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Biomedical subjects

J F Keating

Publications and source records attributed to J F Keating.

46 records · Page 3Linked to original sources
PubMed1993

The detection of fat embolism by transoesophageal echocardiography during reamed intramedullary nailing. A study of 24 patients with femoral and tibial fractures.

We performed transoesophageal echocardiography on 24 patients during reamed intramedullary nailing of 17 tibial and seven femoral fractures. In 14 patients there was only minimal evidence of emboli passing through the heart, but in six copious showers of small emboli (< 10 mm maximum dimension) were observed. In four other patients, there were also multiple large emboli (> 10 mm maximum dimension). Three of these patients developed fat embolism syndrome postoperatively and one died. Earlier nailing was associated with smaller quantities of emboli.

Adolescent↗
PubMed1992

Reduction of seating pressure using FES in patients with spinal cord injury. A preliminary report.

The aim of this study was to investigate the use of functional electrical stimulation (FES) as a means of pressure sore prevention in seated spinal cord injured (SCI) subjects. Nine SCI subjects took part in tests in which electrical stimulation was applied to the quadriceps with the lower legs restrained. Ischial pressures were measured during periods of quiet sitting and FES application. A strain gauged lever arm was used to measure the knee moment during quadriceps stimulation. The average pressure drop at the right and left buttocks was 44 mmHg and 27 mmHg respectively. In general the greatest reductions occurred in subjects with larger knee moments; however, there was no direct relationship between the pressure reduction obtained and the quadriceps strength. This form of FES may be useful as a prophylactic aid in the management of pressure sores in SCI subjects.

Adult↗
PubMed1992

Infection after intramedullary nailing of the tibia. Incidence and protocol for management.

There is concern about the incidence and serious nature of infection after intramedullary nailing of the tibia, especially for open injuries. We have reviewed 459 patients with tibial fractures treated by primary reamed nailing. The incidence of infection was 1.8% in closed and Gustilo type I open fractures, 3.8% in type II, and 9.5% in type III fractures (5.5% in type IIIa, 12.5% in type IIIb). These incidences appear to be acceptable in comparison with other published results. We describe the different modes of presentation of infection in these cases, and suggest a protocol for its management, which has been generally successful in our series.

Age Factors↗
PubMed1991

Management of tibial fractures with the orthofix dynamic external fixator.

We report our experience with the use of the Orthofix external fixator for the management of closed and open tibial fractures. One hundred fractures were treated in 96 patients between May 1985 and December 1989. There were 47 closed and 53 open fractures. Of the open fractures, 11 were grade I, 16 were grade II and 26 were grade III. Forty-five closed fractures and 49 open fractures went on to solid bony union in an average of 15.2 and 20.5 weeks, respectively. Non-union requiring operative intervention occurred in two closed and four open fractures (6%). The other main complications were pin track infection (30% of cases) and malunion which occurred in 14% of closed fractures and 32% of open fractures. We concluded that dynamic axial fixation is a useful method of treatment for open and difficult closed tibial fractures. Our experience indicates that malunion and pin track infection remain common problems and have still to be overcome.

Adolescent↗
PubMed1991

Arthroscopic decompression of meniscal cysts: report of 14 cases.

Meniscal cysts are a painful disorder of the knee affecting young to middle-aged adults. The recommended treatment has been total meniscectomy. With the widespread use of arthroscopic surgery there has been a trend to a more conservative management of meniscal pathology in general. We treated 14 patients with meniscal cysts (13 lateral, one medial) by partial arthroscopic meniscectomy and decompression. At a mean follow-up of 19 months, results were satisfactory in 12 patients; there was one recurrence and one patient had reinjured his knee. We concluded that arthroscopic decompression of meniscal cysts is a promising form of treatment.

Adult↗
PubMed1990

Proximal femoral replacement for pathological fracture.

Nine patients presented to our unit with extensive metastatic destruction of the proximal femur. The extent of bone loss precluded the use of standard methods of fixation. We undertook proximal femoral replacement as a palliative treatment to restore mobility and relieve pain. Six patients mobilized satisfactorily postoperatively. Three patients did not regain independent mobility and died within 4 weeks of surgery. The major complication was dislocation, which occurred in two patients. The mean postoperative survival was 8 months. We believe proximal femoral replacement is a useful palliative procedure in selected cases of metastatic disease of the femur.

Adult↗
PubMed1990

Carotid body tumours: report of six cases and a review of management.

We have treated six patients with carotid body tumours in the period from 1972 to 1988. All patients had a neck mass on presentation. In addition one patient complained of tinnitus and another was noted to have Horner's syndrome. The diagnosis was confirmed by ultrasound and angiography in all cases. Five patients subsequently underwent successful surgical resection. At the time of surgery one of the tumours was found to be locally invasive. One elderly patient was deemed unfit for surgery and was managed non-surgically with a satisfactory outcome. A review of the literature reveals that surgery is still the preferred mode of treatment although preoperative embolization may be a useful adjunct. Although the incidence of peroperative stroke has gradually been reduced from that found in earlier series, injury to the cranial nerves remains high and is the main hazard of surgical management. The improved results of surgical resection in more recent reports support the view that these tumours should be treated in units with expertise in vascular surgery of the neck.

Adult↗
PubMedDate not supplied

The use of functional electrical stimulation to assist gait in patients with incomplete spinal cord injury.

The use of FES (functional electrical stimulation) for gait reproduction in six patients with spinal cord injury is described. Following a detailed neuromuscular assessment the patients commenced a muscle conditioning programme using electrical stimulation applied via surface electrodes. Once patients were strong enough to stand, gait synthesis was initiated in the laboratory utilizing a programmable electrical stimulator. When a satisfactory gait pattern had been achieved, patients used their portable stimulator at home. All six patients became able to stand and walk using the FES system and completed the home phase of the programme. Three patients continue to use the system at home for exercise and walking; the other patients have discontinued using the system, preferring a wheelchair or their original orthoses. We conclude that FES-assisted walking is feasible in patients with incomplete spinal cord injury, even with severe motor loss. Further advances in technology are needed for the system to become applicable to a larger number of patients.

Adolescent↗
PubMedDate not supplied

Minimal trauma causing fractures in patients with spinal cord injury.

The osteoporosis that accompanies spinal cord injury renders bones more susceptible to fracture following minor degrees of trauma. Diagnosis is often delayed due to a subtle presentation with non-specific signs. Three cases are reported that illustrate characteristic features of long-bone fractures in spinal cord injury.

Accidental Falls↗