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Biomedical subjects

P E Scranton

Publications and source records attributed to P E Scranton.

At least 37 records · Page 2Linked to original sources
PubMed1986

Congenital cervical stenosis presenting as transient quadriplegia in athletes. Report of two cases.

The cases of two patients in whom complete but transient quadriplegia developed after an injury that was incurred while playing football are presented. Both patients were found to have a congenitally narrow cervical vertebral canal. Critical stenosis resulting in the transient quadriplegia occurred after a presumed injury to a cervical disc. In our opinion, a myelogram should be made for patients with a history of transient quadriplegia, numbness, or a burning sensation down the back or the lower extremities, even if other radiographic studies are interpreted as negative. Patients who have stenosis of the cervical spine should be advised to discontinue participation in contact sports.

Adult↗
PubMed1985

Cybex evaluation of the relationship between anterior and posterior compartment lower leg muscles.

Twenty adult males were tested with the Cybex II isokinetic dynamometer, comparing in each leg the torque produced by the anterior and posterior muscle compartments. Significant torque is produced by the gastroc soleus muscle group, even when the knee is bent 90 degrees. There is a significant increase in anterior compartment dorsiflexion torque produced with the knee in extension as compared to flexion. There is no difference in right or left handedness in comparing the results of torque generation in the lower extremity. On the average, dorsiflexion torque is approximately one-third of plantarflexion torque at slow speeds and half that of plantarflexion at fast speeds.

Adult↗
PubMed1985

Use of internal compression in arthrodesis of the ankle.

An ankle arthrodesis was done on twenty-five patients, using a specially designed T-plate. The T-plate provides a compressive force across the ankle of approximately 18.5 newtons per square meter and is most often applied through a medial approach to the ankle joint. This new approach provides excellent exposure and supplementary bone graft, and facilitates alignment of the ankle and foot in a neutral position. A successful arthrodesis was obtained in each patient. In the thirteen patients for whom a functional rating could be obtained, the average preoperative score of 47 points improved to an average postoperative score of 82 points.

Adult↗
PubMed1984

Bunion surgery in adolescents: results of surgical treatment.

The results of bunion surgery on 50 feet in 31 adolescents are reviewed. Average follow-up was 3 years 2 months. The failure rate was 36%. Fifty-one percent of the children had hypermobile flatfeet, and 32% had a long first ray. The recurrence rate in these groups was 56 and 50%, respectively. There were 20 reoperations for either recurrence (12) or hardware removal (eight). Elective bunion surgery in adolescents should only be performed in the face of progressive, painful deformity where both the patient and the patient's parents fully understand the goals and risks of surgery.

Adolescent↗
PubMed1983

Flat feet in children.

In the assessment of the child with flat feet a sound knowledge of arch and subtalar biomechanics, epidemiology, and etiology is important. The occurrence and natural history of flat feet are presented, and treatment modalities that have withstood the test of time are discussed.

Arthrodesis↗
PubMed1983

Tarsal coalitions: long-term results of surgical treatment.

We reviewed 40 patients who had undergone 57 operations for tarsal coalition between 1965 and 1980. Ten patients were treated for talocalcaneal coalitions. Four had successful resections and the remainder had successful single or combination arthrodesis. Thirty patients had 39 calcaneonavicular resections and five primary triple arthrodeses. In the entire series only two patients had a poor end result due to either technically poor surgery or failed calcaneonavicular resection because of advanced degeneration. Polytomography, computed tomography, or both were valuable in determining if talocalcaneal coalition resection was feasible. Care must be taken in evaluating the talonavicular joint for degenerative changes. The talar "beak" is not necessarily a degenerative spur, but rather a traction process occurring secondary to increased motion.

Adolescent↗
PubMed1982

The management of superficial disorders of the forefoot.

Superficial disorders of the forefoot are frequently seen in any office practice. Soft corns, ingrown toenails, plantar calluses, and plantar warts are the most common of these disorders. Their etiology, recognition, and operative and nonoperative management are discussed.

Adult↗
PubMed1981

Metatarsalgia: a clinical review of diagnosis and management.

Metatarsalgia is the symptom of pain in the region of the metatarsophalangeal articulations. In a careful analysis of 98 patients who presented with complaints of forefoot pain, 23 distinct diagnoses were made as to the etiology of their pain. These diagnoses were grouped under primary metatarsalgia, secondary metatarsalgia, and pain under the forefoot. Specialized tests, such as stance phase cholesterol-crystal force plate analysis and intraarticular or digital nerve block, are helpful in determining the diagnosis and the likelihood of effective treatment.

Adult↗
PubMed1981

Pathologic anatomic variations in the sesamoids.

This paper reviews 26 patients who presented with disorders of one or both sesamoids of the foot. There is a high association between long-distance running and chondromalacia or stress fractures in these bones. Thirty-eight per cent of these patients had variations in the anatomy at this articulation, including asymmetry in sesamoid size, symmetrical sesamoid enlargement, metatarsal condylar hypoplasia, and metatarsal rotational abnormalities.

