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Biomedical subjects

J R Fisk

Publications and source records attributed to J R Fisk.

11 recordsLinked to original sources
PubMed1999

Passive dynamics of the knee joint in healthy children and children affected by spastic paresis.

OBJECTIVE: The purposes of this study were (1) to evaluate how changes in biomechanical parameters affect segment dynamics in children and (2) to determine whether the biomechanical parameters were changed in children with spastic paresis. DESIGN: In vivo measurements were collected of knee viscoelastic properties. Background. It is unknown if the inertial and viscoelastic properties of a human growing limb should be considered in motor performance. Also unclear are whether changes in passive dynamics might be responsible for abnormal control in human spastic paresis. METHOD: Small oscillation techniques were used to measure moment of inertia of lower leg, stiffness and viscous damping of the knee joint. Eighty seven healthy children and 32 children with spastic paresis participated. RESULTS: Moment of inertia, stiffness and the damping changed with the fifth power of child's height. Dynamic equation of motion parameters were a constant, independent of the child's height. Passive viscoelastic parameters were not changed in spastic patients. CONCLUSIONS: Inertial and viscoelastic properties of a growing limb segment should not be considered in motor performance. Passive viscoelastic properties were not changed in patients with spastic paresis and, therefore, cannot be responsible for abnormal control in human spastic paresis. RELEVANCE: There is no need to adapt control patterns in children (ages 6-18). Passive viscoelastic parameters cannot be used as a descriptor of spasticity.

Adolescent↗
PubMed1983

Back schools. Past, present, and future.

Back schools are playing an ever increasing role in the nonsurgical management of patients with low back pain. With different studies reporting that from 50% to 85% of adults seek medical attention for low back pain, there is a need for increasingly effective treatment and rehabilitative programs. The multiple factors that determine a patient's symptom complex are ill defined. The commonly applied therapeutic approaches are not well understood and have been difficult to evaluate. Back schools appear to be empirically effective but are still being critically evaluated.

Back Pain↗
PubMed1980

The lumbosacral curve in idiopathic scoliosis. Its significance and management.

In 850 consecutive patients with idiopathic scoliosis, no primary lumbosacral curve with only secondary curves above it was found. Forty-four patients with double structural thoracic and lumbar, single structural thoracic, and single structural lumbar curves showed progressive loss of flexibility in the lumbosacral area. Of these, five patients had correction and fusion of the lumbosacral curve and seventeen had correction and fusion of the major curve above the third or fourth lumbar segment without surgical treatment of the lumbosacral area. The results were better in the latter group. Correction and fusion in the lumbosacral area was difficult to achieve. No patient had a permanent list when only curves above the lumbosacral curve were corrected and fused. Lumbosacral fusion should be reserved for primary lumbosacral curves associated with congenital anomalies or spondylolisthesis.

Adolescent↗
PubMed1979

Myopathy limited to the quadriceps and gastrocnemius muscles occurring in three brothers.

This is a report of three cases of myopathy limited to the quadriceps and gastrocnemius muscles, occurring in the male offspring of the same mother but two different fathers. They have many similarities to a previously described clinical syndrome called quadriceps-confined myopathy. The pedigree demonstrates an apparent sex-linked recessive condition which has not been demonstrated previously. Information gained from a review of the literature is related to these three cases. It is suggested that these cases are part of a poorly defined clinical entity and that a new classification of quadriceps-gastrocnemius muscular dystrophy be introduced.

Adolescent↗
PubMed1978

Scoliosis, spondylolysis, and spondylolisthesis. Their relationship as reviewed in 539 patients.

Five hundred consecutive idiopathic scoliosis patients in whom routine oblique roentgenograms of the lumbosacral area were obtained, plus 39 patients with a presenting problem of spondylolisthesis, were reviewed in an attempt to answer questions concerning the best therapeutic approaches in patients having coincident scoliosis and pars defects. The incidence of pars defects in patients with idiopathic scoliosis was found to be 6.2%, slightly higher than in the white female population at large. The indications for a surgical approach to the pars defect and/or the spinal curvature parallel the indications for each problem arising independently.

Adolescent↗
PubMedDate not supplied

Development of septic arthritis by hematogenous seeding in a pediatric patient with burns.

We describe a pediatric patient with burns who experienced a septic hip joint from hematogenous seeding by sustained Staphylococcus aureus bacteremia. A search for a central vascular focus of the bacteremia included the use of an indium scan, which localized purulence within the left hip joint. The physical findings, radiographic findings, and subsequent aspiration of the hip joint were diagnostic for a septic arthritis. This case alerts the physician that the pediatric hip is a potential site for infection in the presence of bacteremia. Once infected, the joint may become a secondary source of an ongoing bacteremia. The diagnostic work-up and treatment for a septic hip have been discussed. This occult site of infection is easy to overlook because a painful hip joint in the pediatric patient with burns may be confused for painful burn wounds. The prerequisites to joint infections in this population were all present: bacteremia, intercurrent illness, unique vascular anatomy, and an impaired immune response.

Arthritis, Infectious↗
PubMedDate not supplied

The mechanical consequence of failure of ossified union in attempted posterior spinal fusion. A canine model.

The mechanical behavior of pseudarthrosis in posterior spinal fusion was investigated. A canine model was developed in which an incompletely ossified posterior fusion mass was consistently produced. The spines were excised, and the motion segments were mechanically tested using a specially developed loading apparatus. Tests were performed to evaluate stiffness of the segments to loading with compression, torsion, and anterioposterior and lateral bending shear stiffness. Changes in other modes of loading were less consistent. The motion characteristics of the pseudarthrosis could not be predicted from the extent of the osseous defect noted on roentgenograms. These findings correlate clinically with the progression of curvature seen with pseudarthrosis in scoliosis surgery and the unpredictable results of pseudarthrosis in posterior fusion performed in treatment of degenerative disc disease.

Animals↗
PubMedDate not supplied

Spontaneous fusion in scoliosis after instrumentation without arthrodesis.

The technique of subcutaneous rod insertion without exposure of the curve has been proposed as a method of controlling the progression of scoliosis while allowing the spine to grow. We review the literature and present three patients whose spines spontaneously fused unexpectedly while undergoing this form of treatment. The fusion occurred posteriorly, and continued anterior growth led to increased deformity from the crankshaft phenomenon. Based on this experience, the authors recommend careful follow-up and early anterior fusion when the crankshaft phenomenon is observed.

Child↗