Biomedical subjects

D R Gunn

Publications and source records attributed to D R Gunn.

13 recordsLinked to original sources

PubMed1985

Ultrasound of the spine in focal stenosis and disc disease.

In the course of reviewing ultrasound scans of the lumbar spine in 67 symptomatic patients, focal stenosis, either as an isolated finding or in conjunction with diffuse stenosis, was noted in 44 patients. The results of ultrasonograms are compared with findings at myelography and surgery. In addition, using gray-scale technique, we found it possible to examine areas of focal stenosis and to visualize herniated discs with a high degree of accuracy. The finding of focal stenosis alone was associated with disc herniation in 53% of patients who came to surgery. Where ultrasound identified a "triple density" representing soft-tissue protrusion between two bony landmarks within the extradural space resulting in focal stenosis, the sensitivity for indicating disc disease was 89%.

Humans↗

PubMed1975

Fractures of tibial plateaus. A review of the literature.

Tibial plateau fractures, common injuries in the middle-aged, often result from falls or vehicular accidents. The wide spectrum of fracture patterns can be theoretically related to the sequential application of bending (valgus/varus) and compression forces. End-results of 599 fractures in 13 different studies were compared by fracture pattern using a clear-cut fracture classification. Minimally displaced (less than 5-10 mm displacement) fractures average 85-90 per cent acceptable end-results. Associated soft tissue lesions include frequent meniscal (50% of cases) and ligamentous (10-30%) injuries. Vascular and nerve injuries are most unusual: non-union is not reported. A diagnostic and therapeutic approach is outlined. The assessment of bony and/or ligamentous instability is stressed. Reduction is required in most displaced fractures: open reduction and rigid internal fixation with ample bone grafting is suggested in displaced local depression fractures and other unstable fracture types refractory to closed reduction. Operative repair of ruptured ligaments seems indicated. Early knee motion is important in all fractures. In unstable fractures angular alignment must be maintained (rigid internal fixation, skeletal traction, or bracing) during early motion. Quadriceps rehabilitation must be vigorous. Weight-bearing should be deferred for at least three months. The cast brace is useful in unicondylar fractures.

Accidents, Traffic↗

PubMed1975

The relative safety of polymethylmethacrylate. A controlled clinical study of randomly selected patients treated with Charnley and ring total hip replacements.

Forty patients from a group of seventy elected to participate in a prospective randomized clinical study designed to evaluate the systemic effects of polymethylmethacrylate implanted with a Charnley total hip replacement, utilizing patients treated with a Ring total hip prosthesis ad controls. Intraoperative alterations in cardiovascular function were related to use of methylmethacrylate, but postoperative changes in pulmonary function, erythrocyte sedimentation rate, serum lactic acid dehydrogenase, serum glutamicoxalacetic transaminase, and alkaline phosphatase were not. Charnley total hip replacements were associated with more ectopic-bone formation twelve months postoperatively. The two "latent" infections recognized during the thirty-four months of the study were in hips without acrylic fixation.

Alkaline Phosphatase↗

PubMed1974