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Biomedical subjects

L A Rinsky

Publications and source records attributed to L A Rinsky.

36 records · Page 2Linked to original sources
PubMed1981

Moiré phototopography in the evaluation of anterior chest wall deformities.

One of the major remaining problems in the management of children with anterior chest wall deformities is the lack of a widely accepted objective method of evaluating the severity of the deformity. This deficiency has made it difficult to evaluate indications for operation or the results of operative repair. Moiré phototopography is a new method of accurately measuring human body contours utilizing recent developments in applied optics and has been used successfully in scoliosis screening programs. This technique has been applied to the evaluation of anterior chest wall deformities and the initial results of this study are presented. Moiré phototopography has proven to be a sensitive, reproducible, and easy to perform method of quantitating pectus deformities. While further evaluation is required, this early experience suggests this technique may provide a means of accurately and objectively measuring chest wall deformities so that their physiologic significance can be precisely investigated and the results of therapy critically reviewed.

Adolescent↗
PubMed1981

Perspectives on surgery for scoliosis in mentally retarded patients.

The goals of surgery in the retarded patient with spinal deformity are to maximize function (for example, free the hands, decrease the occurrence of pressure sores, and so forth). Concomitantly, the goal while treating the patient should be to minimize the interference with social, intellectual, and general development while counting on no operation by the patient. The new tools of internal fixation available to the surgeon have made spinal surgery possible in these patients despite their lack of cooperation and their other medical problems, seizures, and spasticity. Although combined Dwyer instrumentation with subsequent posterior Harrington instrumentation or posterior fusion and Harrington instrumentation alone have been used most commonly, recent favorable experience suggests a larger role for segmental stabilization of the spine because of the greater purchase on the spine and the lack of need for prolonged external mobilization.

Adolescent↗
PubMed1979

Coccidioidomycosis of the spine: unusual roentgenographic presentation.

Vertebral osteomyelitis is a frequent consequence of disseminated coccidioidomycosis. In a 25-year-old man, the sequela was a single level unilateral osseous bridge between the second and third lumbar vertebra. A review of previous cases has disclosed one case with a similar roentgenographic picture. The occurrence of a single level unilateral reactive process should arouse suspicion of a localized chronic bone infection.

Adult↗
PubMed1976

Reflection on the 1976 Toronto Olympiad for the physically disabled.

A report is given on the various aspects of the 1976 Olympiad of the Physically Disabled. The aspects discussed are the historical background, planning and preparation of the Games, accommodation for amputees, blind and paraplegics, transport, games site, organisation of sports events, medical supervision, publicity of the Games, standards of performance and records and last, but by no means least, politics and sport.

Canada↗
PubMedDate not supplied

Combined occipitoatlantoaxial hypermobility with anterior and posterior arch defects of the atlas in Pierre-Robin syndrome.

Combined occipitoatlantoaxial instability of the cervical spine occurred in a 8-year-3-month old boy with Pierre-Robin syndrome. He also had failure of ossification of both the anterior and posterior arches of the atlas. An in situ fusion from the occiput to C2 restored cervical spine stability. This case is discussed in relation to other hypermobility and instability syndromes of the cervical spine.

Atlanto-Axial Joint↗
PubMedDate not supplied

Coxa magna following surgical treatment of congenital hip dislocation.

We studied coxa magna after operative treatment of congenital dislocation of the hip, including incidence, relationship to treatment, and influence of coxa magna on the acetabulum. Coxa magna was defined as a femoral head with a horizontal diameter at least 15% greater than the symmetrical position on the opposite side. Coxa magna developed in 16 hips (33%). The mean increase was 20.9% (range 15-30%). Three factors correlated with coxa magna: femoral osteotomy (100%), open reduction (75%), and operation at a younger age (mean 15.6 vs. 35.8 months). Four of the 16 hips developed coxa magna following Type 1 avascular necrosis; no other growth deformities appeared. At follow-up, the acetabular indices and the center edge angles were not statistically different between the coxa magna and the control groups. One must avoid confusing coxa magna with hip subluxation or inadequate reduction, of which the latter requires appropriate treatment. Coxa magna gives a good hip if a concentric, congruous reduction is obtained, providing the acetabulum has enough growth potential for remodeling.

