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Biomedical subjects

M E Foglesong

Publications and source records attributed to M E Foglesong.

5 recordsLinked to original sources
PubMed1994

Complications of Seidel intramedullary nailing of narrow diameter humeral diaphyseal fractures.

Forty acute blunt fractures of the humeral diaphysis were treated with Seidel nails (9-mm diameter) between April 1988 and August 1992. Follow up was available for 36 patients. Average Injury Severity Score (ISS) was 22. Forty-eight pelvic and lower extremity fractures necessitated humeral weight bearing in 23 patients. Patients were grouped by canal diameter measured at the point of distal humeral fixation: < or = 9 mm or > or = 10 mm. Data were analyzed with regard to complications, fracture pattern, and time to union. Due to difficulties reaming the humeral canal, five different reaming systems were used. In the < or = 9 mm group (N = 12), there were seven complications (58%). Two patients had iatrogenic comminution distal to the nail. The two open fractures in this group (II, IIIA) developed wound infections, and one, osteomyelitis. Three patients had nonunions: one was lost to follow up at 6 months, and two united at 41 and 74 weeks after exchange nailing and bone grafting. Average time to union was 21 weeks. Six of the seven complications occurred in patients who required reaming of a long, tight segment of distal canal. In the > or = 10 mm group (N = 24), there was one complication of iatrogenic comminution (4%). There were four open fractures (three, grade II; one, IIIB) with no infections. All fractures united (average = 10 weeks). The differences in complications (P = .001) and union (P = .04) between groups were significant. Other complications were not associated with canal diameter or union. There were seven radiographic failures of the distal locking device (19%). Four nails (11%) were left prominent in the shoulder due to technical or equipment failures, and were eventually removed. Four patients (11%) had residual shoulder stiffness (three due to neurologic injury). These primary data suggest use of the Seidel nail is associated with a higher complication rate in humeri with canal diameters < or = 9 mm.

Adolescent↗
PubMed1994

Femoral plating.

We have demonstrated that we are able to meet both trauma and orthopedic goals with immediate plate fixation of femoral fractures in patients with blunt polytrauma. Our femoral fracture mortality rate is less than our predicted institutional mortality rate of patients with comparative injury severity scores. Ipsilateral femoral neck and shaft fractures are easily repaired with femoral plating. Infections, even in open fractures and systemically unstable patients, are rare. Implant failures have been infrequent and are easily reconstructed with intramedullary nails. Knee motion has been restored reliably. Stainless steel DCP plate fixation requires primary bone grafting. Achieving union and subsequent knee rehabilitation often requires that patients remain on crutches for up to 6 months. Our experience with titanium LCDCP plates is preliminary, but we are seeing a significant amount of callus formation and, perhaps, earlier union and bearing weight.

Arteries↗
PubMed1988

Acute and chronic effects of the neurolytic agent ricin on dorsal root ganglia, spinal cord, and nerves.

The short- and long-term effects of ricin injections into nerves have been evaluated with light microscopy in the dorsal root ganglia, spinal cord, and peripheral nerves in rats and cats. Dorsal root ganglion cells initially exhibited chromatolysis, followed by gliosis and cell death. These changes were associated with Fink-Heimer degeneration in the somatotopically appropriate region of the dorsal horn. There were no signs of chromatolysis in dorsal horn neurons in ricin-injected animals, but chromatolytic motoneurons were observed. Ricin produced acute necrosis of injected nerves and dissolution of axoplasm. At long survival times (greater than 4 weeks) some apparently regenerating axons were seen in the injection sites of rats. Cell counts indicated that a substantial percentage of dorsal root ganglion neurons associated with the injected nerves were killed, but the presence of regenerating axons suggested that some cells survived the ricin treatment. Although the lesion may not always be complete, even with maximum sublethal doses, this method appears to be useful for specifically destroying afferent fibers associated with a particular nerve without transynaptic destruction of dorsal horn neurons.

Animals↗
PubMed1986

Electrical stimulation reveals relatively ineffective sural nerve projections to dorsal horn neurons in the cat.

Electrical stimulation of the sural nerve (SN) revealed input from sural nerve afferents to L6 and L7 dorsal horn neurons that were not apparent using natural mechanical stimuli, especially in cells with variable latency responses to SN stimulation. Nearly all (31/32) cells that had reliable, fixed latency responses to SN stimulation also had an excitatory receptive field (RF) in the region of skin innervated by the sural nerve (SN region). About one-third (20/57) of the cells with variable latency responses to SN stimulation, however, had an RF outside the SN region. Most (130/146) cells with no response to SN stimulation had RFs outside the SN region. There were no obvious differences between variable latency cells with RFs in the SN region vs those with RFs outside it in latency of response to SN stimulation, recording depth, RF sizes or modality properties. In a subsample of 31 postsynaptic dorsal column neurons all cells responding to SN stimulation also had an RF in the SN region. Strengthening of relatively ineffective projections from the sural nerve by lesions might be expected to lead to an increase in the proportion of cells responding with impulses to natural stimulation of the skin innervated by the sural nerve, and, hence, to an increase in average RF size.

Animals↗