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Biomedical subjects

I V Ponseti

Publications and source records attributed to I V Ponseti.

At least 37 records · Page 2Linked to original sources
PubMed1981

Tibial agenesis.

Tibial agenesis is a congenital defect involving major anomalies of both knee and ankle joints, as well as of the adjacent musculotendinous units. A neoarthrosis at the knee joint was formed in two patients by centralizing the fibular head into the inter condylar notch. A neoarthrosis was also formed at the ankle joint by performing a talectomy and displacing the lateral malleolus over the calcaneus. This allowed independent ambulation in both patients, thus avoiding arthrodesis or amputation.

Adolescent↗
PubMed1981

Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients.

Two hundred and nineteen patients with untreated adolescent idiopathic scoliosis who were seen at the University of Iowa between 1932 and 1948 were studied, and recent information was available on 194 of the patients. The mortality rate was 15 per cent. Backache was somewhat more common in these patients than in the general population, although it was never disabling. The backache was unrelated to the presence of osteoarthritic changes on roentgenograms. Many curves continued to progress slightly in adult life, particularly thoracic curves that had reached between 50 and 80 degrees at skeletal maturity. The lumbar components of combined curves between 50 and 74 degrees also tended to progress. Pulmonary function was affected only in patients with thoracic curves.

Adult↗
PubMed1981

A histochemical study of slipped capital femoral epiphysis.

UNLABELLED: Core biopsies of the proximal femoral growth plate from three patients with slipped capital femoral epiphysis were compared with three normal growth plates from patients of similar ages. The growth plates of patients with slipped capital femoral epiphysis had a normal resting zone, a loose and fibrillated proliferative zone, and a very disarranged and thickened hypertrophic zone. The proliferative zone stained strongly with alcian blue, suggesting the presence of abundant proteoglycans in the cartilage matrix. The thickened hypertrophic zone was strongly positive to periodic acid-Schiff stain, indicating the presence of abundant structural glycoproteins. Enchondral ossification was scanty and irregular, and there were large clusters of cartilage in the metaphysis. Slippage occurred through the thickened proliferative and hypertrophic zones. CLINICAL RELEVANCE: The proximal femoral growth plate in slipped capital femoral epiphysis is histochemically abnormal and histologically disarranged. These features contribute to abnormal widening of the growth plate and to further slippage.

Adolescent↗
PubMed1981

A radiographic study of skeletal deformities in treated clubfeet.

Thirty-two patients with treated unilateral clubfoot deformity were followed for a period of 13 to 30 years. The functional results were satisfactory in 28 feet. A comparison of the skeletal features of the normal and the clubfeet was made on roentgenographs. Many clubfeet had small, slightly flattened talar heads, decreased talocalcaneal angles, undersized or misshapen facets of the subtalar joint, and medially displaced navicular. The residual deformity of the hindfoot was compensated by the lateral displacement and lateral angulation of the cuneiforms with respect to the navicular resulting in a normal alignment of the forefoot in relation to the hindfoot. The range of ankle dorsiflexion, subtalar and midtarsal joint motion was restricted in the clubfeet.

Adolescent↗
PubMed1981

The center of pressure path in treated clubfeet.

The center of pressure paths of foot-floor contact were examined in detail in normal subjects and a group of 44 patients with treated clubfeet. The foot-floor contact areas were wide and the center of pressure paths more variable in clubfeet patients. The center of pressure paths did not always distinguish between normal and abnormal subjects nor between abnormal subjects with varying functional ratings. Foot prints are not sensitive enough to be a diagnostic aid and are of only limited application to the problem of evaluation of treatment of clubfoot deformity.

Adult↗
PubMed1981

Slipped capital femoral epiphysis. Long-term follow-up study of one hundred and twenty-one patients.

We evaluated 121 patients who had had slipped capital femoral epiphysis (149 involved hips) twenty-one to forty-seven years after the diagnosis was made. The results were very good in most of the eighty-three hips with the slip left unreduced. Fifty-four hips that were treated by procedures designed to improve the alignment of the slipped femoral head had more complications and less favorable results, but in general, these were the more severe slips. However, there were enough slips of comparable severity that were treated unreduced to suggest that the long-term results, even in moderate and severe slips, were better after in situ fixation than after operative and manipulative treatment (as performed between 1915 and 1952). Twelve of the thirteen hips with acute slips were reduced (the thirteenth was one of the eighty-three unreduced hips) and aseptic necrosis developed in three, while nine had good results.

