Biomedical subjects

H M Childress

Publications and source records attributed to H M Childress.

9 recordsLinked to original sources

PubMed1976

Vertical transarticular pin fixation for unstable ankle fractures: impressions after 16 years of experience.

The usage of vertical transarticular pin fixation combined with plaster immobilization for severe ankle injuries has been reviewed in 92 consecutive cases over a period of 16 years. Moderately simple in application and without a skin incision, the procedure has been found to provide efficient and reliable short-term stabilization of the ankle and subtalar joints with minimal complications. A new technique is described for accurate placement of the pin and the prevention of its migration. It is a reasonable alternative treatment for certain unstable distal tibial and ankle fractures when open reduction with conventional internal fixation cannot be done. In particular, the method is recommended in treating displaced fractures at the ankle and deltoid ligament ruptures in geriatric patients. It is often useful as a salvage or last-resort procedure in unusually severe ankle injuries with circulatory or neural deficits. In many instances additional trauma to the head, thorax or abdomen may have been sustained. Thus total patient care is essential and priorities must be recognized. The treatment of ankle trauma, furthermore, in a physiologically-aged diabetic patient is often not the same as that for similar injuries in a young healthy adult. The clinical judgement and experience of the operator is the basis for selection of the procedure. The simplest method is often the best. Pin fixation, however, is not for everyone. It should be done only by surgeons qualified to treat bone and joint trauma and even then only for those situations in which its usage is specifically indicated.

Adult↗

PubMed1975

Recurrent ulnar-nerve dislocation at the elbow.

Recurring luxation of the ulnar nerve at the elbow is not uncommon (16.2%), occurring about equally in young and old, male and female, athletes and non-athletes but the greater mobility is usually at the dominant arm. The probable cause of such dislocation is congenital laxity of supporting ligaments. Being more vulnerable to injury than normally-positioned nerves, however, complicating neuritis can does occur. Subluxating nerves which stop on the tip of the medial humeral epicondyle upon 90 degrees or more of flexion at the elbow are more subject to direct trauma than completely displaced neural structures which cross the epicondyle upon elbow flexion. The latter may develop friction neuritis which occurs most frequently in industrial workers and occasionally requires surgical transfer. Deep intramuscular implantation, with or without neurolysis, is definetely superior to subcutaneous placement of the affected nerve. In this report are described chemically-induced ulnar neuritis from cortisone injections about the medial humeral epicondyle; pressure ulnar neuritis in patients with enforced bed rest and from improper positioning on operating table with permanent neural deficit and the relationship of such hypermobile ulnar nerves to extension-flexion (whiplash) trauma to the neck. It is emphasized that most of these complications could have been avoided had the patient and his physician known that such anomalies were present. Of particular importance is the avoidance of pressure to the medial aspect of a flexed elbow in surgical patients under general anesthesia. The unrelated co-existence of intermittently-symptomatic hypermobile ulnar nerves and extension-flexion neck trauma may occur. Recognition of isolated unlar neuritis in these patients is definitely important from the diagnostic, treatment and medical-legal aspects of such cervical spine injuries.

Adult↗

PubMed1972