PubMed Health⌕ Search

Biomedical subjects

G H Thompson

Publications and source records attributed to G H Thompson.

At least 55 records · Page 3Linked to original sources
PubMed1984

Internal fixation of fractures in children and adolescents. A comparative analysis.

A retrospective analysis of 4,411 consecutive pediatric fracture patients managed between 1979 and 1983 demonstrated that only 3.6% (170 patients) required internal fixation. Two patient groups with sufficient follow-up study were compared: Group 1-90 skeletally immature children and young adolescents, and Group 2-66 skeletally mature adolescents. Upper-extremity fractures, especially of the distal humerus, and displaced epiphyseal fractures were the major indication for internal fixation in Group 1, while lower-extremity diaphyseal and intra-articular fractures predominated in Group 2. Complication rates were higher than expected but fortunately most were minor-18% in Group 1 and 12% in Group 2. The results of this study demonstrate that internal fixation can be beneficial in selected fractures in children and adolescents in preventing major complications, such as premature epiphyseal closure and malunion, and in restoring and maintaining normal extremity growth and function.

Adolescent↗
PubMed1984

Postoperative neurological deficits in segmental spinal instrumentation. A study using spinal cord monitoring.

We retrospectively analyzed the postoperative neurological complications in 137 patients who underwent a posterior spine fusion for scoliosis and had concomitant somatosensory cortical evoked-potential spinal-cord monitoring. The patients were divided into three specific operative groups: group 1, forty-nine patients who had a Harrington rod with segmental wiring (segmental spinal instrumentation); group 2, twenty patients who had Luque segmental spinal instrumentation; and group 3, sixty-eight patients who had a Harrington rod without segmental spinal instrumentation. There were neurological complications in twelve (17 per cent) of the sixty-nine patients in groups 1 and 2. Three patients (4 per cent) had a major injury to the spinal cord and nine patients (13 per cent) had only transient sensory changes. No difference was apparent between group 1 and group 2 in the degree of operative correction of curves or in the incidence of neurological complications. The one neurological complication (1.5 per cent) that occurred in the sixty-eight patients in group 3 was a Brown-Séquard syndrome. The factors related to increased risk for spinal cord injury in groups 1 and 2 included: (1) the passage of sublaminar wires in the thoracic and thoracolumbar spine, (2) intraoperative correction exceeding the preoperative bending correction, and (3) the surgeon's lack of adequate experience with the technique. With spinal cord monitoring we were able to predict the impending major neurological deficits, but the transient (sensory) changes that may be associated with segmental wiring were less reliably predicted.

Adolescent↗
PubMed1984

Legg-Calvé-Perthes disease. The prognostic significance of the subchondral fracture and a two-group classification of the femoral head involvement.

From previous experimental investigations of a model of Legg-Calvé-Perthes disease in young pigs, it was speculated that the early radiographic phenomenon of the subchondral crescentic-shaped radiolucent line is a pathological fracture and, furthermore, that this fracture initiates the stage of resorption. Being painful, the fracture also heralds the clinical onset of the disease. From these laboratory investigations, plus a preliminary radiographic investigation in children, it has been observed that only that portion of the epiphysis underlying the subchondral fracture is resorbed. The radiographic investigation of 1,057 children (1,264 involved hips) with Legg-Calvé-Perthes disease from four institutions included 376 hips in which the diagnosis had been made early and the subchondral fracture was detectable. In all of these hips the extent of the subchondral fracture correlated precisely with the subsequent extent of maximum resorption. Consequently, in the early stage of Legg-Calvé-Perthes disease the extent of the subchondral fracture is of prognostic significance in predicting the eventual extent of involvement of the femoral head. We propose a simple and practical two-group classification of the extent of involvement of the femoral head: Group A (less than half of the head) and Group B (more than half of the head). The classification can be applied in the early stage of the disease when the subchondral fracture is detectable as well as throughout the ensuing resorptive stage.

Child↗
PubMed1983

Railyard amputations in children.

Railyard or train-related accidents are a common cause of traumatic amputations in children. Four consecutive children with traumatic lower extremity amputations due to railyard amputation seen between 1975 and 1980 demonstrated: a common mechanism of injury--all were attempting to obtain rides on slow-moving trains near their homes or school; similar lower extremity amputation patterns--four right below knee and two left Syme's amputations; and distinctively abnormal psychosocial backgrounds. The psychosocial abnormalities have been demonstrated to be unique in children sustaining traumatic railyard amputations and are probably contributory. Awareness of these factors is important when considering surgical intervention and in planning for long-term rehabilitation.

Accidents↗
PubMed1982

Beta-adrenergic blockade and peripheral vascular disease.

Hypertension and ischaemic heart disease are common accompaniments of peripheral vascular disease, and are often treated with beta-blocking drugs. Previous reports, however, have suggested that these drugs may aggravate peripheral vascular disease. A study was designed to investigate this problem with claudication-distance and skin and muscle blood-flow studies (as determined by 133Xe clearance) as indices for assessment. In all 11 patients who presented with features of peripheral vascular disease and were found to be taking beta-blocking drugs, administration of the drug was stopped, blood pressure was controlled by other means, and the situation was reassessed four weeks later. There was a significant improvement in claudication distance and in resting and post-exercise muscle blood flow after withdrawal of the drug. This held for both cardioselective and nonselective beta-blockers. It is recommended that this group of drugs be avoided in the treatment of patients with peripheral vascular disease.

Adrenergic beta-Antagonists↗
PubMed1982

Surgical management of resistant congenital talipes equinovarus deformities.

