rabbit femurs and tibiae. Prior to exposure to the shock waves, the bones were mounted on a specially constructed perspex holder which could be placed in a water-filled test basin with an elastic membrane in the front through which the shock waves propagate without loss of energy. This setup made it possible not only to induce complete fractures, but also to detect the existence of a linear relationship with a Spearman rank correlation coefficient of -0.72 (P < or = 0.01) between the energy level of the shock waves and the severity of the cortical bone defects. The latter findings are especially of great importance because this means that the process can be controlled and that the cortical effects will be predictable and reproducible. This study should be considered a preliminary test concerning the effects of high energy shock wave on bone.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1993

Direct and indirect methods for the quantification of leg volume: comparison between water displacement volumetry, the disk model method and the frustum sign model method, using the correlation coefficient and the limits of agreement.

Volume changes can be measured either directly by water-displacement volumetry or by various indirect methods in which calculation of the volume is based on circumference measurements. The aim of the present study was to determine the most appropriate indirect method for lower leg volume calculation using water displacement volumetry as a 'golden standard'. For 20 male volunteers, age range: 20-35 years, the volume of both lower legs was determined directly by water-displacement volumetry, and indirectly by the frustum sign model method and the disc model method. Calculation of the correlation coefficient and the limits of agreement showed that water-displacement volumetry and the disc model method are interchangeable (r = +0.99, mean +/- 2s = -45 +/- 78 ml), whereas this does not hold for the frustum sign model (r = +0.93, mean +/- 2s = 521 +/- 238 ml). In the clinical situation volume measurement can be valuable for monitoring of the severity of oedema or haematoma occurrence after surgery or severe trauma. This non-invasive diagnostic aid may be a valuable adjuvant means of diagnosis for several volume dependent disorders of the extremities.

Adult↗

PubMed1992

Bilateral thoracic outlet syndrome with bilateral radial tunnel syndrome: a double-crush phenomenon. Case report.

A case of bilateral thoracic outlet syndrome combined with bilateral radial tunnel syndrome is reported. Persisting complaints in the upper extremities after bilateral first-rib resection and scalenotomy were due to radial nerve entrapment in the radial tunnel. Although this bilateral double-crush phenomenon is extremely rare, and has not been reported previously, persistence of symptoms after initial treatment of a nerve entrapment is an indication to search for another site of compression.

Adult↗

PubMed1992

Transscapho-transcapitate fracture dislocation of the carpus.

Transscapho-transcapitate fracture dislocation of the carpus is a rare form of perilunate dislocation. It occurs after acute high-energy hyperdorsiflexion trauma and longitudinal compression of the wrist, with concurrent fractures of the scaphoid and capitate neck and rotation of the proximal fragment of the capitate up to 180 degrees. Four cases and their treatments are described, and the literature is reviewed. A possible explanation of the mechanism underlying this condition is offered, and methods of treatment are discussed. If a stable anatomic situation is not obtained with closed reduction, surgical reduction and internal fixation of the scaphoid and capitate bones are recommended to prevent loss of function.

Adult↗

PubMed1992

Comparative cell culture effects of shape memory metal (Nitinol), nickel and titanium: a biocompatibility estimation.

Nitinol is an equiatomic alloy of nickel and titanium which has been attracting increasing interest in the field of biomedical engineering. To quantify toxicity as a preliminary evaluation of biocompatibility, inhibition of mitosis in human fibroblasts in tissue cultures exposed to test materials is an accepted screening method, although a dose-effect relationship had never been investigated. In this experiment, the effect of an increasing dose exposure to Nitinol, nickel or titanium on human fibroblasts in cell cultures was tested in subgroups in comparison with a control group. The results showed that nickel induces a significant (p < or = 0.05) inhibition of mitosis in human fibroblasts, whereas no significant effects of this kind were found for titanium or Nitinol. According to the results of these studies, Nitinol is to be considered in this respect biocompatible and comparable to titanium, which would seem to justify application as a surgical implant.

Alloys↗

PubMed1990

Biomechanical measurements on scaphoid bone screws in an experimental model.

A number of screws commonly used for internal fixation in scaphoid bone fractures and nonunions are compared regarding biomechanical properties and clinical applicability. The experiments were carried out on models made of ash-wood, representing a reconstruction and fixation as is performed in a cortico-cancellous inlay bone graft for scaphoid non-union. For fixation use was made of 2.7 and 3.5 AO/ASIF cortical screws respectively, 4.0 AO/ASIF cancellous screws, Herbert screws, and a newly designed screw called the three components screw (D.K.S.). The models with implanted screws were tested for bending strength, tensile strength and torsion stability. No large differences between the various screws were found regarding the measured parameters, so that a small intra-osteal implant such as the Herbert screw and the D.K.S., which can be inserted easily and which gives a certain amount of interfragmentary compression, will be sufficient for osteosynthesis of the scaphoid bone. In case an intra-osteal implant is not available a single 3.5 AO/ASIF cortical screw, inserted following lag-screw principles, is recommended.

Alloys↗

PubMed1990

Friedrich's disease.

Three patients are reported with Friedrich's disease, a rare deformity of the sternoclavicular joint. This clinical entity is a symptomatic expression of osteonecrotic changes of the medial inferior border of the clavicle, with a still unknown pathogenesis. In our own experience and according to that of others, conservative treatment for this rare condition may be advisable.

Adult↗

PubMed1986

The carpal boss.

A description is given of carpal boss, an arthritic deformity based on an additional ossal growth centre of the carpus in which degenerative changes were induced by (trivial) injury, mostly in young patients. Nine patients are reported in whom operative treatment viz. excision of the carpal boss, produced excellent results.

Adult↗