Biomedical subjects

M M Heare

Publications and source records attributed to M M Heare.

4 recordsLinked to original sources

PubMed1991

Orthopedic fixation devices.

Orthopedic fixation devices are used in the treatment of fractures, soft-tissue injuries, and reconstructive surgery. After fracture reduction, internal, external, or intramedullary fixation devices may be used to provide stability and maintain the alignment of bone fragments during the healing process. They must be strong and secure enough to allow early mobilization of the injured part, as well as the entire patient. Compression is used whenever possible to increase the contact area and the stability between fragments and to decrease the stress on the implant. Screws are used primarily to provide interfragmental compression or to attach plates, which can then provide compression, prevent displacement, and support the fragments during healing. Pins and wires can be used for fixation of small fragments or fractures in small bones and for attachment of external fixation devices and traction. A basic understanding of the devices and principles of use is needed to interpret radiographs obtained after the treatment of musculoskeletal injuries.

Fracture Fixation↗

PubMed1989

Staging techniques and biopsy of bone tumors.

Optimal conditions for diagnosis and, hence, rational treatment planning require the integration of a comprehensive history, physical examination, and screening radiographic studies to formulate a working differential diagnosis. From this the appropriate laboratory and radiographic staging studies can be selected to narrow the differential diagnosis, obtain precise, surgically oriented anatomic localization of the lesion, and identify any distant disease. Only after this information is obtained can a biopsy be performed with the least risk of compromising subsequent treatment and the greatest accuracy in surgical staging. This is done most easily when the radiographic staging studies and biopsy are under the direction of the surgeon responsible for the definitive surgical procedure.

Biopsy↗

PubMed1989

Diagnostic imaging of pelvic and chest wall trauma.

Imaging of patients with pelvic trauma begins with a logical approach to plain radiographs. These films reveal the probable mechanism of injury and suggest a rationale for emergent reduction. Radiographs, along with the clinical impression, suggest the likelihood of associated soft tissue injury, possibly requiring further specific radiographic studies. Significant vascular injury most often accompanies disruption of the posterior pelvic ring. Bladder and urethral trauma may be suspected in any displaced type III pelvic fracture with suggestive clinical signs. Ideally, urethrography precedes bladder catheterization. Acetabular fractures must be recognized because of their implications for future hip joint function. CT is very helpful in definitive treatment planning of pelvic (especially acetabular) fractures but may be delayed until other life-threatening injuries have been addressed. Plain radiography is also well suited to evaluation of chest wall trauma. When multiple ribs are fractured in two places, the radiologist should suggest the possibility of flail chest. Sternal fractures and multiple rib fractures, including the first three ribs, may herald life-threatening vascular or cardiac damage. To summarize, the radiologist contributes most to the care of the trauma patient by recognizing roentgen patterns of injury, knowing which are commonly accompanied by damage to critical soft tissues, and performing the indicated radiographic studies efficiently.

Acetabulum↗

PubMed1988

Direct coronal computed tomography arthrography of osteochondritis dissecans of the talus.

Although radiographs, arthrography, tomography, and computed tomography can all be used to diagnose osteochondritis dissecans of the talus, these imaging methods may not demonstrate whether an undisplaced osteochondral fragment has any attachment to the articular cartilage or bony bed of the talus. As lack of such attachment is a relative indication for surgery, we studied the feasibility of using coronal computed tomography (CT) after double contrast arthrography to demonstrate attachment in four patients with osteochondritis dissecans seen on radiographs. Direct coronal CT arthrographic images showed intact articular cartilage in three patients. In the fourth patient, overlying cartilage was virtually absent and contrast tracked beneath the fragment, an appearance that correlated with arthroscopic findings of partial articular cartilage attachment and no union at the osteochondral fracture line. Our initial experience suggests that direct coronal CT arthrography clearly shows the state of attachment of the osteochondritic fragment to the talus.

Air↗