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Biomedical subjects

Henry G Chambers

Publications and source records attributed to Henry G Chambers.

3 recordsLinked to original sources

Ankle and foot disorders in skeletally immature athletes.

As one of the most commonly injured areas in the immature athlete, the foot and ankle has many disorders. Knowledge of congenital and developmental abnormalities and possible injury patterns enables the clinician to correctly diagnose these disorders. Physical examination and appropriate use of imaging technology provide confirmation of the initial impression. As children and adolescents participate in sports with greater intensity, there is a higher incidence of overuse injuries that may have long-term implications.

Adolescent↗

A practical guide to gait analysis.

The act of walking involves the complex interaction of muscle forces on bones, rotations through multiple joints, and physical forces that act on the body. Walking also requires motor control and motor coordination. Many orthopaedic surgical procedures are designed to improve ambulation by optimizing joint forces, thereby alleviating or preventing pain and improving energy conservation. Gait analysis, accomplished by either simple observation or three-dimensional analysis with measurement of joint angles (kinematics), joint forces (kinetics), muscular activity, foot pressure, and energetics (measurement of energy utilized during an activity), allows the physician to design procedures tailored to the individual needs of patients. Motion analysis, in particular gait analysis, provides objective preoperative and postoperative data for outcome assessment. Including gait analysis data in treatment plans has resulted in changes in surgical recommendations and in postoperative treatment. Use of these data also has contributed to the development of orthotics and new surgical techniques.

Adult↗

Progressive slippage after pinning for slipped capital femoral epiphysis.

The authors retrospectively reviewed seven cases of progressive slipped capital femoral epiphysis after screw fixation. All seven patients initially presented with chronic symptoms, and five had an acute exacerbation of symptoms with the appearance of an acute-on-chronic slip. Of the other two, one had obvious motion at the proximal femoral physis and the other had increased symptoms but did not have an obvious acute slip radiographically. All underwent percutaneous screw fixation. In four patients a single screw was placed, and in three patients two screws were placed. No patient became symptom-free after surgery. Slip progression was noted on average 5 months after treatment. Radiographs in all patients revealed an increase in slip severity and loss of screw purchase in the femoral neck while fixation in the proximal femoral epiphysis remained secure. One patient had hypothyroidism and another Cushing disease, both diagnosed after the slipped epiphysis. Slips occurring in children with underlying endocrinopathies, and unstable slips in children with a history of antecedent knee or hip pain (commonly called an acute-on-chronic slip) may be susceptible to screw fixation failure. In such patients, close radiographic follow-up, particularly in the presence of continued symptoms, is required to document slip progression and fixation failure as soon as possible.

Bone Screws↗