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Biomedical subjects

N L Steg

Publications and source records attributed to N L Steg.

12 recordsLinked to original sources
PubMed1992

Early detection of heterotopic ossification in young patients with traumatic brain injury.

Heterotopic ossification (HO) is frequently a complication in patients with severe head injury, impeding the rehabilitation process. Detection of HO is often delayed until the appearance of clinical manifestations. To better characterize the frequency and distribution of HO, a three-year prospective study at a pediatric brain injury rehabilitation unit was done. Triple-phase bone scans were performed routinely on all patients. Early intervention followed, with intensive physical therapy and indomethacin. We report an incidence of HO in 25 of 111 cases (22.5%). Of 55 sites identified, the hip was most commonly affected. Clinically significant heterotopic bone impeded the rehabilitation process in five patients (20%), although none of these patients required surgical intervention. Bone scanning identified HO in patients whose symptoms were clinically silent, as well as in those who were symptomatic. In addition, multiple sites of involvement were found in areas not clinically suspect. This study suggests that HO may be more prevalent in young, traumatically brain injured patients than previously suspected.

Adolescent↗
PubMed1992

Postoperative heterotopic ossification in the child with cerebral palsy: three case reports.

Three children with cerebral palsy and mental retardation showed irritability after surgical procedures. They were subsequently diagnosed as having heterotopic ossification. Heterotopic ossification developed around the hip in all cases--two after bilateral adductor releases at the operative site and the third after spinal fusion at a site unrelated to the surgery.

Adult↗
PubMed1992

Orthopedic aspects of the Marfan phenotype.

Thirty-six patients with the phenotypic features of Marfan's syndrome (arachnodactyly, abnormal ratio of arm span to height, ligamentous laxity, and tall stature) were evaluated and classified into three groups. Group 1 represented definite Marfan's syndrome and included patients with two or more major signs, with additional minor signs as described by McKusick (18 patients). Group 2 represented probable Marfan's syndrome and included patients with one major sign and multiple minor signs (nine patients). Group 3 represented the Marfan phenotype and included patients with multiple minor signs (nine patients). A high incidence of scoliosis occurred in all groups (100% in Group 1 and 89% in Groups 2 and 3 combined). Group 1 patients had longer, multiple, and more progressive spinal curves. Protrusio acetabuli (Type II and III hips) was present in 22 patients (11 in Group 1, six in Group 2, and five in Group 3), with more severe involvement noted in Group 1. Foot deformities of varying types and severity occurred in all groups but were seen most often in Group 1 patients. Patients with the features of Marfan's syndrome (even without major diagnostic criteria) have a high incidence of progressive scoliosis, protrusio acetabuli, and foot deformities.

Adolescent↗
PubMed1990

Delayed cervical central cord syndrome after trivial trauma.

Spinal cord injuries in children usually result from significant trauma. Two children with a delayed cervical central cord syndrome following trivial trauma are reported, one with no predisposing factor and one with a Chiari I malformation. Although dissimilar, these cases emphasize the importance of an evaluation for an anatomic defect or congenital anomaly in the patient with neurologic dysfunction following trivial trauma. We discuss the differential diagnosis of this rare entity and suggest that early recognition and treatment may improve patient prognosis.

Arnold-Chiari Malformation↗
PubMed1989

Myelomeningocele: comprehensive treatment.

The management of children born with myelomeningocele is now extended over an entire lifespan. Rehabilitation specialists managing these children must understand the initial anatomic dysfunction, its interaction with normal child development, and the effect of normal aging on pediatric-onset disabilities. A model for an interdisciplinary process that keeps the final goals of any child-onset disability in mind is discussed. A review of current medical, surgical, and behavioral interventions for these children is also presented.

Adolescent↗
PubMed1988

Use of intramuscular butorphanol for the treatment of postoperative orthopedic pain in adolescents: a pilot study.

A pilot study was conducted to evaluate the use of butorphanol, administered intramuscularly in 0.7-mg to 3-mg doses, in 27 adolescents with postoperative orthopedic pain. Butorphanol provided good or excellent pain relief in 24 (89%) patients. The duration of the relief was about three to four hours. The only adverse effect experienced in more than one patient was urinary retention, possibly associated with the use of fentanyl, which was administered for balanced anesthesia, and/or with the surgical procedure (spinal fusion). Tolerance and safety were rated as good or excellent in 100% of the patients.

Adolescent↗
PubMed1979

Lower extremity fractures simulating infection in myelomeningocele.

Thirteen patients with myelomeningocele sustained 33 fractures of the lower extremity. Fourteen fractures were accompanied by increased local heat, swelling, redness and a systemic response, including an elevated temperature and leukocyte count. Diagnosis of these fractures, which occur without a significant history of trauma, requires special roentgenographic studies. If routine films fail to reveal a fracture in a swollen red extremity in patients with myelomeningocele, stress films should be obtained in the area of the major swelling or where clinical pseudo-motion is suspected. The proper treatment of these fractures and the associated elevated temperature is immobilization. When these injuries are immobilized, the leukocyte count and temperature quickly return to normal.

Adolescent↗