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Biomedical subjects

H L Thornhill

Publications and source records attributed to H L Thornhill.

6 recordsLinked to original sources
PubMed1990

Long-term function of persons with atherosclerotic bilateral below-knee amputation living in the inner city.

Long-term function of 24 elderly persons with atherosclerotic bilateral below-knee amputation living in an inner city for at least six months after the second amputation, was determined. Twenty-one (87.6%) subjects were living at home; three were living in nursing homes. Fourteen (70%) of 20 subjects who received bilateral prostheses were ambulators. At interview, the mean age was 75.2 years; 4.87 years was the mean time since the second amputation. Ten (50%) subjects remained ambulatory. Among the other ten who received prosthesis, loss of ambulation occurred mostly due to medical factors, at an average of 3.47 years after the second amputation. Those no longer ambulatory were older and "sicker," and the interval between amputations was shorter. Fifteen (62.5%) subjects were independent in dressing, 14 (58.4%) in toileting, and only nine (33.3%) in bathing. All but one subject required housekeeping assistance. The anticipated effect on function of environmental and socioeconomic factors could not be demonstrated in this sample. Survival time and retention of ambulatory skills for an average of nine years after the second amputation in eight (33.3%) subjects who died before the end of the study was longer than previously described. The high rate of success in rehabilitation and in maintenance of ambulatory skills fully justifies intensive restorative efforts for this group of amputees.

Activities of Daily Living↗
PubMed1986

Bilateral below-knee amputations: experience with 80 patients.

This review expands information concerning the bilateral below-knee (BK) amputee, describing the findings of a retrospective assessment of 80 such patients. Factors evaluated included etiology, associated conditions, time between amputations, late revisions, use of prostheses, and survival. In 63 patients both amputations were because of atherosclerosis. Of these patients, 86% were diabetic and 84% hypertensive. Peak incidence of the second amputation was during the 7th decade. Average time between amputations was 23 months. Forty-five (71%) of the atherosclerotic patients achieved some functional use of bilateral prostheses. The five patients employed at the time of the second amputation returned to work using prostheses. Average survival after the second amputation was 44 months for those deceased, and 64 months for those alive at the end of the study period. Nine patients had amputations because of various forms of injury, including one for sequential developments due to alcohol-related sensory loss. Eight of this group had a diagnosis of alcohol abuse of psychosis. Reasons for amputations included frostbite, burns, suicide attempt and sensory loss. Five achieved long-term but generally suboptimal prostheses use. The findings support the impression that most atherosclerotic bilateral BK amputees can use prostheses and that their survival and low rate of late stump revisions justify restorative efforts. Mental status was the major determinant of amputation and prostheses use among the non-atherosclerotic patients; discharge from psychiatric hospitals without adequate community support systems was probably contributory. Management and prevention require close collaboration between the rehabilitation, surgical, psychosocial, and public health disciplines.

Age Factors↗
PubMed1985

Burns: causes and risk factors.

In a retrospective study of 277 adult patients consecutively hospitalized for burns over a five-year period (1975-1979) patients' characteristics, circumstances of burn injury and prevalence of established predisposing factors were determined. The average age was 44.5 years, 78% were black and 62% were men. Average extent of burn was 19.7% body surface area. Major causes included flames in 44.8%, scalds in 28.5%, and chemicals in 9.7%. Seventy-four percent of all burns occurred at home. Burns resulting from assault accounted for 20.9%. Fifty-six percent of the patients had one or more of the established predisposing factors. Judged to be predisposed to burn injury were all of those who attempted suicide, all who were using self-treatment for some preexisting conditions, 85% of the elderly, 83% of those who died, 81% of those burned in the bathtub and 80% of those assaulted. Other described groups were also at high risk. Living alone increased risk of injury in persons prone to burn. The most common predisposing factors were alcohol and drug abuse, physical and mental illness and advanced age. Mortality rate was 12.6%. This study emphasizes the urgent need for effective burn prevention programs in which all health professionals should play an important role.

Accidents, Home↗