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Biomedical subjects

G L Glancy

Publications and source records attributed to G L Glancy.

9 recordsLinked to original sources
PubMed2000

Fibular hemimelia: comparison of outcome measurments after amputation and lengthening.

BACKGROUND: Treatment of fibular hemimelia includes either Syme or Boyd amputation with early prosthetic fitting or tibial lengthening. Numerous studies have documented the success of both procedures. The purpose of our study was to compare the outcome after amputation with that after tibial lengthening, specifically with regard to activity restrictions, pain, satisfaction, complications, number of procedures, and cost, in children with fibular hemimelia. METHODS: Thirty limbs in twenty-five patients treated with either an amputation or a lengthening procedure and followed for at least two years were studied. Fifteen patients underwent amputation, and ten patients underwent lengthening of the tibia. The mean age was 1.2 years at the time of amputation and 9.7 years at the time of initial lengthening. The mean duration of follow-up was 6.9 years after the amputations and 7.1 years after the lengthening procedures. RESULTS: The patients who underwent amputation were able to perform more activities than those who had a lengthening (mean activity score, 0 compared with 1.2 points; p<0.05), and they had less pain (mean pain score, 0.2 compared with 1.2 points; p = 0.091), were more satisfied and had a lower complication rate (0.37 compared with 1.91; p<0.05). The patients who underwent amputation also had fewer procedures (1.9 compared with 7.0; p<0.05), at a lower cost ($7016 compared with $26,900; p<0.05), than those who had a lengthening. Lengthening was successful in equalizing limb lengths; the mean limb-length discrepancy, assessed in nine of eleven limbs, was 0.7 centimeter. CONCLUSIONS: This study demonstrated that children who undergo early amputation are more active, have less pain, are more satisfied, have fewer complications, undergo fewer procedures, and incur less cost than those who undergo lengthening. This was true even though good results were obtained with the lengthening procedures and most patients achieved limb-length equality, were able to walk, had minimal pain, and were quite active.

Adolescent↗
PubMed1999

Juvenile osteochondritis dissecans.

Juvenile osteochondritis dissecans is a diagnosis based on plain radiographic appearance. Although it is on occasion difficult to decide whether the observed radiographic abnormality represents osteochondritis dissecans or physiologic irregular ossification, 50% of children should evidence healing with nonoperative activity modification management. In those who fail this regimen, the majority require simple drilling of the lesion through intact articular cartilage.

Cartilage, Articular↗
PubMed1991

Fracture through the stalk of pedunculated osteochondromas. A report of three cases.

Although fracture through the base of an osteochondroma is a well-recognized clinical entity, the fate of such fractures has never been documented. Recommendations concerning the treatment of these fractures are contradictory. Of the three cases of fracture through the base of a pedunculated osteochondroma observed in the last 12 years, two healed without problem, one in a patient with a solitary osteochondroma, the other in a patient with multiple osteochondromas. The third patient remained symptomatic one year after injury, and histologic evaluation of the specimen after surgical excision confirmed the diagnosis of fibrous nonunion of the fracture. Experience with fractures through the base of a pedunculated osteochondroma suggests that the majority of these fractures will heal without complication, regardless of whether they involve solitary or multiple osteochondromas. However, symptomatic fibrous nonunion of such a fracture may occur particularly when an osteochondroma is located near large, mobile tendons.

Bone Neoplasms↗
PubMed1991

Autograft versus allograft for benign lesions in children.

Benign bone lesions in children are often so large in size that there is not an adequate amount of bone available for an autograft to fill the resultant cavity after surgical curettage. This study compared autografts and allografts with respect to the time required and the success of graft incorporation. Fifty-four patients with 61 lesions were studied. Lesions were classified as small volume (less than 60 cc) or large volume (more than 60 cc) and were separated into four groups: small-volume autograft, large-volume autograft, small-volume allograft, and large-volume allograft. Allografts appeared comparable to autografts when small-volume lesions were treated. The healing time was slightly longer for allografts with an average period of 21 months versus 27 months for autografts. Autografts were superior to allografts in rate and completeness of healing for solitary large lesions. This increased efficacy presumes a somewhat older child in which an adequate amount of bone is available for an autograft. A young child with multicentric or polyostotic lesions can still achieve successful incorporation with allografts. In this study, 38% healed completely and 29% healed partially. Allografts have a distinct place in the treatment of benign bone lesions in children.

Adolescent↗
PubMed1988

Surgical management of the flatfoot.

The flatfoot in a child with sufficient deformity and symptoms to warrant surgery occurs infrequently. A prolonged trial of nonsurgical measures is always indicated. With the exception of the spastic paralytic foot, surgery involving alteration of the bony anatomy should be postponed until the child's foot matures. Restoration of the longitudinal arch at the midfoot naviculocuneiform articulation is a reliable solution to the symptomatic hypermobile flatfoot. The spastic paralytic foot requires tendo Achillis lengthening, medial imbrication, and Grice subtalar stabilization. The symptomatic, cartilaginous tarsal coalition will respond to resection. Treatment of the skewfoot must be individualized depending on the severity and location of symptoms, age of the patient, and joint mobility.

Cerebral Palsy↗
PubMed1988

False negative bone scans in pediatric sepsis of the axial skeleton.

The early diagnosis of disk space infections and sacroiliitis in children can be difficult because of protean presenting symptoms, nonspecific laboratory studies, and normal plain films. Technetium phosphate scintigraphy has been reported as a diagnostic method with an accuracy of up to 100% in some series. In this case report we present two patients with negative technetium bone scans in the face of active infection, illustrating the need to pursue the diagnosis using other modalities.

Discitis↗
PubMed1976

Compartment syndromes.

Explore the source record for details and available documents.

Anterior Compartment Syndrome↗
PubMedDate not supplied

The success of closed reduction in the treatment of complex developmental dislocation of the hip.

The purpose of our study was to determine the efficacy of closed reduction in the treatment of complex developmental dislocation of the hip. We identified two factors, the cone of stability and the limbus type, through the use of arthrography and gentle examination under anesthesia, which are useful guidelines in the management of complex developmental dislocation of the hip. We feel as a result of this study we can select those cases of complex developmental dislocation of the hip that are amenable to closed reduction and separate them from those other cases for which we recommend open reduction.

Arthrography↗