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Biomedical subjects

J W Pritchett

Publications and source records attributed to J W Pritchett.

At least 55 records · Page 3Linked to original sources
PubMed1988

Knee arthrodesis with a tension-band plate.

Twenty-six patients had an arthrodesis of the knee using a single anterior, broad, contoured dynamic-compression plate and screws that were applied as a tension band. Bone grafts were not used. No external immobilization was required, and immediate partial weight-bearing was encouraged. The minimum follow-up period was two years, and solid osseous union occurred in each patient. When last seen, all patients were free of pain and could walk without external support. The desired alignment was achieved in each patient, and no complications that were related to this method occurred. Tension-band plating, in our opinion, represents the best method of arthrodesis of the knee that is currently available.

Adult↗
PubMed1988

Growth and predictions of growth in the upper extremity.

Teleroentgenograms of the upper extremity in 244 children (123 boys and 121 girls) were made at six-month intervals from the age of seven to the time of skeletal maturity. Lengths were measured to determine the growth remaining at both growth plates of the humerus, radius, and ulna. The subjects were healthy, well nourished, middle-class Americans, mostly of northwest European descent. After the age of seven, the proportion between the upper and lower arms does not change appreciably. The humerus is 18 per cent of standing height in girls at the age of seven and 19 per cent at the age of fifteen. In boys, the humerus is 18 per cent of standing height at the age of seven and 20 per cent at the age of seventeen. The length of the radius is 13 per cent of standing height in girls at the age of seven, increasing to 14 per cent by skeletal maturity. In boys, the length of the radius increases from 14 per cent of standing height at the age of seven to 15 per cent at skeletal maturity. From the age of seven to skeletal maturity, the humerus grows approximately 1.2 centimeters in girls and 1.3 centimeters in boys each year. In girls, the ulna grows approximately 1.0 centimeter and the radius, 0.9 centimeter each year after the age of seven. In boys, the ulna grows approximately 1.1 centimeters and the radius, approximately 1.0 centimeter each year from the age of seven to skeletal maturity. Based on these data, accurate predictions of growth and of growth discrepancy in the upper extremity can be made, and the time at which to perform equalization procedures can be determined more precisely.

Adolescent↗
PubMed1987

Prosthetic replacement for chronic unreduced dislocations of the shoulder.

Seven patients with chronic dislocations of the shoulder were treated by humeral head or total shoulder replacement. All patients had significant humeral head damage. Three dislocations were posterior and four were anterior. All had been unreduced for at least two months. A Neer prosthesis was used in each patient and the version of the humeral component was altered by 30 degrees-50 degrees away from the direction of the dislocation. Only a sling and swathe was used postoperatively, and the patient was allowed early motion in a limited-goals physical therapy program. There were no redislocations and all patients were improved over their preoperative status. Five patients achieved a good result and two had a fair result based on a 100-unit rating system. One transient axillary nerve palsy occurred, but there were no other complications. Prosthetic replacement for chronic unreduced shoulder dislocations is a reliable procedure when severe humeral head damage exists.

Adult↗
PubMed1986

Lengthening the ulna in patients with hereditary multiple exostoses.

Deformity of the forearm is common in patients with hereditary multiple exostoses, producing cosmetic and functional impairment in which shortening of the ulna is a significant factor. The results of ulnar lengthening in 10 forearms of eight patients are reported. Lengthening was performed by osteotomy of the shaft followed immediately by a bone graft and internal fixation, or by gradual distraction with an external fixator. In all patients the appearance was improved and the range of radial deviation at the wrist was increased. In most patients forearm movement and radial head stability were improved. Partial recurrence of the deformity was seen during the follow-up of skeletally immature patients, but in general ulnar lengthening was found to be a useful operation.

Adolescent↗
PubMed1985

Bilateral symphalangism of the index fingers.

True symphalangism is a rigid digit of normal length. Fusion at the proximal interphalangeal joint is most common, and the index finger is the least likely to be affected. I report the second instance of true symphalangism involving fusion of the distal interphalangeal joints of both index fingers without symphalangism of any other digits. This is the first case reported in a black and was inherited as a simple Mendelian dominant trait.

Ankylosis↗
PubMed1985

Delayed union of humeral shaft fractures treated by closed flexible intramedullary nailing.

Ten patients with humeral shaft fractures and no clinical or radiographic signs of healing after at least six weeks' immobilisation were treated by flexible intramedullary nailing using a closed retrograde technique. Bone grafting was not performed, and active movement was encouraged after operation. Nine fractures healed; the mean time to union was 10.5 weeks (range 6 to 22 weeks). One patient needed compression plating and bone grafting at 22 weeks, and another required re-operation for distal migration of the rods. There were no infections, nerve palsies or other complications. Stiffness of the shoulder which had developed during early treatment improved after operation.

Adult↗
PubMed1984

Entrapment of the median nerve after dislocation of the elbow.

An unusual case of posterior dislocation of the elbow, complicated by entrapment of the median nerve, is reported. Entrapment occurred in the reduction of an associated medial humeral epicondyle fracture. Because the nerve was not in the joint, differentiating the entrapment from a nerve traction injury was difficult. Careful diagnosis and delayed specific surgery can secure an excellent outcome.