Athletic Injuries↗
PubMed1980

Efficacy and safety of ibuprofen for hemophilic arthropathy.

The safety and usefulness of ibuprofen (Motrin) were evaluated in 15 patients suffering from hemophilic arthropathy via a double-blind protocol with individual crossover. No significant increase in hemorrhagic episodes or alteration in platelet function was observed. A decrease in morning stiffness was noted in nine patients, and three decreased markedly their use of other pain medications. We conclude that ibuprofen represents a relatively safe agent for the management of discomfort caused by hemophilic arthropathy in a select group of hemophilic patients.

Ankle Joint↗
PubMed1980

Metatarsalgia: diagnosis and treatment.

Metatarsalgia is a symptom, not a diagnosis. A careful study of ninety-eight patients who had complaints of pain in the fore part of the foot revealed twenty-three distinct diagnoses. These diagnoses were grouped as primary metatarsalgia, secondary metatarsalgia, and pain under the fore part of the foot. This division assisted in determining the form of nonoperative or operative treatment. The use of a pressure-sensitive cholesterol-crystal force-plate analysis or intra-articular or digital nerve blocks was helpful both in accurately pinpointing abnormal pressures and in determining whether operative treatment had been effective. Unexpected problems occurring after metatarsal surgery may be preventable in the future.

Child↗
PubMed1980

Ankle arthrodesis: a comparative clinical and biomechanical evaluation.

Arthrodesis of the ankle joint is difficult to achieve when there are associated problems with bony deformity or abnormalities of the surrounding soft tissues. In a series of 50 ankle arthrodeses, in which 68% had either damaged soft tissues or fixed ankle deformity, the pseudarthrosis rate was 30%. This high failure rate led us to devise biomechanical studies to evaluate the inherent stability of the Charnley-type compression arthrodesis, the R.A.F. fusion, and a new dynamic compression T-plate. The stability of the Charnley apparatus was directly related to the tension upon the wingnuts. However, in spite of the massive compression generated by the Charnley apparatus, it was relatively unable to resist rotatory forces. The T-plate had excellent rotatory and flexion-extension stability and developed approximately 25 pounds/inch compression across the ankle fusion. The T-plates's clinical application is demonstrated in eight successful arthrodeses. The importance of an intraoperative roentgenogram to confirm satisfactory ankle alignment cannot be overemphasized.

Adult↗
PubMed1980

Anatomic variations in the first ray: Part I. Anatomic aspects related to bunion surgery.

Dissection and roentgenographic findings in 35 nonoperative cadaveric and freshly amputated feet were correlated with disorders of the first day--specifically the sesamoids. There are four noteworthy factors associated with first ray pathology. The most significant are axial rotation of the first metatarsal bone and degenerative changes at the first metatarsophalangeal joint. Significant anatomic variations can be correlated with failed bunion surgery.

Adolescent↗
PubMed1980

Anatomic variations in the first ray: Part II. Disorders of the sesamoids.

Cadaveric and fresh amputation dissection studies revealed that condylar anomalies, metatarsal axial rotation, and bowstrung flexor tendos will commonly produce subluxation and degenerative changes at the metatarsophalangeal-sesamoid joint. The average arc of motion of the sesamoids from maximum plantar- and dorsiflexion was measured at 71.9 +/- 11 degrees. The anatomic variations presented are correlated with the incidence of chronic sesamoiditis, painful bipartite sesamoids, and chronic nonunions.

Adolescent↗
PubMed1979

Intramuscular hemorrhage in hemophiliacs with inhibitors. A medical emergency.

Any hemorrhage in a hemophilic patient must be regarded as a serious problem. A small percentage of hemophiliacs have an inhibitor that will destroy factor VIII or IX clotting activity, thus making control even more difficult. This occurrence predisposes these patients to joint contractures and deformities secondary to repeated, uncontrolled hemorrhages into muscle compartments and joints. Patients with an inhibitor must, therefore, be recognized, and any bleeding should be treated as an emergency. A combined treatment protocol has been developed by the hematology and orthopedic departments in a effort to achieve early hemorrhage control and prevent subsequent deformity.

Antibodies↗
PubMed1978

Metabolic and endocrine alterations in osteosarcoma patients.

Eighteen patients with primary osteosarcoma were studied for abnormal endocrinologic functions. Oral glucose tolerance tests revealed abnormal glucose, insulin, or growth hormone response curves in 78% of the study population. Elevated somatomedin values were noted in 72% of the patients tested. No significant deviations were observed in serum cortisol, estradiol, testosterone, follicle stimulating hormone, and luteinizing hormone levels. Likewise, lipid screening and 24 hour 17-hydroxy and 17-keto steroid excretion levels were normal. Statistically these derangements were unrelated, leading to the hypothesis that some additional factor or factors are present and responsible for the abnormalities noted. These deviations, found in association with primary osteosarcoma, constitute a new "paraneoplastic syndrome."

17-Ketosteroids↗