Child↗
PubMedDate not supplied

Segmental instrumentation without fusion in children with progressive scoliosis.

Nine young children had segmental spinal stabilization without fusion for progressive scoliosis. External bracing was not used. There were no immediate complications, but at a mean follow-up of 28 months, the mean loss of correction was 32% and only four patients maintained the initial correction. The mean interval spinal growth was only 0.8 cm. Rods failed in three patients, requiring revision and fusion. Thus, the early results of this technique are discouraging.

Braces↗
PubMedDate not supplied

Chronic recurrent multifocal osteomyelitis: a distinct clinical entity.

We reviewed the cases of five children with the diagnosis of chronic recurrent multifocal osteomyelitis (CRMO) and compared and contrasted them to 11 cases of subacute osteomyelitis. Significant differences were found between these two groups in the number of cases with positive biopsy cultures, number of clinical episodes, and number of bones involved. In CRMO, cultures are negative, and recurrent clinical episodes involve different bones at different times. The data indicate that CRMO is a distinct clinical entity, different from subacute osteomyelitis; it is a benign, self-limiting inflammatory disease of bone, and no chronic problems have occurred as a result of CRMO. Restraint in antibiotic treatment and in performing repeated biopsies is indicated in CRMO.

Adolescent↗
PubMedDate not supplied

Kingella kingae infection in healthy children.

Kingella kingae is a gram-negative occasional, but normal, inhabitant of the nasopharynx. We present two new cases of this infection that occurred in previously healthy children, and compare and contrast them to other cases reported in the literature. K. kingae osteomyelitis generally has an insidious, subacute onset, whereas septic arthritis has an acute presentation. To date, all strains of K. kingae have been sensitive to penicillin, and no residual damage has been reported following osteomyelitis or septic arthritis, except that residual disk space narrowing did occur after K. kingae discitis.

Acute Disease↗
PubMedDate not supplied

Complications of intramedullary rods in osteogenesis imperfecta: Bailey-Dubow rods versus nonelongating rods.

Twenty-nine patients with osteogenesis imperfecta underwent 108 intramedullary roddings with 42 Bailey-Dubow rods and 66 nonelongating rods. The average age at insertion of the first rod was 5 years; average follow-up was 3.1 years (range 1-9 years). The overall complication rate was 60%-69% for Bailey-Dubow rods and 55% for nonelongating rods. Forty-seven percent of bones receiving rods required reoperation. Nonelongating rods had a 29% reoperation rate and a 24% replacement rate; Bailey-Dubow rods had a 19% reoperation rate and a 12% replacement rate.

Adolescent↗
PubMedDate not supplied

Simultaneous correction of pelvic obliquity, frontal plane, and sagittal plane deformities in neuromuscular scoliosis using a unit rod with segmental sublaminar wires: a preliminary report.

Ten patients with neuromuscular scoliosis and pelvic obliquity had segmental spinal instrumentation using a unit Luque rod with sublaminar wires and fixation into the pelvis. Nine of the 10 patients also had anterior spinal fusion without instrumentation before the posterior procedure. Average preoperative pelvic obliquity was 42 degrees which was corrected to 6 degrees (82% correction). Average preoperative scoliosis was 92 degrees, which was corrected to 16 degrees (81% correction). Complications included a wound hematoma in one patient and a superficial wound dehiscence in another. There have been no pseudarthroses or hardware failures to date. Excellent correction of the pelvic obliquity and the spinal curve in neuromuscular scoliosis can be obtained with use of a unit rod and without use of anterior instrumentation.

Adolescent↗
PubMedDate not supplied

Transverse cervicopertrochanteric hip fracture.

