Transfer of X-rays between hospitals in Sydney.
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Biomedical subjects
Publications and source records attributed to H J Richards.
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A series of 275 repairs is reviewed. Primary or delayed primary repair of the divided digital flexor tendon is advocated. Preoperative splinting and careful operative technique to avoid damage to the blood supply of the divided tendon are necessary. The tendon repair is followed by closure of the fibrosynovial sheath and postoperative splintage. By this means acceptable results are obtained.
The results of a personal series of 275 flexor tendon repairs in the digits in 235 patients are reviewed. The repair technique is designed to respect the intrinsic vascular anatomy of the flexor tendon eculiar to this region. It involves the placement of sutures laterally and volarwards where the circulation is least interfered with. Males greatly predominated, and the majority of patients were aged between 15 and 34 years. Using 90 degrees as the "normal" range of movement of both the proximal and distal interphalangeal joints, the mean percentage range of movement after repair was 89% of normal for the former joints and 49% for the latter.
It is widely accepted that all divided tendons other than the digital flexors, when sutured and with appropriate postoperative treatment, heal well and that a good return of function can be expected. Clinical and experimental evidence is presented. which indicates that digital flexor tendons also have the ability to heal well, with a good return of function, if suitably treated. The results of repair of 275 divided digital flexor tendons in man are presented.
Unilateral pulmonary oedema is a rare complication in the routine management of spontaneous pneumothorax. Previous reports have emphasized excessive negative intrapleural pressure, rapid re-expansion of the lungs and bronchial obstruction as major factors in the pathogenesis. We have encountered four cases, and at least one of these factors have been absent in each case. Review of the literature, and our own experience suggests that the major factor is chronic and total lung collapse resulting in hypoxia and increased alveolar-capillary membrane permeability. Other factors which may be contributory are discussed.
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