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Biomedical subjects

L Root

Publications and source records attributed to L Root.

At least 19 recordsLinked to original sources
PubMed1992

Cerebral palsy in twins.

Eighty-six children with cerebral palsy (CP) born as a product of twin pregnancies were studied. Data regarding their co-twins were also gathered. The authors' findings suggest that (1) monozygotic twins have a higher risk of CP than dizygotic twins, (2) twin order at birth does not seem to be a relevant factor in the etiology of CP, (3) mothers less than 24 or more than 34 years of age had the highest incidence of children with CP as a product of a twin pregnancy, and (4) the data do not support a genetic basis for the disease.

Birth Order↗
PubMed1992

Distal lengthening of the hamstrings in patients who have cerebral palsy. Long-term retrospective analysis.

One hundred and twenty-six patients who had cerebral palsy and who had been managed with distal lengthening of the hamstrings were followed for three to fourteen years so that the long-term results of the procedure could be determined. Twenty-four of sixty-two patients who could not walk before the procedure were able to walk about the house postoperatively. Mild recurvatum developed in only ten patients, and twenty-two patients had a reoperation because of recurrence. Although straight-leg raising and the popliteal angle had improved markedly at one year in all but two patients, both parameters regressed gradually over time. Of several selected variables, only limitation of straight-leg raising preoperatively was of statistical significance (p < 0.001) for the prediction of recurrence. Age, preoperative walking ability, concomitant operations, and postoperative immobilization had no significant effect on the rates of recurrence or recurvatum.

Adolescent↗
PubMed1991

Surgical management of intractable seizure disorders.

The surgical treatment of intractable seizures is still regarded by some as an experimental procedure with questionable rationale. However, in centers where care is taken in the selection process and facilities are available for adequate diagnosis, the procedure has been successful in complete alleviation of seizures in some cases. The decision about surgical interventions for epilepsy is never an easy one. Potential surgical candidates are evaluated by a team of specialists and undergo numerous diagnostic tests and examinations before a decision for surgery is made. It is essential for the neuroscience nurse to have knowledge of the underlying etiology of seizures, diagnostic testing and surgical procedures in order to effectively care for the seizure patient pre- and postoperatively. With this knowledge, nursing management becomes a vital part in the total treatment of the seizure patient.

Epilepsy↗
PubMed1990

Osteogenesis imperfecta.

Osteogenesis imperfecta describes a group of heritable disorders characterized by excessive bony fragility and reduced skeletal mass. It is classified in terms of its clinical manifestations, but our understanding of the underlying genetic defects in collagen synthesis is increasing rapidly. The nonoperative and surgical orthopedic approaches to osteogenesis imperfecta aim at the maximum preservation of limb strength and the correction of deformities. Various pharmacologic agents have been administered to patients with osteogenesis imperfecta, but to date, none have proved effective in controlled trials. Prenatal diagnosis has been attempted and seems certain to assume greater importance as knowledge of the molecular genetic basis of the disease increases.

Child↗
PubMed1987

Treatment of hip problems in cerebral palsy.

The two major problems of the hip in cerebral palsy relate to gait abnormalities and hip instability. Gait abnormalities are a result of muscle imbalance and should be corrected with appropriate muscle transfers and releases. Frequently, femoral anteversion may be associated with internal rotation of the limb, and if severe, should be corrected. Hip instability leading to S/D is a very serious problem in cerebral palsy and is usually worse in the more severely involved patients. Early muscle releases should be done before the hips subluxate. Once subluxation occurs, muscle releases must be combined with a varus rotation osteotomy. If acetabular insufficiency is present, pelvic osteotomy is necessary to obtain stability. In the older patient who has a painful S/D hip, the author recommends either a hip arthrodesis or a total hip replacement.

Adolescent↗
PubMed1987

Posterior tibial-tendon transfer in patients with cerebral palsy.

The results of fifty-seven posterior tibial-tendon transfers through the interosseous membrane to the dorsum of the foot that were performed in fifty-one patients who had cerebral palsy, and who were followed for a mean of 9.3 years (range, five to twenty-six years), were evaluated in terms of pattern of gait, alignment of the foot, formation of callus on the sole of the foot, and requirements for bracing. A good or excellent result was achieved in twenty-seven of thirty feet in the hemiplegic patients, twelve of sixteen feet in the paraplegic patients, and two of eleven feet in the quadriplegic patients. We found that in order for the tendon transfer to be successful the foot had to be passively correctable to at least a neutral position and that the tendon had to be passed superficial to the extensor retinaculum and inserted into the lateral cuneiform bone. The heel cord should be lengthened before the tendon transfer.