Carpal Tunnel Syndrome↗
PubMed1984

The incidence of fabellae in osteoarthrosis of the knee.

I examined radiographs of the knees of 600 men to determine the incidence of fabellae in radiographically normal knees as compared with knees with primary osteoarthrosis. At least a unilateral fabella was present in 106 (35 per cent) of 300 patients with primary osteoarthrosis of the knee. In an age-matched group of 300 patients with radiographically normal knees, only forty-four (15 per cent) had a fabella. The presence of a fabella may represent an atavistic pattern, and the fact that knees with primary osteoarthrosis are more likely to contain a fabella raises the question of whether an atavistic pattern predisposes a knee to osteoarthrosis.

Adult↗
PubMed1984

Supracondylar fractures of the femur.

Twenty-three fractures of the distal femur were treated by open reduction and internal fixation with a compression screw device. Eleven to 34 months of clinical and radiographic follow-up evaluation was available in 19 patients. No nonunions or implant failures and only one deep wound infection occurred. Excellent or good functional and radiographic results were achieved in 74% of patients. Fair results were noted in 16% of patients, and results in 10% were considered failures. The technique is readily mastered and analogous to use of the hip compression screw.

Adolescent↗
PubMed1983

The untreated unstable hip in severe cerebral palsy.

The incidence of pain and other complications associated with the untreated spastic dislocated or subluxed hip was investigated in 80 institutionalized patients. The average patient age was 19 years, and the average length of follow-up study was 12 years. Eighty-five percent of the patients had scoliosis, and 56% had significant pelvic obliquity. A dislocated hip predisposed to lower extremity fractures but did not present problems of pain, decubitus ulcers, or difficulties with perineal hygiene. The loss of sitting balance, scoliosis, and pelvic obliquity are correlated with the severity of neurologic involvement rather than with the mechanics of a dislocated hip.

Adolescent↗
PubMed1982

A statistical study of Knee injuries due to football in high-school athletes.

I analyzed insurance claims for injuries sustained in high-school football over a three-year period in six western states. Nineteen and one-half per cent of the players sustained at least one injury per season, of which 12.7 per cent were knee injuries. Follow-up questionnaires completed by 529 (81 per cent) of the injured players showed that 394 had been diagnosed as having ligament injuries; eighty-eight, internal derangement of the knee; and forty-seven, patellar injuries. Twenty-six per cent of the patients with ligament injuries had further injury to the involved knee. Fifty-nine per cent of the patients with internal derangement of the knee had subsequent injury to the same knee. Eighty-seven per cent of the patients with patellar injuries had a subsequent injury to the involved knee and an increased incidence (34 per cent) of injury to the contralateral knee.

Adolescent↗
PubMedDate not supplied

Inferior subluxation of the humeral head after trauma or surgery.

Inferior subluxation of the humeral head can occur after shoulder trauma or surgery. One hundred consecutive patients were evaluated prospectively after shoulder surgery or injury. The radiographic incidence of inferior subluxation of the humeral head 2 weeks after rotator cuff repair was 10%. The radiographic incidence of inferior subluxation after fracture of the proximal humerus was 42%, and the incidence 2 weeks after prosthetic humeral head replacement was 60%. The immediate postoperative radiograph showed an inferior subluxation of the humeral head in 4% of patients after prosthesis insertion, but no subluxations were seen immediately after rotator cuff repair. Radiographs made immediately after fracture of the humerus showed a 16% incidence of inferior subluxation. The inferior subluxation resolved by 6 weeks in 92% of patients with humeral fractures, 96% of patients with humeral head prostheses, and all patients who had undergone rotator cuff repair. No subluxations were seen 2 years after injury or surgery. The treatment used--early active exercises and a sling when not exercising--was effective.

Adult↗
PubMedDate not supplied

Growth and development of the distal radius and ulna.

Deformities of the wrist and forearm may result from growth disturbance of the radius and ulna. Normal growth patterns were established by measuring the distance between the distal radial and ulnar growth plates in 244 children. The subjects were healthy, well-nourished, middle-class Americans, mostly of Northwest European descent. After the age of 5 years, the distance between the distal radial and distal ulnar growth plates progressively decreased from a mean of 6 mm to a mean of zero by age 13 in girls and age 15 in boys. These measurements are helpful in determining the normal appearance of the wrist during growth and in the early detection of growth discrepancy.

Adolescent↗
PubMedDate not supplied

Mechanical factors in slipped capital femoral epiphysis.

We performed three-dimensional force analyses on the hips of 50 normal patients and 50 patients with slipped capital femoral epiphysis to determine if mechanical factors alone could account for slips. We found that slipped epiphysis patients have reduced resistance to shear because of increased body weight and a decreased neck shaft-plate shaft angle. Slipped epiphysis patients have relative retroversion, and this generates increased sagittal plane shear stress at the proximal femoral growth plate. We suggest that, during running, these mechanical factors cause shear failure of the growth plate in obese adolescents.

Adolescent↗