Biomedical subjects
Publications and source records attributed to G Sumner-Smith.
This article describes the different situations that result in interference with fracture healing and discusses the possible causes of such problems. Prevention and treatment of these states are reviewed.
An uncemented scaled down version of the Mueller SLS femoral component was inserted into 30 dogs. The material (Protasul 100), geometry, and finish were identical to those designed for clinical use. Half of the prostheses inserted were fitted out with a modular collar to improve stability. Initial stability was achieved through press fit which was made possible by the special modification of the surface area and external configuration of the prosthesis. The function of the prosthesis was assessed through clinical assessment and force plate gait analysis. This was correlated with the degree of osseous integration which was evaluated on the basis of regular radiological examinations, and at post mortem by microradiography of the serially sectioned undecalcified femurs, and histological examination of selected sections under regular and ultraviolet light. The animals were sacrificed at 4, 8, and 12 months. Force plate gait analysis revealed that all animals walked with a normal gait by the 4th post-operative month. Evaluation revealed that 29/30 femoral prostheses became successfully integrated. The prostheses without the collar were less stable and most achieved stability only by incorporation of the distal tip of the prostheses in bone and the remainder in dense fibrous tissue. The prostheses with the collar were stable and achieved without fail full bony integration. The stability was provided by appositional growth of bone which came into direct contact with the implant over the proximal 1/3 and the distal 1/3 without an intervening fibrous membrane. Despite failure of full integration of the collarless prostheses clinically and by force plate analyses the two groups were indistinguishable.(ABSTRACT TRUNCATED AT 250 WORDS)
Electrical resistance rosette strain gauges bonded directly to the surface of the midshaft of the normal canine tibia were utilized to study the effect of the AO external skeletal fixator on the magnitude and orientation of the peak strain values recorded during locomotion. The application of the fixator in a single lateral bar configuration resulted in a significant decrease in surface bone strain magnitude but in only minor changes in the orientation of those strains. However, in only one of three dogs tested did the addition of a second external connecting bar result in significant further decreases in bone strain.
High-speed cinematography with computer aided analysis was used to study equine hindlimb kinematics. Eight horses were filmed at the trot or the pace. Filming was done from the side (lateral) and the back (caudal). Parameters measured from the lateral filming included the heights of the tuber coxae and tailhead, protraction and retraction of the hoof and angular changes of the tarsus and stifle. Abduction and adduction of the limb and tarsal height changes were measured from the caudal filming. The maximum and minimum values plus the standard deviations and coefficients of variations are presented in tabular form. Three gait diagrams were constructed to represent stifle angle versus tarsal angle, metatarsophalangeal height versus protraction-retraction (fetlock height diagram) and tuber coxae and tailhead height versus stride (pelvic height diagram). Application of the technique to the group of horses revealed good repeatability of the gait diagrams within a limb and the diagrams appeared to be sensitive indicators of left/right asymmetries.
This report concerns the analysis of the dynamic measurements of torque and bending on nailed tibiae, using two sheep walking at different speeds on a treadmill, both before and after nailing. The amplitude and the period of the measured values are reported and discussed in relationship to the speed and duration of the experiment.
Twelve surface replacement arthroplasties were performed on the hips of ten mongrel dogs using scaled-down replicas of the Wagner prosthesis. The contralateral hips and two further animals served as nonoperated controls. Animals were killed 5 months postoperatively. Clinical, radiological, histological and fluorochrome-labelling studies were employed to assess the bony and soft tissue reaction to resurfacing arthroplasty. There was no clinical or radiographic evidence of prosthetic loosening. Histological examination disclosed a thick foreign body and chronic inflammatory membrane containing acrylic cement and polyethylene wear particles at the bone-cement interface of both components. Generally, the bone marrow and trabecula were viable. There was evidence of increased bony remodelling and new bone formation in the subchondral area. The similarity between the above findings and those of aseptic component loosening in man suggests a mechanism whereby wear debris initiate a biological foreign body reaction culminating in component loosening.
