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Biomedical subjects

G F Pennal

Publications and source records attributed to G F Pennal.

11 recordsLinked to original sources
PubMed1980

Nonunion and delayed union of fractures of the pelvis.

A review of 42 patients with delayed union and nonunion of fractures of the pelvis demonstrates that this rarely reported entity does exist. Nonunion occurred primarily in young patients (average age 35 years) and caused severe disabling symptoms. Bone graft surgery combined with external skeletal fixation of the pelvis produced union in 15 patients, each of whom was able to return to the work force. In the nonoperative group, only ten of 24 achieved bony union while 14 of those had only fibrous union. Pain in association with a limp were the predominant symptoms. Tangential radiographs of the pelvis, stress X-rays and tomograms proved the diagnosis. The average time to diagnosis in this series was 38 weeks. Earlier diagnosis and treatment are possible and would greatly reduce the morbidity of patients with extensively injured pelves.

Adult↗
PubMed1980

Results of treatment of acetabular fractures.

If it is not possible to achieve a satisfactory position by conservative methods, surgical treatment is indicated in displaced fractures of the acetabulum in order to restore and stabilize both the hip joint structure and the integrity of the pelvic ring. Restoration of the joint surfaces to as near normal as possible offers the best chance for a symptom-free hip. The postoperative recovery time is not hastened, but the conditions for early activity and restoration of function are improved. As demonstrated in 270 cases reported here, and as is well recognized in the past, a significant proportion of patients will require secondary or salvage surgery, i.e., total hip arthroplasty. Such treatment may not be possible if there is extensive residual disorganization of the hip joint. Preparation for future reconstructive surgery is important as an indication for operative reduction of the acetabulum.

Acetabulum↗
PubMed1980

Pelvic disruption: assessment and classification.

A precise radiologic technique for assessing the forces producing pelvic disruption has been helpful in arriving at a logical classification of pelvic injury. The radiologic examination should include anteroposterior, inlet and outlet views, as well as tomograms and occasionally computed-assisted tomographic evaluation (CT scanning). On the basis of this radiologic assessment with some biomechanical studies, a classification of three major forces producing injury is suggested. The anteroposterior and lateral compression types, while vastly different, may both have stable and unstable subtypes associated with them. The vertical shear fracture is always unstable. An accurate history and physical examination in conjunction with the above radiologic principles will lead the surgeon to a precise determination of the fracture pattern. A knowledge of the forces necessary to produce this pattern is helpful in the management of the patient with this particular traumatic lesion.

Adult↗
PubMed1980

Pelvic disruption: principles of management.

Using the previously outlined classification of pelvic disruption to assess the displacement and stability, a logical method of treatment for the individual case follows. Anteroposterior fractures of the open-book variety and with intact posterior sacroiliac ligaments require simply reduction of the fracture (closure of the book), and immobilization by a sling, plaster spica or external skeletal fixators. The lateral compression types all produce some degree of inward rotation of the hemipelvis. If the supine position does not reduce the hemipelvis spontaneously, a general anesthetic and the application of external rotation forces are often required. Immobilization can be maintained either by complete bed rest with traction through a supracondylar femoral pin or with external skeletal fixators. Pelvic slings or binders will increase the deformity and are contraindicated. The very unstable types of vertical shear fractures can be reduced easily with traction, but maintenance of reduction is difficult. Fracture healing may be delayed because of instability through the hemipelvis and some degree of compression through the posterior fracture is desirable, either by various forms of external skeletal fixation, or occasionally by open reduction. Pelvic fractures associated with acetabular disruption and requiring open reduction of the acetabular fracture also require anatomic repositioning of the pelvic fragments simultaneously, in order to anatomically restore the integrity of the acetabulum. Finally, the pelvic fracture should not be neglected during the early phase of general resuscitation of the patient, but management should proceed concomitantly with the management of the associated injuries. Delay in treatment of the pelvic injury makes management much more difficult and even hazardous at a later phase.

Acetabulum↗
PubMedDate not supplied

Spinal stenosis. Results of treatment.

Seventy patients with spinal stenosis are reported according to the new international classifications. Cases where the stenosis was caused mainly by interluminar lesions such as disk protrusion are excluded. The treatment of patients with segmental disease and adequate technical decompression was generally successful while the patients with more generalized disease had less predictable end results. In spite of wide decompression of the lateral gutter of the spinal canal, there was little tendency to further olisthesis except in the degenerative spondylolisthesis group. Spinal fusion did not appear to be necessary except in this latter group of patients. Technetium polyphosphate scanning techniques have shown an active process in the facet joints of the spondylolisthesis group with degenerative disease.

Constriction, Pathologic↗