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Biomedical subjects

L T Staheli

Publications and source records attributed to L T Staheli.

At least 37 records · Page 2Linked to original sources
PubMed1987

Desmoid tumors in childhood.

Eight cases of extraabdominal desmoid tumors in children are reviewed. Seven were located in the pelvis or forearm, and the most common presenting complaint was a slowly enlarging mass. In all cases, diagnosis was established by open biopsy, and initial treatment was by surgical excision. At follow-up (average, 5.8 years), six patients were tumor free. Desmoids are benign tumors that usually carry a good prognosis. There is no difference between the tumor behavior in children and adults. The treatment of choice is wide local excision. If vital structures are involved, it may be more appropriate to preserve function by performing partial tumor excision. For quiescent recurrent tumors, observation is appropriate management, but if further treatment is required, reexcision or radiotherapy may be tried.

Adolescent↗
PubMed1987

The longitudinal arch. A survey of eight hundred and eighty-two feet in normal children and adults.

Both feet of 441 normal subjects, who ranged in age from one to eighty years, were studied to document the configuration of the longitudinal arch. The findings showed that flat feet are usual in infants, common in children, and within the normal range of the observations made in adult feet. Documentation and observation is the recommended management of the flexible flat foot that falls within the normal range.

Adolescent↗
PubMed1986

Philosophy of care.

An accurate diagnosis is essential in managing musculoskeletal problems in children. Active treatment is only occasionally necessary and should meet the criteria of being essential, effective, and prudent.

Bone Diseases↗
PubMed1986

Torsional deformity.

Torsional deformity should be localized, quantitated, and usually managed by "observation," an approach that is set forth in detail in this article. Shoe modifications and daytime braces are inappropriate. Night splints or operative procedures are rarely indicated.

Child↗
PubMed1986

The effectiveness of the Salter innominate osteotomy in the treatment of congenital dislocation of the hip.

A retrospective review of sixty-eight innominate osteotomies that were performed in fifty-four patients at a university teaching hospital was undertaken to compare the results of these operations with those published by Salter and by his colleagues and to see if the results were different when the procedure was combined with open reduction compared with when it was performed after open reduction. Over-all, nearly three-quarters of the patients had excellent or good radiographic and clinical results. Avascular necrosis occurred in four patients after open reduction and innominate osteotomy. Postoperatively, eight complications developed in seven patients. Innominate osteotomy improved coverage of the femoral head. There was no noticeable difference between the results of innominate osteotomy combined with open reduction and those of innominate osteotomy performed after a previous open reduction. The patients who had an open reduction combined with innominate osteotomy before the age of four years had better results and required fewer subsequent procedures than did patients who had the operation after that age.

Age Factors↗
PubMed1985

Lower-extremity rotational problems in children. Normal values to guide management.

We studied 1,000 normal lower extremities of children and adults in order to establish normal values for the rotational profile. The intrauterine position of the fetus molds the femur by rotating it laterally and molds the tibia by rotating it medially. These molding effects usually resolve spontaneously during infancy, and then genetically determined individual differences are unmasked. Rotational problems should be clinically evaluated and the findings compared with the normal values provided by this study. Out-toeing in infants, medial tibial torsion in toddlers, and medial femoral torsion in young children are extremes of a normal developmental pattern. In the vast majority, these rotational variations fall within the broad range of normal and require no treatment.

Adolescent↗
PubMed1984

Acetabular augmentation for progressive hip subluxation in cerebral palsy.

Between 1969 and 1981, 20 acetabular augmentations were performed on 17 cerebral palsied patients with progressive hip instability. Average follow-up was 41.5 months, with a range from 24 to 147 months. Evaluation of results was based on assessment of hip stability, center edge (CE) angle, range of motion, and postoperative complications. Eighteen hips were rated good, one fair, and one poor. Stability was achieved in 19 hips. The CE angle was increased from a preoperative mean of -17 degrees to a follow-up mean of 50 degrees. There was no significant difference between preoperative and follow-up hip range of motion. The only complication encountered was a supracondylar femur fracture sustained after spica cast immobilization. Acetabular augmentation can be used effectively in the treatment of progressive hip instability in patients with cerebral palsy.

