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Biomedical subjects

M E Castle

Publications and source records attributed to M E Castle.

12 recordsLinked to original sources
PubMed1988

Management of civilian gunshot fractures of the extremities.

One hundred thirty-two gunshot fractures of the extremities in 126 patients were studied retrospectively and followed until clinical union from January 1980 to January 1985. Civilian handgun missile velocities have increased; should the trend continue, treatment protocols will need to be modified. All uncomplicated low-velocity gunshot fractures, less than 615 m/second, (2000 feet/second), can be managed conservatively, with superficial debridement, surgical cleansing, immobilization, and antibiotics. Seventeen orthopedic procedures were performed; specific treatment was dictated by the type or location of the fracture caused by the missile. One hundred thirty-two fractures were treated with antibiotic therapy, 80 intravenously and 52 oral administration. Only two infections were encountered, both in the oral therapy group. No statistically significant advantage of intravenous over oral administration was found. Emergency room debridement along with oral antibiotic therapy for uncomplicated low-velocity gunshot fractures not requiring operative fixation yielded results comparable to those of hospitalization, with dramatically reduced medical costs.

Administration, Oral↗
PubMed1987

Total hip arthroplasty and polyostotic fibrous dysplasia: a case report.

Polyostotic fibrous dysplasia with Albright's syndrome causes progressive skeletal lesions which require orthopaedic surgical management. A case is presented of a 43-year-old woman with a history of multiple proximal femoral osteotomies with iliac bone grafting who developed a degenerative hip joint. A total hip arthroplasty was performed and a specially designed Charnley-Mueller type of prosthesis implanted. The patient is asymptomatic eight years postoperatively.

Adult↗
PubMed1984

Acute traumatic retrosternal dislocation of the clavicle.

A review of the literature on acute traumatic retrosternal dislocations of the clavicle revealed that closed reduction often fails. In six of our seven patients retraction of the shoulders with caudal traction on the adducted arm, while the patient was supported by an interscapular bolster, achieved reduction of the dislocation. We analyzed the mechanism of this and other methods of closed reduction.

Adolescent↗
PubMed1984

The effect of tenotomy and tendon transfers on muscle fiber types in the dog.

Different muscle groups have been shown to have variable muscle-fiber type patterns that may be, in part, due to function and use. In an attempt to identify any changes in fiber composition following surgical alteration of function, eleven beagle dogs had the fibularis longus tendon severed. Four dogs had the tendon reattached 6-24 weeks later. After 6-24 weeks, four dogs had the tendon surgically transferred to the tendon of the tibialis anterior, a functionally different muscle. Three dogs had the tendon immediately transferred to the tendon of the tibialis longus. Biopsies were performed after each procedure to assess fiber changes, and late biopsies were performed in one dog from each group at 27-29 months. Fiber characteristics in the biopsy specimens were identified using histochemical staining. In the first group (tenotomy-reattachment), variable atrophy occurred early but disappeared following reattachment. In the second group (tenotomy and tendon transfer), variable atrophy occurred along with an increased percentage of Type I and Type IIB fibers. Early biopsies performed in the third group (direct transfer) revealed mild Type II hypertrophy. In the late biopsy specimen, an increase of Type I and Type IIB fibers was noted and was similar to the fiber composition of the tibialis anterior to which it was transferred. These findings indicate that muscle-fiber remodeling does occur and that multiple operative procedures are not intrinsically harmful to the muscles. The best evidence from this and previous studies suggests that changes in muscle-fiber type are manifestations of functional adaptation.

Adaptation, Physiological↗
PubMed1978

Proximal femoral resection-interposition arthroplasty.

In the severely retarded, multiply handicapped child who has a dislocated hip and severe adduction of the lower extremity, the deformity often interferes with perineal hygiene, nursing care, and positioning in bed and in a wheelchair. In twelve such patients we did an extensive resection of the proximal part of the femur, down to below the lesser trochanter, and constructed a capsular flap across the acetabulum. The quadriceps muscle was sutured around the resected end of the femur. This one-stage, uncomplicated operation allowed our patients to sit confortably and nursing care was made easy. In contrast, three patients who had single resection of the femoral head and neck had recurrence of deformity and pain.

Adolescent↗
PubMed1974

One-bone forearm.

Six patients with complicated forearm injuries with ununited fractures of the ulna and soft-tissue deficits, and one patient with the same deficit from infection, were treated by production of a one-bone forearm positioned in neutral of supination-pronation. A stable, functional extremity resulted in each patient and only mild complications were encountered.

Adult↗
PubMedDate not supplied

Pathology of spastic muscle in cerebral palsy.

The histopathology of muscle in cerebral palsy has not been elucidated because correlated morphologic and biochemical data on normal pediatric muscles are insufficient to allow adequate correlation of pathologic findings. One hundred and eight muscle biopsies were taken during reconstructive operations on 85 patients. Normal values for pediatric muscles were obtained from a literature review and supplemented with our data on normal patients. Fiber sizes are normally different for children of different ages. Histochemical staining of enzyme systems demonstrate that adenosine triphosphatase staining, pre-incubated at pH 9.4, 4.6, AND 4.3 WAS USED FOR FIBer typing and fiber size. Depending on the muscle biopsied and the clinical status of the patient, there is a variety of patterns of type I and type II fiber atrophy, hypertrophy, and myopathy. In some cases, denervation changes are present to suggest nerve entrapment. Correlated clinical observations suggest type I fiber predominant muscles do not re-educate well when surgically transferred to perform a specified function.

Adenosine Triphosphatases↗
PubMedDate not supplied

Tibial rotational osteotomy.

Accurate rotational osteotomy is especially difficult in a triangular bone such as the tibia. A technique using a fibular graft to locate the center of rotation and provide stability has been used in 9 operations with very satisfying results. Average healing time was 7 1/2 weeks. A protractor has been designed to measure the degrees of rotation.

Child↗