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Biomedical subjects

E T James

Publications and source records attributed to E T James.

7 recordsLinked to original sources
PubMed1998

Problems with the Rotaflex: a 10 year review of a rotating hinge prosthesis.

The results of the first 10-year review of the Rotaflex total knee prosthesis are presented. Loosening, fracture, implant failure, and damage to the extensor mechanism have been frequent findings. Of 25 implants reviewed, an arthrodesis has been performed in 4 patients and an amputation in 2. Surgery has been declined in a further 4 patients. A brace is required by 7 of 19 patients in whom the prosthesis has not been removed, and the results of surgery are considered poor in 13 of these 19 patients. With an overall complication rate of almost 80%, there would appear to be no place for this prosthesis despite its continued availability.

Activities of Daily Living↗
PubMed1984

Vibration disease of the capitate.

There are four previous cases of isolated avascular necrosis of the capitate in the literature. This report describes a fifth, and the first to be associated with vibration. A paint sprayer presented with wrist pain, tenderness over the capitate and radiological changes of avascular necrosis of the capitate. Following mid-carpal arthrodesis, he returned to work. The role of trauma and a pre-existing ligamentous abnormality of the wrist in the aetiology of this condition is discussed.

Adult↗
PubMed1983

Closure of osteomyelitic and traumatic defects of the leg by muscle and musculocutaneous flaps.

A retrospective review was carried out of 17 muscle and musculocutaneous flaps in the leg performed for traumatic and osteomyelitic defects in two groups of patients. One group of ten patients with soft-tissue defects resulting from trauma underwent muscle flap coverage in nine and musculocutaneous flap cover in one. Nine of the ten healed uneventfully. The second group of seven patients with defects resulting from chronic osteomyelitis underwent muscle flap cover in two, musculocutaneous flap cover in three, and combined muscle and musculocutaneous flap cover in two. All seven of the flaps transposed healed well without recurrence of infection. This series illustrates that the technique of muscle and musculocutaneous flap transposition can provide a safe, relatively straightforward method of cover for defects of the leg from trauma and chronic osteomyelitis with predictable results.

Accidents, Traffic↗
PubMed1982

Total hip revision arthroplasty: does sepsis influence the results?

The results of revision total hip arthroplasty, with or without sepsis, are compared in a review of the recent literature. In 661 total hip revisions without sepsis, there is an overall 54% excellent/good/satisfactory rate and a 12% infection rate. Of 1063 total hip revisions in the presence of or after sepsis, there is an overall success rate of 73% and a 17% reinfection rate. Comparison of the two groups is difficult due to the different criteria used to diagnose infection, the variable use of parenteral antibiotics and cement impregnated with antibiotics, the frequently short follow-up periods, and the definition of success by different rating s stems. Aside from infection, before advising revision surgery or excision arthroplasty, consideration should be given to the individual patient, the hip to be revised, and the technical skills available. Follow-up should be monitored yearly by an independent examination of the patient, not by chart review or telephone questionnaire. Standardized rating methods should be used, together with strict criteria for the diagnosis of infection. Only in this way will results from different centers be comparable.

Bacterial Infections↗
PubMedDate not supplied

The dilemma of painful old os calcis fractures.

This study of 16 patients (17 amputations) draws attention to intractable pain as a rare, but not previously emphasized, sequela of os calcis fracture. The fracture remained painful despite, in many cases, exhaustive measures to relieve symptoms. The majority of patients still had pain even after amputation and revision, suggesting the development of a regional (phantom) pain syndrome. Patients should be advised that severe os calcis fractures may not heal sufficiently to stabilize the foot for 18-24 months. Patients who continue to complain of pain following treatment of a fracture of the os calcis should be carefully evaluated in a pain management clinic. Since in some patients the pain may not be entirely organic in origin, amputation would not solve the problem. In the present series amputation did not always relieve pain and also made prosthetic fitting difficult.

Adult↗