Biomedical subjects

G H Thompson

Publications and source records attributed to G H Thompson.

63 records · Page 4Linked to original sources

PubMedDate not supplied

Acetabular epiphysis-labrum entrapment following traumatic anterior dislocation of the hip in children.

Traumatic anterior dislocations of the hip during childhood are rare injuries. Although a concentric reduction can usually be achieved with closed techniques, open reduction is occasionally required. We recently treated two children, 10 and 13 years of age, with nonconcentric closed reductions following traumatic anterior dislocation sustained 6 weeks and 6 months previously, respectively. Preoperative evaluation revealed intraarticular entrapment of the acetabular epiphysis and its contiguous labrum as the cause of the nonconcentric reduction. This was confirmed at surgery. Although displacement of the acetabular epiphysis has not been previously described, it is probably a common source for cartilaginous and osteocartilaginous fragments that have been recognized at open reduction following both traumatic anterior and posterior hip dislocations in children. Damage to this secondary center of ossification does not appear to affect adversely further growth and development of the acetabulum.

Acetabulum↗

PubMedDate not supplied

Magnetic resonance imaging of an osteoid osteoma of the proximal femur: a potentially confusing appearance.

Osteoid osteomas are common benign pediatric bone tumors. However, radiographic diagnosis and location of the tumor nidus can be difficult. We recently diagnosed and treated an osteoid osteoma of the right proximal femur in a 9-year-old girl in whom the preoperative magnetic resonance images demonstrated a well-marginated lesion in the medullary canal but no tumor nidus. This was confusing and misleading. Correct diagnosis was made with a computed tomography (CT) scan. Care must be taken in interpretation of magnetic resonance imaging (MRI) in disorders in which secondary bone marrow changes occur to avoid erroneous diagnoses and possible incorrect operative procedures.

Child↗

PubMedDate not supplied

A three-dimensional study of calcaneonavicular tarsal coalitions.

The authors studied 37 presumed calcaneonavicular tarsal coalitions from the Hamann-Todd Osteological Collection at the Cleveland Museum of Natural History. The anatomy of the coalitions and the associated subtalar and transverse tarsal joints was quite variable. The coalitions in 8 specimens completely spared the anterior facet of the calcaneus and in 7 specimens it was partially replaced by the navicular portion of the coalition, whereas in 22 specimens the anterior calcaneal facet was completely replaced by the navicular portion of the coalition. The authors suggest that the pathoanatomy of calcaneonavicular coalitions is not uniform and may involve the subtalar and transverse tarsal joints. This may have clinical relevance and contribute to the unsatisfactory results in feet undergoing coalition resection and soft tissue interposition.

Adolescent↗

PubMedDate not supplied

Late-onset tibia vara: a histopathologic analysis. A comparative evaluation with infantile tibia vara and slipped capital femoral epiphysis.

Histopathologic and histochemical studies were performed on the entire physes and contiguous structures of five knees (three patients) with late-onset tibia vara (Blount's disease). A constellation of abnormalities of both medial and lateral physeal components resulted in disorganization and misalignment of the physeal zones. The changes were remarkably similar to those observed in both infantile tibia vara and slipped capital femoral epiphysis, suggesting a common etiology. Our evaluation indicates that asymmetric compressive and shear forces acting across the proximal tibial physis effect its disruption and causes suppression and deviation of normal endochondral ossification, thereby resulting in tibia vara.

Adolescent↗

PubMedDate not supplied

Atlantoaxial rotatory subluxation, congenital absence of the posterior arch of the atlas, and cerebral palsy: an unusual triad.

Posttraumatic chronic atlantoaxial rotatory subluxation and congenital absence of the posterior arch of the atlas are rare upper cervical spine abnormalities. The present case is that of a 4-year-old girl who had these two spinal disorders as well as spastic cerebral palsy. The interrelationship, if any, between these three conditions is unclear but presented an unusual diagnostic triad. A posterior spinal fusion between the occiput and third cervical vertebra was performed because of concern for upper cervical spine instability. The patient was immobilized in a halo vest, and a solid fusion occurred within 3 months. Preoperatively the child had never walked independently, but postoperatively, while wearing the halo vest, she was able to walk without external support, thus raising the suspicion of previous spinal instability. Fifteen months postoperatively she remains spastic but has a stable, orthotic-free, independent gait.