A 3-year-old boy sustained a previously undescribed transverse hip fracture that involved the cervical, cervicotrochanteric, and intertrochanteric regions. The fracture was successfully treated with skeletal traction for 4 weeks using a Steinmann pin placed through the distal femoral metaphysis followed by spica cast immobilization. The 3-year follow-up examination demonstrated satisfactory growth and remodeling of the proximal femur with no evidence of osteonecrosis, premature physeal closure, or coxa vara.

Casts, Surgical↗
PubMedDate not supplied

Electromyographic differentiation of diplegic cerebral palsy from idiopathic toe walking: involuntary coactivation of the quadriceps and gastrocnemius.

Clinical differentiation of patients with mild diplegic cerebral palsy (CP) and idiopathic toe walking (ITW) can be difficult. However, an involuntary extensor pattern may be a distinguishing sign. The purpose of this study was to determine if selected gait parameters or patterns of electromyogram (EMG) timing of quadriceps, gastrocnemius, and tibialis anterior during knee extension while sitting can distinguish between these patients. The hypothesis was that EMG testing for selective control of the quadriceps and gastrocnemius could differentiate patients with diplegic CP from normal controls and from patients with ITW. We evaluated 10 control, eight CP, and eight ITW subjects. Measurements included walking speed, energy expenditure index (EEI), ankle position during stance, and EMG of the quadriceps, gastrocnemius, and tibialis anterior during gait and during knee extension while sitting. Dynamic EMG timing during gait showed significant differences in the mean onset of the gastrocnemius between subjects with CP and ITW, but there was considerable overlap. More consistent differences were found during active and active-resisted knee extension while sitting. Mean values for gastrocnemius EMG timing recorded as a percentage of duration of quadriceps EMG while sitting were 0 and 0.4% for controls, 0 and 3.9% for ITW subjects, and 84.3% and 93.4% for CP subjects. Patterns of EMG timing of the quadriceps and gastrocnemius during knee extension while sitting can help to differentiate patients with mild diplegic CP from those with ITW.

Cerebral Palsy↗
PubMedDate not supplied

Electromyographic test to differentiate mild diplegic cerebral palsy and idiopathic toe-walking.

The purpose of this study was to determine whether children with mild spastic diplegic cerebral palsy (CP) could be differentiated from those with idiopathic toe-walking (ITW) based on an obligatory coactivation during voluntary contraction of the quadriceps or gastrocnemius. Twenty-four subjects participated in this study, eight children with mild spastic diplegia CP, eight with ITW, and eight age-matched controls. Measurements included passive range of motion and surface electromyographic recordings of the lateral quadriceps and lateral gastrocnemius. Electromyographic recordings were obtained during resisted knee extension with knee flexed 30 degrees, isometric quadriceps contraction with knee extended (quad set), active plantarflexion, and during gait. The range-of-motion values were not different between the CP and ITW subjects, with the exception of the popliteal angle, which was greater in subjects with CP, with an overlap in values. Gait electromyography showed premature firing of gastrocnemius in swing in both groups of subjects compared with controls. During resisted knee extension and quad set, the mean duration of gastrocnemius coactivation in subjects with CP was high: 86% and 86% compared with 20% and 35% for the subjects with ITW and 0.4% and 3% for controls, respectively. Voluntary plantarflexion did not consistently elicit coactivation of the quadriceps. The results suggest that electromyographic testing of resisted knee extension and quad set to identify gastrocnemius coactivation can help differentiate patients with mild CP from those with ITW.

Case-Control Studies↗
PubMedDate not supplied

Simple method of documenting metatarsus adductus.

A simple, accurate, and inexpensive method of documenting metatarsus adductus involves taking photocopies of the foot in the weightbearing position. Subsequently, treatment progress can be assessed objectively by reviewing serial photocopies. Some caution is urged because the strength of the glass copying surface of photocopying machines is unknown.

Copying Processes↗