Biomedical subjects
Publications and source records attributed to M C Wilber.
We have described a patient who as a child sustained a Monteggia's fracture that was neither diagnosed nor treated. Neurologic deficit and limitation of motion were clinically apparent. A high index of suspicion, careful examination of the patient, and high-quality roentgenograms should enable accurate diagnosis of this and similar lesions in less obvious cases, thus avoiding the complications of missed diagnosis.
In a study of the results of operative reduction and internal stabilization of eighty-nine femoral fractures, operative reduction was performed within six days in fifty-four of the fractures and between seven and thirty days in thirty-five. Dual Eggers plates were used in sixty-three fractures; intramedullary nails, in eighteen; a nail-plate, in six; and a single plate, in two fractures. The criteria for ultimate healing were roentgenographic demonstration of bridging callus and the ability of the patient to bear full, unsupported weight on the extremity. Healing that occurred later than nine months after fracture was considered to be delayed. In the group treated by early operative management, the incidence of delayed union was 18 per cent and of non-union, 18 per cent. In the group treated by delayed operative management, the incidence of delayed union was 3 per cent and there were no instances of non-union. All ten non-unions, ten of the eleven delayed unions, and five of the six infections occurred in the early operative group.
Skin bioelectric potentials were obtained from both normal and injured human thighs using surface direct current silver/silver chloride monitoring electrodes. Electrical patterns in normal subjects fell into 4 distinct groups. In subjects with injured thigh significant electrical differences were associated with bone formation. The findings are discussed.
In forty patients treated at The University of Texas Medical Branch Hospitals for fifty-two fractures of forty-one scapulae from 1961 through 1973, most of the fractures were the result of vehicular accidents. The thirty-eight fractures involving only the body, neck, or spine of thirty scapulae (without involvement of the acromion, glenoid, or coracoid process) were successfully treated with a sling and early active motion. Three other fractures involving body were associated with three fractures involving the glenoid. The eleven fractures of the acromiom, glenoid, or coracoid process resulted in loss of motion in ten of the eleven shoulders. For fractures of this type we now recommend immobilization in 60 degrees of abduction, 25 degrees of flexion, and 25 degrees of external rotation, with early active abduction exercises. Open reduction is rarely indicated, only when there is disruption of the glenohumeral joint.
From 1971 to 1973 twenty-three consecutive patients with low back pain of undetermined etiology and two patients with arachnoiditis were treated by the sedation of active acupuncture loci located in the low back area. Sedation was accomplished by means of one to six injections of one-half milliliter of a local anesthetic at weekly intervals. Nineteen patients obtained complete relief and four patients were improved. The two patients with arachnoiditis showed no improvement.
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