Acute Disease↗
PubMed1981

Juvenile kyphosis: histological and histochemical studies.

UNLABELLED: Histological and histochemical studies of the spine of a sixteen-year-old boy with juvenile kyphosis who was killed in an automobile accident showed abnormal cartilage in extensive areas of the vertebral and growth plates of the involved vertebrae. In these areas the cartilage matrix was loose, strongly positive when stained with alcian blue and weakly positive to periodic acid-Schiff, and it contained numerous chondrocytes. Some chondrocytes were irregularly shaped and others were in clusters. Vertebral bone growth was stunted under the areas of abnormal vertebral and growth plates. The ossification in the ring apophyses was irregular in areas of abnormal cartilage plate, but necrotic bone was not seen. Schmorl nodes had formed where areas of abnormal cartilage plate adjoining the nucleus pulposus had collapsed, allowing the disc material to herniate into the vertebral body. CLINICAL RELEVANCE: The defective vertebral-bone formation in juvenile kyphosis appears to result from abnormal vertebral and growth-plate cartilage. The kyphosis and presumably also the cartilage abnormality can be improved during the florid stage of the disease by decreasing the postural load on the anterior part of the vertebrae with the use of a proper brace.

Adolescent↗
PubMed1980

Long-term results of treatment of congenital club foot.

In seventy patients with 104 club feet that were treated at our hospital and followed for ten to twenty-seven years after treatment, the functional results were satisfactory according to our rating system in 88.5 per cent of the feet, and 90 per cent of the patients were satisfied with both the appearance and function of the club foot. However, in the majority of the patients, foot and ankle motion was limited and the talocalcaneal angles as seen on the anteroposterior and lateral roentgenograms were not fully corrected. The amount of motion in the joints of the foot and ankle and the correction of the lateral talocalcaneal angle correlated with the degree of patient satisfaction and the functional rating of the club foot. Transfer of the anterior tibial tendon to the third cuneiform appeared to prevent relapse.

Adolescent↗
PubMed1980

Congenital club foot in the human fetus. A histological study.

Five club feet and three normal feet of fetuses aborted at sixteen to twenty weeks of gestation were studied by making serial histological sections cut in the sagittal, frontal, and transverse planes. In the club feet we found gradations in the severity of the following abnormalities: 1. Altered shape, size, and relationships of the tarsal bones. 2. Decrease in the size and number of fibers in the distal third of the muscles of the posterior and medial aspect of the leg; increased fibrous connective tissue in these muscles, their tendon sheaths, and the adjacent fasciae; and shortening of the triceps surae. 3. Thickening of the distal parts of the tendo archillis and of the posterior tibial tendon. 4. Ligaments on the posterior and medial aspects of the ankle joint pulled into the joint by the severe plantar flexion and varus displacement of the talus, and marked shortening and thickening of the tibionavicular and plantar calcaneonavicular ligaments. On the basis of these pathological findings, the possibility of a retracting fibrosis as the primary etiological factor of the club-foot deformity should be considered.

Ankle Joint↗
PubMed1979

Successful management of popliteal arterial disruption in Ehlers-Danlos syndrome.

A review of the literature on Ehlers-Danlos syndrome with particular attention to vascular complications enabled us to outline an orderly diagnostic and therapeutic plan which has allowed salvage of an individual with a popliteal false aneurysm. In patients with Ehlers-Danlos syndrome and brachial, superficial femoral, or popliteal arterial disruption, the use of proximal tourniquet control to allow ligation of the disrupted artery under a no-flow, no-pressure situation is recommended. The ligations should be carried out with a large ligature or possibly with large hemoclips and/or reinforced with multiple fine atraumatic vascular sutures distally. These patients may be treated successfully for flexion contractures because of the laxness of their tissues.

Adolescent↗
PubMed1979

Acetabular development after reduction in congenital dislocation of the hip.

A study of acetabular development in 148 patients with 185 congenitally dislocated hips treated by closed reduction from 1940 to 1968 showed that eight years after reduction the acetabular index was normal (less than 20 degrees) in 49.2 per cent, satisfactory (from 20 to 24 degrees) in 34 per cent, and poor (more than 24 degrees) in 16.7 per cent. Early treatment led to the best acetabular development. Significant and continuing improvement of the acetabular index was observed between two and eight years after reduction when the femoral head remained concentrically reduced. Failure to maintain proper reduction and necrosis of the femoral head led to poor results.

Acetabulum↗
PubMed1979

Congenital dislocation of the hip.

