Biomedical subjects

D Raymond Knapp

Publications and source records attributed to D Raymond Knapp.

5 recordsLinked to original sources

PubMed2006

Anaplastic large cell lymphoma presenting as an epiphyseal lytic lesion--a case report with clinico-pathologic correlation.

Anaplastic large cell lymphoma (ALCL) is predominantly a systemic disease with nodal involvement, but extranodal involvement can occur either as the primary presentation or during the disease course. Primary epiphyseal involvement is extremely rare with lymphomas. This case report illustrates an 8-year old boy who first presented with pain over the right upper extremity, which was initially treated as epiphyseal osteomyelitis. A few weeks later, he presented with abdominal pain and an abdominal wall mass, which on biopsy proved to be an anaplastic large-cell lymphoma.

Bone Neoplasms↗

PubMed2005

Allograft bone in spinal fusion for adolescent idiopathic scoliosis.

OBJECTIVE: The purpose of this long-term study was to determine the efficacy of allograft bone for spinal fusion for adolescent idiopathic scoliosis. Prior studies comparing allograft and autograft have been short term. METHODS: This multicenter retrospective study was carried out on 111 patients with 132 total curves fused for adolescent idiopathic scoliosis. Minimum follow-up was 5 years (average 72 months). A variety of segmental instrumentation was used, with most being dual-rod, multiple-hook constructs. RESULTS: Average preoperative curve was 59 degrees with immediate correction to 29 degrees (51%) and final follow-up of 32.24 degrees (45.4%). Average loss of correction was 3.5 degrees (5.9%). There were three pseudarthroses, one infection, and no rod breakage. CONCLUSION: Pseudarthrosis rate of 2.7% and loss of correction of 5.9% are comparable with or better than those in previous reports using autogenous bone graft and either segmental or nonsegmental instrumentation.

Adolescent↗

PubMedDate not supplied

Traumatic hip dislocation with spontaneous incomplete reduction: a diagnostic trap.

We are reporting three children and adolescents who presented with incongruous reduction of the hip following injury. In each case, the diagnosis was initially missed. None of the patients presented with a hip dislocation, but two gave a history consistent with transient hip subluxation or dislocation. Low-energy trauma was the cause in two cases. Treatment consisted of arthrotomy to remove interposed capsule and labrum to obtain concentric reduction. When reduction of a hip dislocation occurs spontaneously, the condition may be misjudged. Any child or adolescent who complains of hip pain following injury should have radiographs scrutinized for asymmetric widening of the hip joints. Any asymmetry should be evaluated by appropriate imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI). Removal of any interposed tissue is recommended, even when the diagnosis is delayed by several months.

Adolescent↗

PubMedDate not supplied

Osteotomy for malunited forearm shaft fractures in children.

Osteotomy to correct malunion after forearm fracture in children is an uncommon procedure. The uncommon nature of this procedure and the complex nature of forearm anatomy contribute to the difficulty of restoring proper alignment. The purpose of this paper is to report nine cases and describe a simplified method for deformity correction. This is a retrospective review of the authors' experience with recommendations for surgical technique. Average maximum deformity prior to osteotomy was 31 degrees. All patients united with satisfactory postoperative alignment. There was one superficial wound infection. Average improvement in forearm rotation was 102 degrees. Based on these satisfactory results and a review of the literature, the authors recommend correction of forearm malunion when functional range of motion does not return by 6 months after the initial injury.

Child↗

PubMedDate not supplied

Untreated hip dislocation in cerebral palsy.

The purpose of this study was to evaluate the problems associated with hip dislocation in adults with cerebral palsy. Twenty-nine subjects with dislocated hips and no prior hip surgery were identified. There were a total of 38 dislocated hips. Age range was 21 to 52 years (average 34). Seven dislocated hips (18%) were definitely painful and four hips (11%) produced only mild or intermittent pain. Twenty-seven hips (71%) were not painful. The seven painful hips underwent proximal femoral resection, resulting in excellent range of motion and no pain. In conclusion, for established nonpainful hip dislocation in the severely involved spastic quadriplegic patient, aggressive surgical treatment should be undertaken only after careful consideration of the natural history. If a dislocated hip becomes painful in adulthood or develops an adduction contracture interfering with perineal care, a proximal femoral resection can be performed with reliably good success.

Adult↗