Biomedical subjects

M L Routt

Publications and source records attributed to M L Routt.

41 records · Page 3Linked to original sources

PubMed1993

Plate fixation of femoral shaft fractures in multiply injured children.

A study was done of twelve patients (seven boys and five girls) who, because of multiple injuries or a head injury, had been managed with compression plating of a unilateral or bilateral femoral-shaft fracture at a level-I trauma center from 1986 through 1990. The patients had a total of fifteen fractures. The average age at the time of the injuries was eight years (range, five years to nine years and eleven months). There were nine closed fractures and six open fractures; three of the open fractures were Grade I; two, Grade II; and one, Grade IIIA, according to the criteria of Gustilo et al. Each patient had an average of three associated injuries. All fifteen fractures had healed clinically and radiographically at an average of eight weeks (range, six to twelve weeks) after the operation. There were no infections. Anatomical alignment was obtained in fourteen limbs. One fracture healed with 13 degrees of anterior angulation. The compression plates were removed at an average of ten months (range, three to twenty-four months) after the index operation. At the latest follow-up evaluation (average, twenty-six months; range, eleven to fifty-seven months), no patient had restriction of activities due to the femoral fracture. Scanograms revealed overgrowth of the injured femur averaging 0.9 centimeter (range, 0.3 to 1.4 centimeters) in seven patients who had an uninjured contralateral femur. We believe that plate fixation of the femur is a good treatment option for children who have a femoral shaft fracture and a major head injury or multiple injuries, or both.

Bone Plates↗

PubMed1993

Closed interlocking nailing of femoral shaft fractures: assessment of technical complications and functional outcomes by comparison of a prospective database with retrospective review.

Although closed interlocking femoral nailing is generally considered to be a difficult but effective procedure, the true incidence of technical complications has not been well documented. Similarly, long-term and functional patient-oriented data are limited. We reviewed our experience with an interlocking nail system that was introduced in our institution in October 1987. One hundred and twenty-three patients were retrospectively reviewed with particular attention to technical complications (Group I). A second group of 144 patients with femoral shaft fractures were reviewed prospectively as a part of our Orthopaedic Trauma Outcome Database (Group IIA). In the earlier retrospective group, the technical complications in 123 cases included one distal screw fracture, one broken drill bit left (in situ), one "missed" locking distal screw, and three cases where comminution at the fracture site was increased. In the prospective group of 144 fractures, the technical complications included two "missed" distal locking screws, two broken screws, and one bent nail due to additional secondary trauma. In a third group of 56 patients (Group IIB) selected from Group IIA, an abbreviated functional assessment was performed at a minimum of 12 months postinjury. Of this group, 37% of the patients had pain that was described as related to barometric changes and was either constant or activity related; 39% had some limitation in ability to ambulate or stand. Nine percent had to obtain new employment or seek job modifications. Based on our data we conclude that closed intramedullary nailing can be done at a Level I Trauma Center with relatively few technical complications, but the functional outcomes are not as good as had been previously believed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1990

Operative treatment of complex acetabular fractures. Combined anterior and posterior exposures during the same procedure.

Over a four-year period, twenty-four patients who had a complex fracture of the acetabulum were treated by the same surgeon. The operation consisted of open reduction and internal fixation with combined anterior and posterior exposures during the same period of anesthesia. The cases of these patients were reviewed to ascertain whether access to both acetabular columns during the same procedure facilitates open reduction and internal fixation and to determine the indications for this combined procedure. As determined by intraoperative assessment and at follow-up examination four to thirty-two months postoperatively, anatomical reduction and rigid fixation were achieved in 88 per cent of the patients. No patient had an infection of the wound. All twenty-four patients had some degree of heterotopic ossification; as defined by Brooker et al., it was Class I in seven, Class II in thirteen, Class III in three, and Class IV in one. However, the heterotopic ossification limited motion of the hip enough to impair function in only two patients. We concluded that combined anterior and posterior exposures facilitate reduction and fixation and that these approaches should be used during the same period of anesthesia whenever anatomical reduction and rigid internal fixation cannot be achieved through a single exposure. Heterotopic ossification should be expected postoperatively, but it is rarely clinically important, at least in the short term.

Acetabulum↗

PubMed1989

Jefferson fracture in a 2-year-old child.

Fractures of the atlas vertebra in the pediatric population are very rare, yet must be considered when evaluating a child with neck pain and torticollis. Plain radiographs and computerized tomography should be used in conjunction to confirm the diagnosis.

Cervical Atlas↗

PubMedDate not supplied

Superior gluteal artery injury during iliosacral screw placement.

Percutaneous fixation of an unstable pelvic ring injury is becoming a popular method of pelvic stabilization. As posterior pelvic percutaneous techniques become more common, the possibility of iatrogenic complications increases. This case report describes an injury to the superior gluteal artery during percutaneous iliosacral screw insertion and the treatment of this potentially devastating injury.

Aged↗