We evaluated the results of surgery for resistant congenital talipes equinovarus deformity in 164 children (244 feet). No patient was followed for less than two years. They were divided into three groups for analysis, based on their treatment. Group 1 consisted of seventy-five children (112 feet) who had incomplete releases only; Group 2 consisted of twenty-three children (thirty-nine feet) who had had a failed incomplete release followed by a one-stage complete posteromedial plantar release, without internal fixation, and serial application of casts; and Group 3 consisted of sixty-six children (ninety-three feet) who had the complete posteromedial plantar release as the initial surgical procedure. Group 1 had 42 per cent, Group 2 had 79 per cent, and Group 3 had 86 per cent satisfactory (excellent or good) long-term results. The radiographic measurements that correlated best with the clinical results were the anteroposterior talocalcaneal overlap, the lateral talocalcaneal angle, and the positions of the navicular and calcaneus. The results in our series emphasize the complex interrelationship of the pathological anatomy and the need for complete simultaneous release of all components of the deformity.

Adolescent↗
PubMed1979

Erythromelalgia.

Erythromelalgia is an extraordinary disorder of unknown etiology and pathophysiology that resembles the post-traumatic reflex dystrophy syndromes but has not been described previously in the orthopedic literature. Its distinctive triad of intense burning extremity pain associated with erythema and increased skin temperature are diagnostic. Primary or idiopathic and a secondary or associated form have been identified. The latter occurs in association with an underlying disease process, especially myeloproliferative disorders. Treatment with pharmacologic agents and surgery are ineffective except in the secondary group where treatment of the associated disorder generally results in a remission. Symptoms in the primary group can be minimized by appropriate environmental control with cooling and avoiding heat-producing situations that would raise skin temperature above a critical thermal threshold.

Adolescent↗
PubMed1978

Healed untreated anterior cervical spine dislocation. A case report.

Fracture and fracture-dislocations of the cervical spine are serious injuries that rarely go undiagnosed. A case report of a bilateral facet dislocation with anterior displacement is presented that went undiagnosed and untreated, and healed without neurologic sequelae. No previous similar reports are known.

Aged↗
PubMed1978

A quantitative review of the performance of implanted cardiac pacemakers, Medtronic Model No. 5944.

One of the service functions of the Sir Charles Gairdner Hospital Department of Biophysics since 1972 has been the routine performance testing of pacemakers implanted by the Hospital's Cardiologists. This service was set up to measure pacemaker pulse parameters with a view to detecting battery depletion. It was also found to be of great help in showing lead insulation deterioration, intermittent capture and movement of the catheter tip within the right ventricle, information that is frequently of help to the Cardiologists in planning acute or elective pacemaker replacement.

Electric Conductivity↗
PubMed1977

Vector cardiographic assessment of implanted cardiac pacemakers.

The design and use of an on-line PDP 11/40 based vector cardiographic pacemaker assessment system is described. The system has been designed for comprehensive, automated testing of either fixed rate or demand implanted cardiac pacemakers. It is accurate and can be operated by a laboratory assistant without special training. Pacemaker parameters extracted are pulse height, width, rate, energy index and the frontal plane vector length and angle at maximum inspiration and during quiet breathing. In addition, a graphical representation of the patient's ECG and the pacemaker pulse is obtained on a computer graphics terminal. Patient data are written to cartridge disk for permanent record following the test. At each subsequent test of the implanted pacemaker, the data on disk are addended with the latest quantitative results. A separate off-line FORTRAN program can interrogate disk files for detailed analysis of patient data and display of parameter trends since implantation.

Computers↗
PubMedDate not supplied

Salter-Harris type II fractures of the capital femoral epiphysis.

Salter-Harris type II fractures of the capital femoral epiphysis have not been previously documented. The authors have treated three patients who sustained four such fractures. One child had a recurrent fracture two years after the first had healed satisfactorily. Two fractures were treated by spica cast immobilization, one fracture by closed reduction and internal fixation, and the other fracture healed without treatment. No patient developed avascular necrosis or other complications. Two of the children had an association with idiopathic slipped capital femoral epiphysis. An etiologic relationship with slipped capital femoral epiphysis, if any, is uncertain.

Adolescent↗
PubMedDate not supplied

Spontaneous atlantoaxial subluxation as a presenting manifestation of juvenile ankylosing spondylitis. A case report.

Juvenile-onset ankylosing spondylitis is an unusual disorder which can present with either peripheral arthritis or with more classic hip girdle and back symptoms. Atlantoaxial instability has been recognized as a late complication in only one patient and has not been reported as an early manifestation. This paper presents a case in which atlantoaxial instability and neck pain without neurologic involvement was a presenting manifestation. The laboratory and clinical features of juvenile ankylosing spondylitis are discussed, along with the importance of qualitative sacroiliac joint scintigraphy in the diagnosis of early or confusing cases.

Axis, Cervical Vertebra↗
PubMedDate not supplied

Late skeletal deformities following meningococcal sepsis and disseminated intravascular coagulation.

Late skeletal deformities following meningococcemia associated with disseminated intravascular coagulation are rare. Two basic lesions have been described: epiphyseal avascular necrosis and epiphyseal-metaphyseal defects. These occur primarily in the lower extremities and result in angular deformity and leg length inequality. We recently encountered these lesions in a child 3 years following sepsis. The etiology appears to be acute vascular thrombosis of epiphyseal and metaphyseal vessels mediated through the generalized Shwartzman reaction. An increased incidence of these deformities may be anticipated as more children survive fulminant meningococcemia.

Bone Diseases, Developmental↗