From January 1970 to December 1976, seventeen patients with twenty-two congenital hip dislocations were treated by open reduction through a medial approach. The average follow-up was 42.2 months. The patients were evaluated for acetabular development, aseptic necrosis, and intraoperative findings. The incidence of aseptic necrosis was 10 per cent. The acetabular index improved rapidly during the first year after reduction. After the first year the rate of development was decreased, but the acetabular index continued to improve throughout the period of study. The medial approach provides a safe, effective way to reduce a dislocated hip in infancy. This procedure is advocated when closed reduction cannot be obtained by gentle manipulation or maintained by positioning once reduction is done.

Acetabulum↗
PubMed1978

Growth and development of the acetabulum in the normal child. Anatomical, histological, and roentgenographic studies.

Postmortem studies of ten normal full-term infants and of three children, seven, nine, and fourteen years old, showed that the acetabular cartilage complex is a unit that is triradiate medially and cup-shaped laterally and is interposed between the ilium, ischium, and pubis. This complex is composed of epiphyseal growth-plate cartilage adjacent to these bones, of articular cartilage adjacent to these bones, of articular cartilage around the acetabular cavity, and, for the most part, of hyaline carilage. Interstitial growth within the triradiate part of the cartilage complex causes the hip socket to expand during growth. The concavity of the acetabulum develops in response to the presence of the spherical femoral head. The depth of the acetabulum increased during development as the result of interstitial growth in the acetabular cartilage, of appositional growth at the periphery of this cartilage, and of periosteal new-bone formation at the acetabular margin. At puberty, three secondary centers of ossification appear in the hyaline cartilage surrounding the acetabular cavity. These centers are homologous with other epiphyses in the skeleton. The os acetabuli, which is the epiphysis of the os pubis, forms the anterior wall of the acetabulum. The epiphysis of the ilium, which has been called the acetabular epiphysis, forms a good part of the superior wall of the acetabulum. A small epiphysis of the ischium was seen in the oldest patient, who was fourteen years old. The bone in these epiphyses expands toward the periphery of the acetabulum and thus contributes to its increase in depth.

Acetabulum↗
PubMed1978

Morphology of the acetabulum in congenital dislocation of the hip. Gross, histological and roentgenographic studies.

At autopsy, the hips of six infants who died soon after birth and had unilateral congenital hip dysplasia were found to have a cartilaginous ridge in the acetabulum which separated the hip socket into two sections. In two of the hips with a moderate degree of dysplasia and in one completely dislocated hip the ridge was formed exclusively by a bulge of acetabular cartilage. In three completely dislocated hips the ridge was formed by a bulge of acetabular cartilage covered by the inverted labrum. The acetabular cartilage showed signs of degeneration whereas the triradiate cartilage was normal. Examination of many newborn infants indicated that hip "clicks" are common and are not diagnostic of hip dysplasia. This diagnosis should be made only when the femoral head slides with a jolt over the acetabular ridge, causing a true positive Ortolani sign. Scattered ossification centers in the acetabular cartilage were seen on the roentgenograms of nearly half of fifty-nine hips with congenital dislocation reduced after the child was two years old, but less frequently in hips reduced at an earlier age.

Abnormalities, Multiple↗
PubMed1977

Congenital pseudarthrosis of long bones: a clinical, radiographic, histologic and ultrastructural study.

Sixteen patients with pseudarthrosis of the tibia and one of the radius were evaluated clinically, radiograpically, and microscopically and separated into 3 groups; 8 had neurofibromatosis clinically, 3 had fibrous dysplasia histologically, and 6 had no evidence of either neurofibromatosis or fibrous dysplasia. Prognosis and therapy were determined by correlated clinical, radiographic, and histological observations. Fracture before age 2 years carried a poor prognosis. Electron microscopy allowed neither differentiation among these fibrous lesions, nor any clue to their origin, nor did it support the concept of a neural or vascular derivation.

Adolescent↗
PubMed1977

The ultrastructure of the growth plate in slipped capital femoral epiphysis.

Core biopsy specimens of the proximal femoral growth plate from three patients with slipped capital femoral epiphysis were studied by light and electron microscopy. In the resting zone, the cartilage matrix was composed of large, densely packed collagen fibrils. The cartilage matrix in the zones of chondrocyte hypertrophy where the slippage occurred contained only scattered fine collagen fibrils in a homogeneous ground substance. The change in composition of cartilage matrix in the distal region of the epiphyseal plate may predispose that region to slippage.

Adolescent↗