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Biomedical subjects

J P Browett

Publications and source records attributed to J P Browett.

9 recordsLinked to original sources

Treatment of delayed- and non-union of fractures using pulsed electromagnetic fields.

A prospective series of 32 consecutive patients, with 33 long-bone fractures suffering from delayed- or non-union were treated by pulsed electromagnetic fields (PEMF) or by PEMF with surgery. The management regime for the PEMF treatment was simpler and less rigid than that reported by Bassett et al. and our stimulation waveform was also different. Nineteen fractures (100%) treated with surgery and PEMF united within nine months of the commencement of PEMF treatment. Fourteen fractures were treated with PEMF alone. Twelve (86%) united within ten months and two failed to unite. The results of this study suggest that the stimulating waveform is less critical than is claimed by Bassett et al. and that a simpler and easier management regime for PEMF treatment can be just as effective. Alternatively PEMF may have no effect on fracture healing.

Adult↗

Delayed median nerve injury due to retained glass fragments. A report of two cases.

Two cases of delayed median nerve division after laceration of the wrist by glass are described. In both there was no neurological damage at the time of the original injury. However, retained fragments of glass were subsequently responsible for division of the median nerve in both cases and of the surrounding tendons in one. Radiographs were an important diagnostic aid in treating the delayed injury.

Adult↗

Ruptured femoral vein. A complication of the use of gentamicin beads in an infected excision arthroplasty of the hip.

Despite widespread use of gentamicin beads in the treatment of chronic infections of bone and soft tissue, no serious complications have been reported. This report describes a rupture of the femoral vein which occurred during the attempted removal of a chain of beads after radical excision of a chronically discharging Girdlestone arthroplasty. The patient later had a disarticulation at the hip. In the light of our experience with this and other cases we offer some suggestions as to the positioning of gentamicin beads, as well as the timing and method of their extraction.

Aged↗

Osteoarthritis of the hip: the patient behind the disease.

Previous epidemiological studies suggested that patients with osteoarthritis (OA) of the hip might constitute a definable subset of the population with characteristics that predispose them to joint failure. To investigate this possibility a comparative study of somatotype, bone density, disc degeneration, polyarticular joint degeneration, and soft-tissue calcification was carried out in 3 groups of individuals: (1) patients presenting with OA of the hip; (2) patients with acute femoral neck fracture; (3) healthy controls. OA of the hip was rare in patients with femoral neck fracture; conversely, patients with coxarthrosis did not have the low values for bone density seen in the fracture group. There were significant differences in somatotype in the 2 patient groups; 94% of those with OA were endomorphic mesomorphs. Polyarticular OA occurred with the same prevalence in the 2 groups of women, but among males there was a significantly greater involvement of knees and hands in the OA group than in the fracture group. The highest incidence of joint calcification was found in the fracture group and the lowest in the OA group. It was concluded that patients with OA of the hip form a definable subset of the general population. Within this group the appearances of hip OA are determined by 3 interacting factors: mechanical stress, cartilage degeneration, and bone response.

Aged↗

The use of suction drainage in the operation of meniscectomy.

A prospective trial has been carried out to determine the value of suction drainage in the operation of meniscectomy. One hundred operations were analysed, in half of which drains had been used. The use of the drain could not be shown to result in any sustained advantages. The demand for analgesics after the operation was reduced but not to a statistically significant level. The size of the early effusion was significantly reduced, but this benefit was lost when the knee was mobilised. The return of power to the quadriceps and of movement to the knee were not hastened. The average volume of fluid drained was 134 millilitres and it has been shown that forty-eight hours is a suitable time for removal of the drain. The use of suction drainage is not advocated for the uncomplicated operation of meniscectomy.

Cartilage, Articular↗

Appendicitis and mimicking conditions. A prospective study.

A prospective study of 444 consecutive patients diagnosed as having acute appendicitis was carried out in a district general hospital. The appendix was acutely inflamed, gangrenous, or perforated in 346 patients. Diagnostic error, 22% overall, was twice as common in females as in males. Organisms were isolated from the outer appendix wall in 117 patients, isolation increasing with the severity of inflammation. 12% of children under 11 had mesentric adenitis, 10% of all females had gynaecological lesions, and 14% of patients over 50 had acute diverticulitis. In only 6% of patients was no abnormality found at operation, and in every case the disorder was dealt with through the gridiron incision.

Abdomen, Acute↗