Adolescent↗
PubMed1986

Hip changes in spastic cerebral palsy.

Radiographs of the hips of 69 patients with cerebral palsy were evaluated for the angle of Wiberg, acetabular angle, degree of subluxation, shape of the femoral head, and, when the appropriate studies had been performed, anteversion and neck-shaft angles. Abnormalities included various degrees of superior lateral subluxation or dislocation, dysplasia of the acetabulum associated with femoral head displacement, flattening of the medial and/or lateral portions of the femoral head, an increase in the anteversion angle, functional increase in the neck-shaft angle, and, in long-standing cases, secondary degenerative joint disease and pseudoarticulation. Neuromuscular imbalances and abnormal ambulation caused by cerebral palsy change the biomechanical forces on the hip and result in characteristic osseous changes. Recognition and proper treatment of these changes can significantly alter the clinical course of the disease.

Adolescent↗
PubMed1986

The treatment of the painful hip in cerebral palsy by total hip replacement or hip arthrodesis.

The painful dislocated or subluxated hip in the patient with cerebral palsy presents a difficult problem in management. Twenty-three patients with cerebral palsy who had a painful subluxated or dislocated hip with degenerative changes were operated on at The Hospital for Special Surgery. Eight patients had a unilateral hip arthrodesis. Six had a successful arthrodesis initially, resulting in relief of pain and return to the preoperative functional level. A pseudarthrosis developed in two patients, but both had successful revision surgery, one by a second arthrodesis and the other by a total hip replacement. Thirteen of the fifteen patients with a total hip replacement were pain-free and functioning at a level consistent with their over-all involvement. One patient had migration of the greater trochanter and slight bending of the femoral component, with persistent pain. A second patient had progressive loosening of the femoral component over a period of seven years, but continued to walk with minimum pain. Two patients had a recurrent dislocation, one requiring revision of the femoral component and the other, of the acetabular component. We think that the presence of cerebral palsy, even in the patient with severe involvement, is not a contraindication for either a hip arthrodesis or a total hip replacement for a painful deformed or degenerated hip. These patients should be treated for the pain in the hip, and the presence of the underlying neuromuscular disorder should not deter the appropriate treatment. For unilateral hip disease in patients who are unable to walk and in young, active patients, we recommend hip fusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

The prevalence of tardive dyskinesia in geropsychiatric outpatients.

The prevalence of tardive dyskinesia was studied in a geropsychiatric outpatient clinic. All currently active patients were examined using the Abnormal Involuntary Movement Scale (AIMS) and a standardized procedure. Data were collected on a number of previously reported risk factors. A higher prevalence was noted in both tardive dyskinesia and spontaneous involuntary movement disorders in this patient population. Only sex and duration of exposure to antipsychotic drugs were noted to be significant risk factors.

Aged↗
PubMed1984

The treatment of osteogenesis imperfecta.

In this article, the author discusses the classification, genetic patterns, histologic and radiographic features, and treatment of osteogenesis imperfecta. Four types of treatment are available: (1) drugs or medications to increase the strength of bone and decrease fractures, (2) physical therapy, (3) bracing and splinting, and (4) surgery, with the most effective treatment being an operation consisting of multiple osteotomies and intramedullary rod fixations.

Bone Nails↗
PubMed1983

ECT and tardive dyskinesia: two cases and a review.

A brief review of the literature on electroconvulsive therapy in the management of tardive dyskinesia is presented and two patients are described who were treated for major functional disorders with ECT and showed dramatic remissions in tardive dyskinesia. This response was noted during the course of ECT and has been sustained at 1-year follow-up.

Antipsychotic Agents↗
PubMed1977

Hypoplasia of the fibula.

Fibular hypoplasia occurs in differing degrees of severity with fibular hemimelia as its most severe form. Normally the distal epiphyseal plate of the fibula is at the same level as the distal end of the distal tibial epiphysis, whereas the tip of the proximal fibular epiphysis is level with the proximal tibial epiphyseal plate. Varying degrees of shortening of the fibula in relation to the tibia were found in 14 children, 6 of them boys. Shortening at the distal end of the tibia leads to instability of the ankle. Shortening at the proximal end of the fibula leads to hypoplasia of the lateral tibial plateau and valgus deformity of the knee. Syme type ankle disarticulation became necessary in five cases of fibular hemimelia because of leg length discrepancies or ankle instability.

Ankle Joint↗