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Biomedical subjects

R S Adelaar

Publications and source records attributed to R S Adelaar.

12 recordsLinked to original sources
PubMed1991

Effect of isolated talocalcaneal fusion on contact in the ankle and talonavicular joints.

A cadaveric model was developed to establish the articular contact area and load distribution in the ankle joint, posterior facet of the talocalcaneal joint, and talonavicular joint using pressure sensitive film. Positions of dorsiflexion, neutral, and plantarflexion were evaluated. This model was further used to determine the effect of talocalcaneal fusion on the articular contact area in the talonavicular and ankle joints. Alteration of articular contact was most pronounced in the talonavicular joint. There, a statistically significant reduction in contact area postfusion was noted when the foot was in the plantarflexed position. Reductions in ankle joint articular contact area were observed in the dorsiflexed and plantarflexed positions in the majority of specimens. Lateral displacement of the region of articular contact was noted in some specimens. A pressure-weighted centroid calculation was performed to provide a quantitative measure of the shift of the contact region.

Ankle Joint↗
PubMed1990

A comparison of the Brooker-Wills and Russell-Taylor nails for treatment of patients who have fractures of the femoral shaft.

Seventy-three fractures of the femoral shaft (seventy patients) were randomized to treatment with interlocked nailing with either the Brooker-Wills femoral nail (thirty-nine fractures) or the Russell-Taylor femoral nail (thirty-four fractures). Sixty-one patients (sixty-four fractures) were prospectively followed from admission until healing of the fracture. Specific attention was paid to recording operative details, including technical difficulties associated with insertion of the nails. Technical difficulties were encountered in insertion of the proximal screw, distal screw, and nail, and in deployment of the fins. Insertion of the Russell-Taylor nail was associated with less technical difficulty, operative time, and estimated loss of blood. The two nails differ in their biomechanical properties, methods of fixation, and instrumentation. These differences did not affect the clinical outcome; the fractures in both groups of patients healed with excellent functional results.

Biomechanical Phenomena↗
PubMed1989

Nerve sheath myxoma of digital nerve.

A case of a dermal nerve sheath myxoma arising in a digital nerve is reported. Similar tumors and its variants have been termed neurothekeoma, pacinian neurofibroma, bizarre cutaneous neurofibroma, and plexiform neurofibroma. The perineural sheath or the Schwann cell have been presumed to be the cell of origin by several investigators. The positive reaction with antibody to S-100 would appear to favor the Schwann cell as the progenitor of this tumor.

Adult↗
PubMed1989

The treatment of complex fractures of the talus.

The treatment of complex talar injuries entails an intricate knowledge of the anatomy and blood supply to the talus. The approach used should not violate any vascular structure, and the fixation used should be biomechanically stable to allow fracture healing. The three classes of talar fractures are discussed as well as avascular necrosis, talar salvage problems, and talar body fractures.

Fracture Fixation, Internal↗
PubMed1985

Lumbosacral dislocation.

We describe a patient with dislocation of the lumbosacral junction. No previous report of this rare injury has included a normal lateral radiograph without displacement in an anteroposterior direction. The radiologist should be aware that marked lumbosacral abnormality may be present despite the innocent appearance of a lateral radiograph.

Accidents, Traffic↗
PubMed1983

Sarcoidosis of the upper extremity: case presentation and literature review.

Sarcoidosis of the skeletal system is not rare but problems related to it are unusual. Two cases of sarcoidosis, with involvement of the upper extremity, are presented to point out problems that may occur in its treatment. Osteolytic sarcoid involvement of the phalanges leads to resorption and collapse, with a poor response to bone grafting or splinting. The phalangeal collapse could be treated with intramedullary cement or Kirschner wire fixation. Sarcoid involvement of fractures can lead to a nonunion and they should be treated with excision when appropriate, rather than attempting osteosynthesis. Arteriograms of sarcoid lesions show them to have a very poor blood supply. A bone scan can be used to demonstrate areas of sarcoid involvement before the characteristic lesion becomes evident on a radiography.

Adult↗
PubMed1977

Experimental evaluation of microsurgical techniques in small artery anastomoses.

A number of factors that influence the success of microvascular anastomosis have been studied, including adventitial stripping, choice of suture material and needles, suturing technique, and perfusion of the distal lumen. It is apparent that only minimal stripping of the adventitia is indicated in order to prevent increased necrosis of the vessel ends at the anastomosis site. The use of 10-0 monofilament nylon suture material with needles 75 microns or less in diameter achieves the best results in small vessel anastomoses. Optimal anastomosis of 1 mm. vessels requires interrupted full thickness sutures with minimal adventitial stripping and the use of the smallest number of sutures possible. We do not advocate routine perfusion of small arteries unless there are specific indications. An experienced team of microsurgeons utilizing these principles along with proper patient selection and a sound postoperative regimen should be able to achieve more than a 70 per cent success rate in replantation of completely amputated digits and hands.

Amputation, Traumatic↗
PubMedDate not supplied

The practical biomechanics of running.

The foot and ankle is a complex structure made of many small bones with capsular and ligamentous constraints. The physiology, kinematics, and muscle interaction of the walking, jogging, and running cycles will be discussed and the current biomechanical literature reviewed. To analyze the pathologic state, one must be aware of the normal stresses and functions of the running cycle. This knowledge establishes a rational basis for the interpretation of problems in providing medical and orthotic treatment.

Ankle↗