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Biomedical subjects

M A Craigen

Publications and source records attributed to M A Craigen.

15 recordsLinked to original sources
PubMed2001

The changing epidemiology of acute and subacute haematogenous osteomyelitis in children.

We have reviewed the incidence of bacteriologically or radiologically confirmed acute haematogenous osteomyelitis in children under 13 years of age resident in the area of the Greater Glasgow Health Board between 1990 and 1997. In this period there was a fall of 44% in the incidence of both acute and subacute osteomyelitis, mainly involving the acute form (p = 0.005). This mirrors the decline of just over 50% previously reported in the same population between 1970 and 1990. Using multiple regression analysis a decline in incidence of 0.185 cases per 100,000 population per year was calculated for the 28-year period (p < 0.001). Staphylococcus was the most commonly isolated pathogen (70%). Only 20% of patients required surgery and there was a low rate of complications (10%). In general, patients with a subacute presentation followed a benign course and there were no complications or long-term sequelae in this group. Haematogenous osteomyelitis in children in this area is becoming a rare disease with an annual incidence of 2.9 new cases per 100,000 population per year.

Acute Disease↗
PubMed1995

Distal ulnar instability following wrist arthrodesis in men.

11 male patients with rheumatoid arthritis and 14 with osteoarthritis had total arthrodesis of the wrist. All patients with rheumatoid arthritis and ten (71%) of those with osteoarthritis had distal ulnar excision, two of the latter as a secondary procedure for impingement. Seven patients with osteoarthritis and none of the rheumatoid patients developed painful instability of the distal end of the ulna following excision. It is suggested that, in male patients with rheumatoid arthritis, distal ulnar excision with wrist arthrodesis produces excellent results with no complications. However, in male patients with osteoarthritis attempts should be made to avoid excessive shortening and ulnar impingement. If distal ulnar surgery is required, a procedure that does not affect the stability of the distal radio-ulnar joint should be performed rather than distal ulnar excision.

Arthritis, Rheumatoid↗
PubMed1995

Wrist kinematics. Row, column or both?

Analysis of radiographs of 52 wrists showed that, from ulnar to radial deviation, the amount of scaphoid shortening and ulnar translation of the scaphoid varies in a normal distribution. There is a significant correlation between the two measurements, such that the more the scaphoid shortens the less it translates and vice versa. Females subjects were more likely to have greater scaphoid shortening and less translation. It is felt that carpal kinematics thus cover a spectrum from the "row" theory to the "column" theory which is normally distributed and that women are more likely to have a column type wrist. This variation may affect the result of treatment of scapholunate dissociation by techniques such as scapho-lunate fusion. A "CR index" is proposed so that the tendency of a wrist towards row or column theory can be quantified. This may be used to predict the success of some surgical procedures in the treatment of scapho-lunate dissociation.

Adult↗
PubMed1995

Familial congenital pseudarthrosis of the ulna.

A mother and daughter, both presented with congenital pseudarthrosis of the ulna due to neurofibromatosis. The daughter is one of identical twins, the second twin not having a pseudarthrosis. The mother's uncle also had pseudarthrosis of the tibia. This suggests a complex variable genetic inheritance pattern for pseudarthrosis in neurofibromatosis. Despite having had no treatment, the mother had minimal symptoms, minimal deformity, and no radial head dislocation.

Child, Preschool↗
PubMed1995

Children's proximal phalangeal neck fractures with 180 degrees rotational deformity.

Five patients under 4 years of age with 180 degrees rotational deformity of a proximal phalangeal neck fracture are described. All cases resulted from a direct shear force to the bone coupled with a sharp withdrawal reaction of the hand. All of the children were successfully treated with open reduction and internal fixation but only after fruitless attempts at closed manipulation and an initial lack of recognition of the severity of the fracture. Each child achieved a full functional recovery of the finger with clinical and radiological union at 4 weeks.

Bone Wires↗
PubMed1994

Wear patterns of the articular cartilage and triangular fibrocartilaginous complex of the wrist: a cadaveric study.

The incidence and patterns of degenerative changes within the radio-carpal joint were studied in 138 specimens of elderly cadaveric wrists. Articular cartilage wear of varying severity was seen on the distal radial and ulnar articular surfaces in 27% of cases and on the proximal row articular surfaces in 54%. Wear was most commonly seen on the radial styloid and corresponding area of the scaphoid. The triangular fibrocartilaginous complex (TFCC) was found to be degenerate or torn in 24%. Central degenerative perforation was commonly associated with articular cartilage wear on the ulnar head and the ulnar half of the lunate. No significant wear pattern was seen in those wrists with peripheral linear (i.e. traumatic) TFCC tears. Interosseous scapho-lunate and luno-triquetral ligament disruptions were found in less than 10%, suggesting that disruption of these ligaments is usually traumatic and not degenerative.

Aged↗
PubMed1994

Symptomatic cortical irregularities of the distal femur simulating malignancy.

We reviewed the records and radiographs of seven children who presented with knee pain, local tenderness over the medial femoral condyle, and radiological irregularity of the distal medial metaphysis of the femur suggestive of malignancy. In the five patients who had biopsies, histological changes were consistent with musculotendinous avulsion, and the dissection of ten cadavers confirmed the site to be the insertion of part of the adductor magnus. The recognition of this lesion and knowledge of its benign nature may avoid unnecessary anxiety and needless biopsy.

Adolescent↗
PubMed1992

The changing epidemiology of osteomyelitis in children.

We reviewed 275 cases and calculated the prevalence of bacteriologically or radiologically confirmed acute haematogenous osteomyelitis in children under 13 resident in Greater Glasgow during 1970 to 1990. In the 20-year period there was a fall of over 50%, mainly involving cases of long-bone infection, and those due to Staphylococcus aureus. There was a reduced incidence of complications. The proportion of cases involving long bones decreased from 84% to 57%, and those of Staphylococcus aureus infection from 55% to 31%. These changes, in what is becoming a rare disease, need to be known to ensure early diagnosis and adequate treatment, particularly of subacute non-staphylococcal infection at unusual sites.

Child↗
PubMed1991

Traumatic epidermal inclusion cysts due to shoe impingement: a report of two cases.

Two cases are presented of bilateral traumatic inclusion cysts occurring on the dorsum of the first metatarsophalangeal joint. Both cases were women who wore high-heeled fashion shoes and the cysts occurred where the edge of the shoe impinged on a particularly prominent extensor hallucis longus tendon. Inclusion cysts have not previously been reported on the dorsum of the foot and their occurrence where impingement exists confirms a traumatic etiology. The importance of identifying the causative factor in such cases is emphasized.

Adult↗
PubMed1988

Metastatic adenocarcinoma of the carpus: a case report.

A patient is described who presented with a painful swelling of the dorsum of the hand which arose from the hamate and proved histologically to be a secondary from a previously resected gastric adenocarcinoma.

Adenocarcinoma↗