In order to assess the response of bone to low-viscosity polymethylmethacrylate, CMW or Simplex acrylic cement was digitally packed while in a doughy state into drill holes in the proximal diaphysis in each of four long bones (humeri and tibiae) of mongrel dogs. Histological assessment was performed in areas of minimal load at the interface between the viscoelastic bone and the acrylic cement. Decalcified and undecalcified sections were evaluated and a remodeling or activity index calculated. Fluorescent labeling studies were performed in order to assess bone growth. Animals were killed at 2, 4 or 5 months. Histological analysis showed a thin connective-tissue membrane containing scattered giant cells and histiocytes at the bone-cement interface. Inflammation was not an important facet of this response. The marrow and trabecular bone were viable, except for scattered localized areas of marrow necrosis and fibrosis immediately adjacent to the cement. The bone adjacent to the cement showed a lower remodeling or activity index, fewer fluorescent bands, and smaller distances between successive bands, suggesting decreased bone formation and turnover. The etiology of these findings may include a vascular disturbance secondary to disruption of the cortical and marrow circulation, temperature effects during cement polymerization, and/or chemical effects from the acrylic monomer.
The use of analytical grade of metrizamide as contrast material in canine stifle arthrography was evaluated in 27 stifle joints. A concentration of 280 mg of I/100 ml was prepared, and the material was injected at a rate of 0.3 ml/cm thickness of the lateral to medial measurement. Acceptable arthrograms were produced in 22 (81.5%) cases. The mediolateral radiographic view was useful in demonstrating the cranial and caudal cruciate ligaments, the infrapatellar fat pad, and the tendon of the long digital extensor muscle. The caudocranial radiographic view was useful in demonstrating the medial and lateral menisci, the articular surfaces of the femoral condyles, and the outline of the joint capsule. Radiographs made within 15 minutes after injection of the contrast medium were acceptable, thus setting this period as the limit for obtaining useful arthrograms. The double contrast technique was found to be of little value.
Corrective osteotomy of the long bones may be required in patients with Paget's disease. Experiments on rabbits suggest that the safety of the procedures is of concern while the patient receives Calcitonin. Twenty-four rabbits were divided into 4 groups of 6 animals. Half of each group received maintenance doses of Calcitonin subcutaneously. In all animals the left and right ulnae were osteotomized through middiaphysis. The right ulna was fixed with a "mini" dynamic compression plate. The left ulna was not immobilized. Each group of animals was sacrificed at successive intervals of 3 weeks. Histologically, no difference was found in the healing of the fracture of test or control animals. Radiographically, the fracture line persisted longer in animals receiving Calcitonin (6 weeks vs 3 weeks). All fractures healed by 9 weeks. The fracture line disappeared more rapidly in all the immobilized bones. Based on these observations, administration of Calcitonin is not a contraindication for corrective osteotomy in Paget's disease. Osteotomies should be rigidly fixed to maintain the correction achieved surgically until healing is established.
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The advances made by the use of a telemetric system in the study of bone strain in a free-moving horse are reported. A rosette strain gauge was bonded to the craniomedial aspect of the metacarpus of the horse. Attachment of a miniature FM transmitter to lead wires facilitated telemetric transmission of of resistance changes which corresponded to limb movement. During 3 different gaits, the trace pattern remained similar, although frequency and amplitude varied. The tracings were similar to those reported in other species in which nontelemetric transmission was used.
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Movement between screw threads and bone inhibits bone formation, revascularization and remodeling of dead bone. Movement causes the screw to become enveloped by fibrous tissue in response to necrosis and resorption of adjacent dead cortical bone. This results in a radiologically discernible radiolucent "halo" about the screw, a certain sign of screw loosening.
Cortical bone subjected to compression by screw threads retains its integrity and is not resorbed. Screws which generate compression at the interface of their threads with bone can be expected to provide adequate fixation until bone union occurs.
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The increasing use of methylmethacrylate in orthopedic surgery makes it desirable to determine whether the curing temperature of methylmethacrylate is high enough to cause bone necrosis and whether methylmethacrylate damages articular cartilage. Studies in dogs showed that methylmethacrylate plut temperatures ranged from 95 to 107degrees C and that temperatures at the cement-bone interface ranged from 50 to 95degrees. Curing temperatures therefore are high enough to cause necrosis of bone. Other studies revealed no harmful action of methylmethacrylate on articular cartilage. Fractures stabilized with methylmethacrylate can therefore be expected to heal provided the normal criteria of fracture management are fulfilled.
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