Acetabulum↗
PubMed1984

Fracture separation of the distal humeral physis in the newborn.

Fracture separation of the distal humeral physis in the newborn is a rare injury. Two case reports are presented, both with a history of traumatic delivery and a clinical examination revealing swelling, hypermobility, and muffled crepitance about the elbow. Radiographs demonstrated posteromedial displacement of the distal humeral epiphysis with respect to the shaft. Closed reduction with splint immobilization is the most common form of treatment.

Humans↗
PubMed1983

Orthopedics in adolescence.

Many orthopedic problems occur during adolescence. This paper describes the various types of musculoskeletal deformities associated with this stage of development, and discusses methods of diagnosis and correction. It is argued that since such problems are managed most effectively if diagnosed early, the role of the primary-care physician is critical.

Acetabulum↗
PubMed1983

In-toeing and out-toeing in children.

Torsional problems are common in children but rare in adults. Most resolve spontaneously; however, some require treatment. The primary care physician should be able to determine the cause of the deformity. A general screening examination is performed to rule out hip dysplasia and other skeletal defects, estimate in-toeing or out-toeing, determine hip rotation as a measure of femoral torsion, and observe the shape of the foot. These observations determine the torsional profile. The site and severity of the deformity can be ascertained from the information on the torsional profile. The common problems encountered in clinical practice include metatarsus adductus, out-toeing in early infancy, medial tibial torsion, and medial femoral torsion. The persisting or severe forms of these torsional deformities are probably genetically determined. Shoe modifications are useless; bracing is ineffective. Surgical rotational osteotomies are effective, but risky, and indicated only for severe, persisting deformities.

Biomechanical Phenomena↗
PubMed1980

Corrective shoes for children: a survey of current practice.

A survey of shoe-prescribing practices for children was taken among pediatricians, orthopaedists, pediatric orthopaedists, and podiatrists. Opinions differed significantly regarding the usefulness of shoe modifications for common pediatric lower limb and foot problems. Parents' attitudes toward children's shoes were also surveyed. Pediatricians and pediatric orthopaedists tended to prescribe corrective shoes less often than did orthopaedists and podiatrists. High topped shoes are not necessary to promote normal foot development, in the opinion of 85% of those surveyed; however, high topped shoes were often recommended for infants because they slip off less easily. Preferences for Thomas heels, scaphoid pads, reverse lasts, straight lasts, wedges, torque heels, and shoe lifts for problems including flexible flat feet, metatarsus adductus, intoeing, bow legs, knock knees, and leg length inequalities were delineated among the four groups treating children's feet. The authors conclude that whereas studies show that shoe modifications are of questionable value in the problems discussed, corrective shoes are often prescribed when regular shoes would be more appropriate and economical.

Attitude↗
PubMed1980

Medial femoral torsion.

1. Medial femoral torsion is a common benign, spontaneously resolving deformity of childhood. 2. Nonoperative treatment is ineffective and therefore inappropriate. 3. It is fortunate that surgical correction is rarely necessary, for it carries significant risks of complications. 4. Severe medial femoral torsion is rare but carries the potential for disability. Surgery is the only method of correction, and should be undertaken only for serious persisting disability, not for prophylaxis.

Bone Diseases↗
PubMed1980

Spinal deformity.

Early results of scoliosis screening programs have demonstrated that mild spinal deformity is common, usually nonprogressive, and often requires no specific treatment. The role of the primary care physician is an important one in identifying the rare case, which is secondary to some underlying disorder which itself requires treatment, and the progressive curves, which should be managed by bracing. The informed physician can make this separation efficiently with minimum cost to the family and minimum radiation exposure to the patient.

Adolescent↗