Biomedical subjects

R A Probe

Publications and source records attributed to R A Probe.

5 recordsLinked to original sources

PubMed1999

Night splint treatment for plantar fasciitis. A prospective randomized study.

A prospective randomized study of 116 patients with plantar fasciitis was performed to determine the effectiveness of adjuvant night splint therapy in relieving the acute symptoms of plantar fasciitis. Patients were randomized into one of two groups. Patients in Group 1 were treated with 1 month of oral antiinflammatory medication, Achilles stretching exercises, and shoe recommendations. Patients in Group 2 received identical treatment but also used a dorsiflexion night splint for 3 months. Blinded clinical review of patients was performed at 4, 6, and 12 weeks. Health status data Short Form 36 also was collected at these times and again at an average 19 months of followup. Overall, 68% of patients reported improvement with this nonoperative protocol for a 12-week period. No statistical difference was seen with the presence or absence of a night splint. In addition, no differences in improvement rates were observed with gender, duration of antecedent symptoms, the presence of bilateral symptoms, or the presence of a heel spur. Age older than 45 years did prove to be a statistically significant poor prognostic factor for improvement at the 12-week follow-up. Short Form 36 data obtained at baseline showed significantly lowered perception of health when compared with age matched controls. Patients in both treatment groups had significant improvement in Short Form 36 scores with 12 weeks of conservative care.

Fasciitis↗

PubMed1996

Contamination risks from a high-speed bone burr.

STUDY DESIGN: The authors recorded the contamination rate at a mock surgical site below a high-speed burr creating debris from a fresh-frozen allograft specimen. OBJECTIVES: To document possible contamination rates associated with high-speed burr use. SUMMARY OF BACKGROUND DATA: The literature contained no studies addressing a known rate of contamination from high-speed burr use. METHODS: Samples of debris were collected in a mock-up of an operation involving bone burring. Set distances were maintained between objects within the field. High-speed bone burring was performed on fresh-frozen allograft bone specimens, and falling debris was collected on sterile culture plates. Control specimens were obtained randomly. Two hundred test and 20 control samples were collected by means of standard sterile techniques. RESULTS: Thirty-five percent of the cultured specimens from the test group grew skin flora, compared with 10% from the control group (P = 0.02). CONCLUSIONS: The authors propose that the higher contamination rate in the experimental samples resulted from airborne bone chips striking nonsterile surfaces before landing on the culture plates. Such contamination may increase the risk of wound infection.

Bacteria↗

PubMed1996

Titanium plate fixation: a review of implant failures.

Titanium plates and screws have become widely used for the fixation of fractures and osteotomies. We began using them in 1992; however, several early hardware failure prompted a retrospective review of the occurrence of this complication. A 2-year time period was reviewed at two institutions with comparison of hardware failure rates using titanium and stainless steel implants. At one institution, 51 fractures or osteotomies of the long bones were fixed by the senior author using titanium implants between July 1992 and July 1994. One hundred one similar cases were treated over the same period by the same surgeon using stainless steel implants. The outcome is known for 48 of the cases performed with titanium and for 80 of the cases performed with stainless steel. There were five postoperative implant failures using titanium and one using stainless steel. Metallurgical analysis of one set of broken implants retrieved during a revision surgery showed no manufacturing defects. At the second institution, 21 titanium and 138 stainless steel platings were performed over 2 years. There were four titanium implant failures in four patients and one stainless steel implant failure. Our experience suggests that these implants should be used with care, particularly in high-demand settings such as nonunion or noncompliance, and that further research needs to be conducted to establish appropriate clinical indications for their usage.

Adolescent↗

PubMed1991

Early experience with the gamma interlocking nail for peritrochanteric fractures of the proximal femur.

Surgical fixation, early weight-bearing, and bony union remain a challenge in the treatment of peritrochanteric femur fractures, especially if the fractures are comminuted or unstable. Preliminary experience with the Gamma locking nail, a short intramedullary nail connected to a sliding compression screw augmented with distal locking screws, is presented. In a consecutive series of 29 patients, all fractures were adequately reduced and immediate weight-bearing was begun regardless of fracture configuration (13/27 fractures classified as unstable). Twenty-seven patients were reviewed at 6 months. At follow-up, all patients continued to be ambulatory and all fractures healed. Major complications included screw migration in the femoral head (two patients), difficulty in securely placing the distal screws (eight patients), and a femoral shaft fracture through the distal locking screws following a fall. The technical problems inherent in the device and its instrumentation are discussed. In this early experience, the Gamma nail appears to allow for early patient ambulation regardless of the fracture configuration with excellent clinical results.

Adolescent↗

PubMed1991

Treatment of humeral nonunions with the Ilizarov technique.

Eighteen patients with nonunions of the humerus were treated by the Ilizarov method at the General Hospital in Lecco, Italy, between 1982-1989. This report is based upon 16 of those patients. The results are encouraging. Union was achieved in 14 patients. There were two failures: one patient had been irradiated 14 years earlier for what was thought to be plasmocytoma of the proximal humerus; the other had a humeral nonunion of the proximal third with advanced disuse osteopenia of the surrounding bone. Complications were few, and none compromised the achievement of union.

Adult↗