Biomedical subjects
Publications and source records attributed to L R Irwin.
We present a case of a Galeazzi-type of fracture dislocation with an irreducible distal radioulnar joint. This is illustrated by intraoperative pictures which may assist others who find themselves faced with this injury.
Rapidly progressive cases of primary idiopathic hip osteoarthrosis are well known and recognized. Their prevalence and significance are, however, often poorly appreciated. This article aims to assess the prevalence of the condition in a United Kingdom district general hospital. Several points arise: 1) Patients suffering rapid deterioration do not always alert their surgeon to the worsening symptoms; 2) Waiting lists need regular administration and the patients regular review while on such lists; 3) Decisions about surgery and case selection should be made purely on clinical grounds with financial, political, and administrative considerations accorded little or no relevance.
Recurrent dislocation of the patella is a disorder with a complex aetiology. Several surgical procedures have been recommended for its correction, but there are few clinical or radiological guidelines to facilitate the selection of a particular procedure. The results of treating a series of 29 knees are presented with a follow-up of at least 2 years. A significant correlation has been found between the horizontal movement of the centre of the patella on quadriceps contraction (quadriceps pull test) and surgical outcome when lateral release alone is selected for the correction of recurrent patellar dislocation.
Strips of tissue from knuckle pads contract in response to the myofibroblast stimulant mepyramine in a reversible, repeatable and dose-dependent manner. The significance of this finding is discussed.
We studied the medium- to long-term results of steroid injection into the carpal tunnel of women with the carpal tunnel syndrome (CTS). Of 45 hands, only 11 had lasting relief of symptoms and 22 had no relief whatsoever. There was no correlation of the typical signs and symptoms of CTS with outcome. Other series have offered various predictive factors for the outcome of injection but we found little or no correlation between these factors and outcome.
This prospective trial collected all cases where injuries had resulted from the hand passing through or striking glass and had been referred to a hand injury service during 1 year. Eighty-seven cases were referred and the factors relating to these injuries were examined. A record was made of the structures damaged, the surgery performed and prevailing socioeconomic factors. These injuries were very costly in terms of morbidity, surgical effort and time, with significant resource implications. The study appears to confirm other reports that current legislation on glazing safety was too long delayed and is inadequate now that it is in place.
Two cases of loss of function of the flexor pollicis longus tendon are presented. Initial assumptions that these were cases of primary tendon rupture proved to be wrong when unexpected intraoperative findings suggestive of previous long standing tendon rupture were later matched with a history of previous trauma. Spontaneous subcutaneous rupture is rare in otherwise healthy tendons.
We present an unusual case of carpal dislocation which to our knowledge has not previously been described in any of the current classifications of such injuries. Despite the extensive damage sustained, the case was managed without difficulty and outcome has been very satisfactory.
This retrospective study looks at the severe head injury patients admitted to one unit in a year. Within this group, those with significant gastrointestinal bleeding were further studied to assess medical prophylaxis against this complication. A preliminary attempt is made to gauge whether such medication is appropriate, particularly with reference to H-2 antagonists. No firm conclusions can be drawn, but sufficient doubt remains to justify a prospective trial which is planned.
It is often said that casualty officers are unable to assess burns accurately. This prospective study examines this, proving the point and offering basic suggestions for improvements.
A case of rupture of the flexor carpi radialis tendon in association with scapho-trapezial osteoarthritis is reported. The symptoms of pain and swelling contrast with the loss of function which characterizes rupture of other tendons in the hand and wrist.
Dermal eccrine cylindroma, or turban tumour, is a rare benign tumour of the eccrine sweat glands. Despite its histologically benign behaviour, the disease process is distressing for the patients. We present our experience of this condition, with a review of the literature, and recommend a treatment protocol for the disease.