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Biomedical subjects

R L Worland

Publications and source records attributed to R L Worland.

14 recordsLinked to original sources
PubMed1996

Preoperative medical evaluation in patients having joint replacement surgery: added benefits.

Elderly patients having elective total joint replacement surgery are at increased perioperative risk because of comorbid conditions. To show the importance of the preoperative medical evaluation for total joint replacement, we reviewed the records of 238 patients who had screening for total joint replacement surgery in 1994. Of these 238 patients, 76 (32%) benefited from findings on the preoperative medical evaluation. Four percent of these patients were found to have a condition that warranted the postponement or cancellation of surgery, and others were found to have a condition that was immediately treatable. Some patients required referral to their primary care provider or to a specialist. This study emphasizes the importance and added benefits of the preoperative medical evaluation for elderly patients having elective total joint replacement surgery.

Adult↗
PubMed1996

Simultaneous bilateral total knee replacement versus unilateral replacement.

Over a 5-year period the two authors performed 213 simultaneous (sequentially) bilateral total knee arthroplasties (426 knees). A matched series of 107 unilateral arthroplasties was performed within this time frame, and the two groups of patients were evaluated based on postoperative complications and functional improvements. The patients in both groups were primarily osteoarthritics with an average age of 70 years. Knee function according to Hospital for Special Surgery (HSS) scores showed no significant difference, with the postoperative scores for the bilaterals and unilaterals averaging 93.6 and 93.4, respectively. The complication rate in the bilateral series was not increased over the unilaterals; it was less. These results lead to the conclusion that in patients with bilateral arthritis, both knees should be operated on under a single anesthetic, providing the surgical team is able to carry out the operative procedure expeditiously.

Aged↗
PubMed1993

Treatment of rotator cuff impingement.

The author performed 497 shoulder decompression procedures between 1978 and 1989. Of these procedures, 252 (51%) had tears of the rotator cuff that were repaired concomitantly. The results were successful in over 90% of the cases. It is suggested that articular-surface tears or intratendinous tears are the possible cause of some of the failures of the open procedure. The findings also suggest that the use of arthroscopy or magnetic resonance imaging may be indicated in selected cases. However, for the appropriate patient, open shoulder decompression continues to be an excellent treatment.

Arthroscopy↗
PubMed1979

Mineral metabolism of the healing arterial wall.

The mineral metabolism of healing arterial walls was studied by measuring the accumulation of several radioisotopes at the site of vascular repair in rats. Each rat was subjected to a 1-cm full-thickness aortotomy and then immediately injected by tail vein with c 5 muCi of one of the following radioisotopes: chromic chloride Cr 51 or sodium chromate Cr 51; ferrous chloride Fe 59 or ferric chloride Fe 59; manganous chloride Mn 54; selenious acid Se 75; strontium chloride Sr 85; or zinc chloride Zn 65. At intervals of 1, 2, 4, 6, and 10 days after operation and injection, groups of four rats for each radioisotope were killed, aortas dissected, and the specific radioactivity of healing vascular tissue compared with that of adjacent normal artery. There were sharp and statistically significant differences in the preferential accumulation of the radioisotopes in healing compared with normal aorta. Zinc appeared to be the element most involved in vascular repair, followed by selenium and chromium.

Animals↗
PubMed1977

Below-knee amputations.

Below-knee amputations are commonly performed for peripheral vascular disease. To be successful, the technic must be exacting, and it is crucial to bevel carefully the anterior and medial tibial surfaces to permit successful prosthetic rehabilitation.

Adult↗
PubMed1975

Transnavicular perilunate dislocations.

A complex injury of the wrist, the transnavicular perilunate dislocation, is analyzed along with a review of the literature. A method of management is proposed for this injury based on experience gained with nine such injuries. Our conclusion is that open reduction and internal fixation is a necessity unless an anatomic manipulative reduction can be accomplished. It is proposed that a navicular bone graft be employed at 6 weeks if avascular necrosis of the navicular and early signs of nonunion are evident. The rationale for these proposals is discussed.

Adolescent↗
PubMed1975

Bone cyst following gunshot wound: case report.

A case of a large bone cyst developing in the distal femur of a 17-year-old boy requiring curettage and grafting 20 months following a low-velocity gunshot wound is reported. The etiology of such cysts remains obscure, and removal of bullets from weight-bearing bones is recommended when feasible, or followup roentgenograms of weight-bearing bones with retained missiles. The literature on civilian gunshot injuries is reviewed and implications from the present case are discussed.

Adolescent↗
PubMed1975

Displaced fractures of the major pelvis: a method of management.

Fractures of the bony pelvis occur with such violence that associated non-musculo-skeletal injury is common. The patients require an aggressive team approach if they are to leave the hospital alive. After the visceral injuries are treated, the bony pelvis should be aligned to minimize secondary sacroiliac arthritis. Following initial pelvic sling management, the reduction of these fractures is accomplished by using the Keim-Surcingle table coupled with a pantaloon spica cast to maintain the reduction. The patient is then managed by bedrest at home until 12 weeks post-injury at which time the plaster is removed and ambulation is progressed as tolerated. The pubic diastasis may increase if plaster immobilization is discontinued too early. We hope that an aggressive initial evaluation and team approach coupled with this method of reduction and immobilization will decrease significantly the mortality and morbidity associated with displaces fractures of the major pelvis.

Adult↗
PubMedDate not supplied

Osteoid-osteoma of the radius. Report of a case.

This case is a report of a 9-year-old boy with an osteoid osteoma in the distal radius, an unusual location. The tumor was remarkably large in size, and pain unrelieved by aspirin. Osteoid-osteomatat have been described in just about every bone in the skeleton. Lower extremity involvement is more frequent than upper in all series and incidence is much higher in males than in females. Pain is the major complaint, both night and day. The response to aspirin is variable. The diseases is most frequently encountered in the second decade of life.

Bone Neoplasms↗