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Biomedical subjects

F C Sherman

Publications and source records attributed to F C Sherman.

17 recordsLinked to original sources
PubMed1984

Osseous destruction by neurofibroma diagnosed in infancy as "desmoplastic fibroma".

A 2-month-old male infant presented with a lytic lesion of the distal radius which was diagnosed as desmoplastic fibroma. Tumor recurred following en bloc resection of the distal radius and forearm, necessitating an elbow disarticulation. Subsequently, the child developed multiple café-au-lait spots, and histologic sections have been reinterpreted as neurofibromatosis. This case illustrates the potential difficulty in diagnosing neurofibromatosis when few or no classic stigmata of the disease are present.

Adult↗
PubMed1981

Triple arthrodesis: a long-term study with force plate analysis.

This study evaluated triple arthrodesis at late follow-up using the liquid crystal force plate and standard clinical methods. Twenty-four patients with 36 triple arthrodeses were followed-up at an average of 8 +/- 2 years. Fifty-eight per cent of patients achieved an ideal or good rating with 11% failures. Failures were due to inadequate surgical correction of varus deformity. Seven per cent of joints with roentgenographic degenerative changes has associated mild pain. Triple arthrodesis produced many deviations from normal load-bearing: 1) calcaneovalgus residuals produced symptomatic posterior heel force concentrations; 2) residual forefoot supination produced symptomatic force concentrations under the fifth metatarsal and toe; 3) residual forefoot pronation produced increased midfoot and medial metatarsal load-bearing, generally asymptomatic; and 3) a significant increase in midfoot weightbearing occurred in most triple arthrodesis patients.

Arthrodesis↗
PubMed1981

Plantar release in the correction of deformities of the foot in childhood.

One hundred and ninety-one feet with residual cavovarus deformities from club foot or poliomyelitis were treated by a plantar release followed by correction with serial cast application. Roentgenographically, there was significant improvement in the adduction of the fore part of the foot and the cavus deformity, but the varus angulation of the hind part of the foot did not improve. In children more than six years old with deformities resulting from club foot, the plantar release was particularly effective in alleviating residual cavus deformity. In cavus deformity resulting from poliomyelitis, preliminary data indicate a positive effect in feet with pure cavus deformity and cavus deformity associated with equinus angulation of the hind part of the foot, while the results in feet with a cavus deformity and associated calcaneal deformity of the hind part of the foot typically were unsatisfactory.

Adolescent↗
PubMed1980

The hip-shelf procedure. A long-term evaluation.

Renewed interest in the hip-shelf procedure as a solution to the dysplastic acetabulum in the older child stimulated an evaluation of the long-term results in an effort to clarify the role of this procedure. Only patients with a minimum of ten years of follow-up were evaluated in the study. The average follow-up for the entire series of twenty-nine hips in twenty-seven patients was twenty-two years and ten months. At evaluation, pain was present in fifteen hips, a limp was present in twenty-five, and degenerative changes were present in twenty hips. Complications occurred in twenty-one hips and additional operative procedures were required in fourteen hips. Twenty-one of the twenty-nine hips were evaluated by us, with an average follow-up of twenty-five years and eight months. One hip was rated as excellent; eight, as satisfactory; and twelve, as poor. Although the hip-shelf procedure has been described as a safe, conservative, and reliable approach to the problem of a dysplastic acetabulum, our long-term results suggest a more cautious view of the use of this procedure. We recommend consideration of other stabilizing procedures for the dysplastic acetabulum.

Acetabulum↗
PubMed1977

Reactive sclerosis of a pedicle and spondylolysis in the lumbar spine.

Eleven patients were seen with reactive sclerosis and hypertrophy of one pedicle and lamina of a lumbar vertebra and a contralateral spondylolysis in the same vertebral segment. Differentiating the reactive sclerosis in this condition from that associated with osteoid-osteoma is necessary since excision of a sclerotic pedicle associated with contralateral spondylolysis will create painful instability. In asymptomatic patients observation is sufficient, while in those with symptoms not relieved by external immobilization, spine fusion, usually of three levels, is indicated.

Adolescent↗
PubMedDate not supplied

Neonatal gangrene in the newborn infant of a diabetic mother.

