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Biomedical subjects

L F Hubbard

Publications and source records attributed to L F Hubbard.

9 recordsLinked to original sources
PubMed1988

Metacarpophalangeal dislocations.

Although MCP joint dislocations are much less common than PIP dislocations, they present a unique set of problems. MCP dislocations usually require open reduction. The obstructions to reduction include the volar plate, interposed ligaments, and the finger-trap effect of intrinsics and flexor tendons. The key to management of such injuries is proper identification of the dislocation type, use of open reduction where necessary, and an aggressive postinjury rehabilitation program. Complications of these injuries do occur, and they must be identified and managed properly.

Combined Modality Therapy↗
PubMed1985

Free vascularized fibula transfer for stabilization of the thoracolumbar spine. A case report.

Anterior strut grafting for kyphosis has become an accepted procedure. High stresses are placed across these grafts, however, and it would seem advisable to use a living bone graft that could remodel in response to these stresses, rather than an avascular graft of fibula or rib such as is commonly employed. This case report demonstrates the use of a free, vascularized living bone graft in the treatment of a post-traumatic kyphosis, with successful subsequent incorporation into the anterior fusion mass.

Adult↗
PubMed1983

Computed tomography in orthopedics.

The enormous interest in CT scanning appears fully justified as this remarkable technique continues its development. In orthopedics, it has a variety of roles to play: in trauma, tumor management, and developmental disorders. As experience with the CT scan in musculoskeletal disease is accumulated, new applications will undoubtedly become apparent, adding to the already impressive list.

Bone Diseases↗
PubMed1983

Total joint replacement in the upper extremity.

Prosthetic replacement of the joints of the upper extremity relieves pain, mitigates deformity, and improves function. As newer designs of prostheses are tested, we expand our knowledge of the biomechanics of each joint. Newer materials are rapidly changing the variety of implants on the market and improving prosthetic function. The problem of fixation of the noncemented prostheses to viable bone tissue remains one of the major unanswered questions for orthopedic surgeons today. Extensive research around the world is underway; different means of providing the environment that allows biologic ingrowth with fixation of a prosthesis are being investigated, thus avoiding the use of methyl methacrylate and its inherent problems.

Arm↗
PubMed1982

Computed axial tomography in musculoskeletal trauma.

In the evaluation of patients with musculoskeletal trauma routine X-ray studies are often limited by difficulty in delineating overlapping structures and tissues of similar density. Computerized axial tomography (CT) has proven to be of great value in many diagnostic situations in orthopaedic surgery, particularly in the evaluation of mass lesions. This new technique resolves many of the problems of standard X-rays. It is noninvasive, and can be safely employed in the evaluation of critically ill patients. To assess the usefulness of this technique to trauma, computerized axial tomography has been employed in the diagnosis of injuries of the spine and acetabulum. CT studies of 26 patients with spinal injuries demonstrated accurate localization of displaced bone fragments and other elements of fracture anatomy, obviating the need for myelography. CT scanning of 28 fractures of the acetabulum defined intra-articular fragments and precise details of fracture lines. The additional data provided by CT scanning in these patients was a major asset in the management of their injuries. It influenced the decisions in regard to the need for surgery, and when surgery was indicated, the data helped to define the most appropriate operative approach. Use of the CT did not delay therapy or cause any complications. This experience with spinal injuries and fractures of the acetabulum indicates that computerized axial tomography is a valuable adjunct to the management of musculoskeletal trauma.

Acetabulum↗
PubMed1982

Radiation therapy in the prevention of heterotopic ossification after total hip arthroplasty.

The administration of radiation to prevent heterotopic bone formation after total hip arthroplasty has been highly successful in this prospective study. It was extremely effective in high-risk patients, including those with preexisting heterotopic ossification. No early deleterious effects were noted. Long-term follow-up is planned to observe for late tumor induction. No wound complications were encountered. Trochanteric nonunions did occur and may be in part related to the radiation. This study demonstrated the importance of the early initiation of treatment. Ninety-eight percent of high-risk patients who began treatment on the second to fourth day postoperatively were free of heterotopic bone after surgery. Meticulous technique is always employed to eliminate debris in the surgical wound, and soft tissues are handled carefully. The search continues for a more complete explanation of the pathogenesis of heterotopic bone formation. A current study has been constructed to demonstrate the minimum dose of radiation that will continue to be effective. Further evaluation of methods to more accurately identify the high-risk patient continues. The effectiveness of radiation therapy in the prevention of heterotopic bone following total hip replacement has been shown.

Aged↗
PubMed1977

Malignant fibrous histiocytoma of the forearm: report of a case and review of the literature.

The tissue histiocyte can give rise to a variety of lesions, either benign or malignant, and the latter often is confused with other sarcomas. The multipotential nature of the histiocyte results in the presence of at least five different cell types in these tumors, and all may be derived from a common precursor cell. The anaplasia of elements which differentiate as fibroblasts appears to correlate with survival. The tumors may be highly malignant, and the 10 year survival rate approximates 40%. Aggressive surgical management of these tumors is mandatory, with either wide en bloc resection or primary amputation of the involved extremity. Should the tumor recur locally after a wide resection and there be no detectable metastases, prompt amputation is indicated.

Female↗