Biomedical subjects
Publications and source records attributed to M B Werd.
This article focuses on materials used as bone substitutes. The materials may be used as substitutes for autografts or, in some cases, along with autografts. Each material has unique properties that may be beneficial for specific applications. Some future developments in bone substitute materials are also discussed.
Metallic materials have provided a tremendous advantage in the current treatment of many surgical specialties. Further studies on the long-term effects at both local and distant sites of implantation are essential. As this field continues to expand, the podiatric applications of these new devices will grow exponentially. Because all metallic implants in the human body will corrode, several recommendations can be made: 1. Beware of placing reactive components in the younger population. These should be followed accordingly because of latent periods of reported tumor findings in these metals. 2. Consideration should be made toward removal of implant devices when they are no longer effective. 3. The least reactive materials should be considered for implantation. At the present time, titanium alloys have been shown to be more inert than their metallic counterparts. As the search for the ideal human implant material continues, a few important lessons have been learned. First, mixtures of elements such as stainless steel have a higher incidence of antigenicity because they contain a number of different elements, each of which may be an allergen. The smaller the number of elements that are combined to form a metal, the more biocompatible the material will be. Second, certain elements have been found to have increased tissue reactivity, namely nickel, cobalt-chrome, and even vanadium. The less a metal contains these antigenic elements, the less likely the metal will be incompatible. Third, newer "pure" elements with a greater degree of chemical inertness, such as commercially pure titanium and titanium-alloy niobium, are being studied. This ongoing research may lead to a universally biocompatible human implant material that will be used exclusively for all types of implants.
Mycobacterium tuberculosis is a disease that is being reported much more frequently in the literature, primarily because of the rapid increase in severely immunocompromised patients, but also because of the development of multiple drug-resistant tuberculosis strains. Extrapulmonary M. tuberculosis is also reportedly on the rise, and may manifest itself at a number of sites in the body, including the peripheral skeleton. It is important to recognize peripheral tuberculosis osteomyelitis early because early treatment can effectively eliminate long-term morbidity. The authors present a review of the diagnosis and treatment of extrapulmonary M. tuberculosis, with special emphasis on peripheral skeletal tuberculous osteomyelitis. A case study involving peripheral skeletal tuberculous osteomyelitis in the foot is presented.
The indications for arthroscopic stabilization include those patients with isolated ruptures or strains of the ATF. The procedure is particularly convenient for patients with ankle joint pathology that is already most commonly treated arthroscopically, such as chronic instability, in which inflamed synovium or meniscoid bodies are to be excised. Although significant stability can be gained with this technique, injuries that result in damage to the calcaneofibular ligament may require additional open surgery, since this ligament cannot be visualized arthroscopically. However, the anchoring techniques described in this article can still be used when performing open surgery.