Accidents, Traffic↗

PubMedDate not supplied

Legg-Calvé-Perthes disease: Results of discontinuing treatment in the early reossification phase.

The major controversy in Legg-Calvé-Perthes disease concerns its treatment. All authors recognize the need for containment of the femoral head but do not agree on the method of containment. Surgical containment is constant, does not require an endpoint for discontinuing treatment and has a short treatment period. Conservative treatment, however, produces comparable results, avoids operative and anesthetic complications but requires prolonged immobilization. The concept of Ferguson and Howorth can be validated and indicates that when early subchondral reossification is present on both the anteroposterior and lateral roentgenograms that conservative containment treatment can be safely discontinued thus shortening outpatient time to 12 months or less. The results of 165 hips undergoing conservative treatment and 27 who received surgery are analyzed. Eighty-one conservatively treated hips were mobilized early and followed for an average of 5 years. Their results were identical to those treated until the time of complete restoration of the capital femoral epiphysis. This reduction in outpatient treatment and the decrease in potential complications minimizes several of the major arguments in favor of surgical management.

Age Factors↗

PubMedDate not supplied

Innominate osteotomy in the management of residual congenital subluxation of the hip in young adults.

The application of innominate osteotomy (IO) to persistent subluxation of the hip in adults is limited. Indeed, a relatively small percentage of such adults, particularly those in the fourth and fifth decades of life, meet the precise indications and essential prerequisites for IO. Nevertheless, in most carefully selected young adults in up to and including the fifth decade of life, IO has proved successful. The objective of IO is to prevent degenerative processes in adults with only potential arthritis, seeking arrest or even reversal of the progression of degenerative disease. IO is applicable only to adults who have arthritis in its earliest stages. Achievement of these objectives is dependent on adherence to the exact indications, prerequisites, and contraindications as well as to the details of the surgical technique as described.

Adolescent↗

PubMedDate not supplied

Emergence of diabetes mellitus in a Mexican-origin population: a multiple cause-of-death analysis.

The "New World syndrome" is comprised of disorders that are hypothesized to have resulted from an interaction of the Amerindian genotype with an environment that includes marked changes in lifestyle and diet. The principal component of the syndrome is adult-onset (noninsulin dependent) diabetes mellitus. The purpose of this paper is to describe the emergence of diabetes in a Mexican-origin population. Using a unique file of multiple-cause mortality data, we have computed standardized mortality ratios and relative standardized mortality ratios for Mexican-origin individuals and for other white persons age 30 and over from the 1930's through the middle 1980's. Results for the study population residing in Bexar County (San Antonio), Texas, show that diabetes mortality for Mexican-origin individuals did indeed increase in a pattern consistent with the New World syndrome hypothesis. This study is the first description of the emergence of diabetes using a data set with consistently defined causes of death and demographic characteristics.

Adult↗

PubMedDate not supplied

Barton's fractures-reverse Barton's fractures. Confusing eponyms.

Anterior and posterior marginal fracture dislocations of the distal radius are unusual injuries, both of which are called Barton's fracture in the current world literature. Barton's original description delineates only the posterior marginal injury. An attempt is made to clarify the nature of these injuries by a complete review of the literature and a study of the clinical experience at UCLA Hospital from 1972 through 1975. Ten anterior and five posterior marginal fractures were treated during that period of time, constituting 2.3 per cent of all distal forearm fractures. Fractures in males typically stemmed from high velocity accidents in the younger age group and were associated with significant additional injuries. The injuries in females resulted from simple falls, generally in the older age group. Eight fractures were treated open and seven closed without complications; treatment results have not been determined yet. Eponym descriptions should be discontinued and replaced with a lucid anatomically descriptive classification such as anterior and posterior marginal fracture-dislocations of the distal radius.

Accidents, Traffic↗