The newborn daughter of a diabetic mother developed neonatal gangrene of an upper extremity with massive muscle necrosis of the forearm, and required early dorsal and volar fasciotomies with subsequent debridements to salvage the limb. Decreased perfusion and local ischemia resulting in neonatal gangrene may result from the greater propensity for intravascular thrombosis in infants whose mothers have diabetes mellitus. While previous investigators have suggested that surgical intervention should be avoided in neonatal gangrene, in more severe cases early fasciotomy may be required to salvage a limb and avoid life-threatening complications.

Arm↗
PubMedDate not supplied

Gallium scintigraphy for diagnosis of septic arthritis and osteomyelitis in children.

Thirty-four children with presumptive acute osteomyelitis or septic arthritis underwent early gallium-67 citrate scintigraphy and have been retrospectively reviewed. Diagnostic accuracy using this technique was 91%. Gallium-67 citrate is a more reliable radiopharmaceutical agent for the detection of selected acute musculoskeletal infections than either technetium methylene diphosphonate or indium-111. However, the radiation dosage from gallium is higher than from other radiopharmaceutical agents, and the authors would recommend its use only in cases where the diagnosis cannot be made on the basis of clinical, laboratory, or plain roentgenographic criteria.

Acute Disease↗
PubMedDate not supplied

Medial adductor open reduction for congenital dislocation of the hip.

Twenty-two consecutive patients with 26 dislocated hips were evaluated for a mean of 7 years after open reduction through a medial adductor approach. Severin classification of grade I or II and center-edge angles greater than 20 degrees were present in 73% of hips and 88% of patients treated between the ages of 5 and 14 months. Avascular necrosis (AVN) with partial head involvement occurred in 15% of hips and correlated positively with increased age at surgery, but did not preclude a satisfactory Severin classification. Best results were obtained in children treated between the ages of 5 and 14 months.

Child, Preschool↗
PubMedDate not supplied

Untreated scoliosis in severe cerebral palsy.

An institutionalized adult cerebral palsy (CP) population was studied to evaluate the orthopaedic, functional, and cardiopulmonary status of 14 residents with untreated scoliosis greater than 45 degrees as compared with 42 residents with mild or no curves. Both groups were comparable in age, sex distribution, percentage of quadriplegics, and extent of mental retardation. Patients in the scoliosis group had more orthopaedic deformities involving the pelvis and hips and needed modified wheelchairs more often than did those without curves. There were no differences in incidence of decubiti, highest functional level achieved, functional loss, oxygen saturation, or pulse.

Adult↗
PubMedDate not supplied

Supracondylar fractures of the humerus in children.

Thirty-five children were evaluated at a mean of 2 years, 3 months following treatment of supracondylar fractures of the humerus. Elbow motion, clinical carrying angle, and roentgenographic measurements including Baumann's angle, humeral-ulnar angle, and metaphyseal-diaphyseal angle were determined for both the normal and the involved extremities. The humeral-ulnar angle best correlated with the final clinical carrying angle, followed by Baumann's angle and the metaphyseal-diaphyseal angle. We recommend postreduction measurement of the humeral-ulnar angle in fractures that have been surgically stabilized and Baumann's angle in those fractures treated by cast immobilization alone to determine the adequacy of reduction.

Child↗
PubMedDate not supplied

The effect of treatment on growth and deformity in hypophosphatemic vitamin D-resistant rickets.

Vitamin D-resistant rickets is characterized by short stature, lower extremity deformities, and defective mineralization of bone. While basic biochemical defects vary among involved individuals, all patients show a failure of the proximal tubule of the kidney to resorb inorganic phosphate. Laboratory findings consist of low serum phosphorus, elevated alkaline phosphatase, and abnormal serum calcium. Previously recommended treatment programs of high doses of vitamin D have effected some roentgenographic improvement in the rachitic lesions, but no related increase in height or severity of deformities has been associated with significant complications resulting from vitamin D toxicity. Daily administration of low doses of vitamin D and oral phosphates has more recently been suggested to be beneficial in promoting growth and preventing deformities. Thirteen children with documented vitamin D-resistant rickets were treated with oral phosphate and low doses of vitamin D for a mean of five years, and followed for a mean of ten years. Partial roentgenographic resolution of rachitic lesions was similar to those who received vitamin D alone. While the majority had consistently lowered alkaline phosphatases, no patient had consistently normal phosphate levels. No patient exceeded the third percentile in height. One half required osteotomies of the lower extremities. All osteotomies (eight) performed before maturity required revision, whereas those done after maturity (12) did not. Since no apparent clinical roentgenographic benefit can be documented by the addition of oral phosphate to low doses of vitamin D, we would not recommend continually doing so at this time.

Adolescent↗