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Biomedical subjects

E E Bleck

Publications and source records attributed to E E Bleck.

At least 19 recordsLinked to original sources
PubMed1991

Early complications in the operative treatment of ankle fractures. Influence of delay before operation.

We have reviewed the early complications of 121 surgically treated closed ankle fractures; the complication rate was 30%, with 14 major and 22 minor complications. Fractures with skin blisters or abrasions had more than double the overall complication rate. Fracture-dislocations had three times as many major complications as simple fractures, and those not fixed within 24 hours had a 44% major complication rate compared to 5.3% in those operated upon as emergencies. Patients transferred from another medical facility had high complication rates, especially if they had fracture-dislocations. We conclude that operative treatment of ankle fractures must be delivered in a timely fashion, especially in severe fractures. We would caution against the practice of transferring patients with serious ankle fractures before completion of definitive care.

Adolescent↗
PubMed1990

Established hip dislocations in children with cerebral palsy.

Hip dislocation in children with cerebral palsy is caused by a combination of factors, including spastic muscle imbalance, persistent fetal femoral geometry, acetabular dysplasia, and flexion-adduction contracture. The incidence of dislocation correlates with the severity of the spasticity, and the prevalence is close to 50% in neurologically immature, spastic quadriplegic children. Successful hip reductions improve muscular balance, provide satisfactory reduction of the femoral head, and establish good pelvic coverage. In 31 occurrences of established hip dislocation in 24 patients, the most successful operations used a combined procedure consisting of soft-tissue release, open reduction, femoral varus derotation and shortening osteotomy, and pelvic osteotomy.

Cerebral Palsy↗
PubMed1990

Biomechanical analysis of the Chiari pelvic osteotomy. Preserving hip abductor strength.

Although the Chiari osteotomy is usually effective in reducing pain, many patients are left with a long-term limp. The postoperative limp can at times be caused by hip abductors that have strength insufficient to counteract the torque from body weight during single-leg stance. To study how the surgical technique affects the hip abductor muscles, a biomechanical model was developed that computes the postsurgery pelvic geometry and the resulting hip abductor torque given three surgical parameters: angulation of the osteotomy, distance of medical displacement, and angle of internal rotation. The computer simulations of the Chiari osteotomy showed that some sets of surgical parameters conserve abductor torque while others greatly reduce it. Simulated surgeries with high angulation and large medial displacement reduce gluteus medius abductor torque by up to 65%. Therefore, this combination of surgical parameters may account for some instances of the postoperative limp. In the model, high angulation reduces the length of the gluteus medius and is the primary cause of reduced abductor strength. Simulated horizontal osteotomies (0 degrees to 10 degrees) were found to best conserve both muscle length and abductor torque.

Biomechanical Phenomena↗
PubMed1979

Integrating the physically handicapped child.

This paper will serve several purposes: (1) to provide information on the incidence of physically handicapped children (exclusive of the blind and deaf) who are likely to be integrated into schools for normal non-physically impaired children, (2) to describe briefly the major handicapping conditions and their educational implications, (3) to comment on why integration has come about and why it promises to enrich the lives of normal children, (4) to suggest how physicians, physical therapists, and occupational therapists might help to make schools programs successful, (5) to comment briefly on financial implications of this program and to suggest ways in which the complexity of the medical management might be simplified, (6) to provide factual knowledge about the handicapped child and his potential to teachers who are already on the firing line to "improve" the academic achievement of the alleged normal child.

Arthritis, Juvenile↗
PubMed1979

Congenital dislocation of the hip--prognostic implications of early diagnosis.

A retrospective analysis of 62 patients with 78 congenital dislocations of the hip (CDH) referred to Children's Hospital at Stanford was done to ascertain whether CDH was being diagnosed as early as had been thought possible and whether various treatments were effective. In this series there were a substantial number of cases of CDH that were not diagnosed within the first 48 hours of life. At Children's Hospital the Pavlik harness was the most effective form of treatment of congenital dislocations of the hip in the perinatal period.

Female↗
PubMed1977

Congenital clubfoot: pathomechanics, Radiographic analysis, and results of surgical treatment.

Twenty-one patients with resistant or relapsed clubfeet, ranged in age from four months to 7 years, and all had initially been treated with plaster by board certified orthopaedic surgeons. Surgery was recommended only after an Achilles tenotomy failed to bring the foot into dorsiflexion after approximately four months of age. Surgical correction was based upon the derotation and dorsiflexion of the talus in the ankle mortise. The criteria for a satisfactory result were: no recurrence of the equinus or varus; neutral position of the heel; dorsiflexion of the ankle to at least neutral; a fairly straight forefoot so that the center line of the foot bisected either the second or third toes or passed no further laterally than the third and fourth toes. Of the 33 feet surgically treated, 28 had satisfactory results following the first procedure, and five required additional procedures.

Achilles Tendon↗
PubMed1976

Light patterns as a means of assessing and recording gait. I: methods and results in normal children.

A method of analyzing and documenting gait in normal children is described. Patterns produced during walking, by means of lights situated at seven sites on the head, trunk and extremities, were recorded on color transparency film. With this technique, features of both normal and pathological gait are identifiable. The wide applicability of this method, its satisfactory reproducibility and uncomplicated design are emphasised.

Adolescent↗