PubMed Health⌕ Search

Biomedical subjects

R T Morrissy

Publications and source records attributed to R T Morrissy.

At least 19 recordsLinked to original sources
PubMed1990

Os odontoideum detected on a lateral cephalogram of a 9-year-old orthodontic patient.

A 9-year-old girl was seen for routine orthodontic care. The lateral cephalogram revealed an irregularity, os odontoideum, of the second cervical vertebra. The patient was referred to a pediatric orthopedist, and subsequent surgical correction was accomplished without complications. This condition has significant implications for the spinal cord at the level of C1 and C2. Phase I orthodontic care proceeded normally.

Axis, Cervical Vertebra↗
PubMed1990

Measurement of the Cobb angle on radiographs of patients who have scoliosis. Evaluation of intrinsic error.

To quantitate the intrinsic error in measurement, fifty anteroposterior radiographs of patients who had scoliosis were each measured on six separate occasions by four orthopaedic surgeons using the Cobb method. For the first two measurements (Set I), each observer selected the end-vertebrae of the curve; for the next two measurements (Set II), the end-vertebrae were pre-selected and constant. The last two measurements (Set III) were obtained in the same manner as Set II, except that each examiner used the same protractor rather than the one that he carried with him. The pooled results of all four observers suggested that the 95 per cent confidence limit for intraobserver variability was 4.9 degrees for Set I, 3.8 degrees for Set II, and 2.8 degrees for Set III. The interobserver variability was 7.2 degrees for Set I and 6.3 degrees for Sets II and III. The mean angles differed significantly between observers, but the difference was smaller when the observers used the same protractor.

Adolescent↗
PubMed1989

Bone and joint infection in the neonate.

Bone and joint infections during the neonatal period differ from those in the older child. Neonates are relatively immunocompromised and their growth plate is pierced by blood vessels. Special characteristics of skeletal infection in the neonate are: (1) multiple foci of infection; (2) simultaneous involvement of the bone and the adjacent joint; and (3) limited systemic and local inflammatory response. The more common causative organisms are group B Streptococcus, Staphylococcus aureus, and gram-negative bacteria. Clinical findings can be minimal or absent. The more common findings include local swelling and limited motion in a joint or a limb. Early soft tissue radiographic changes are found in most cases and should be looked for. Every suspected bone or joint should be aspirated. Hip joint aspiration is recommended in the presence of other skeletal infection, even without local signs. Intravenous antibiotic treatment is started according to Gram's stain results or the best "educated guess." Surgical debridement is indicated for every site of pus in the extremities. Joint destruction and bone deformity and shortening are a common outcome. The only way to minimize early and late complications is high index of suspicion, aggressive workup, and adequate early treatment.

Arthritis, Infectious↗
PubMed1988

A histological study of acute hematogenous osteomyelitis following physeal injuries in rabbits.

In young rabbits, the effects of an intravenous injection of Staphylococcus aureus alone, and in combination with a traumatic injury of the proximal tibial physis, were studied by light and electron microscopy. Metaphyseal osteomyelitis and radiographic changes were seen within forty-eight hours after the injury in all rabbits that had a growth-plate disruption and bacteremia. An intravenous injection of bacteria alone produced no morphological or microbiological evidence of infection. In the absence of trauma, normal tibiae were sterile after forty-eight hours. Foreign-body particles have been shown to accumulate in the fine vessels that are adjacent to the growth plate, but we found no similar deposition of bacteria or evidence of phagocytic removal in this area. Phagocytosis of bacteria by neutrophils did not appear to be impaired in the distal third of the metaphysis, but a delayed inflammatory response that allowed proliferation of bacteria and destruction of tissue was observed in the proximal two-thirds of the metaphysis after trauma.

Animals↗
PubMed1988

Brace treatment in adolescent idiopathic scoliosis. An update on concepts and technique.

Correct guidelines for the initiation and evaluation of brace treatment in adolescent idiopathic scoliosis are dependent on a thorough knowledge of the condition's natural history. Recently acquired data from school children screening programs and long-term follow-up studies of idiopathic scoliosis have added new insight to the natural history of the condition. This new information has raised questions concerning the validity of previous treatment guidelines and has led to changes concerning patient selection and indications for brace initiation, type of spinal orthotic used, duration of brace treatment, brace-wear programs, and anticipated results from bracing. Proper application of this new knowledge allows the physician to avoid overdiagnosis and overtreatment and to become more efficient in the use of spinal orthoses.

Adolescent↗
PubMed1987

Congenital dislocation of the hip. Early detection and prevention of late complications.

Most congenitally dislocated hips (CDHs) are inapparent and asymptomatic during the neonatal period, although at that time a high percentage can be detected. Treatment during this period can decrease the late sequelae of CDH. Although the abduction tests of Ortolani and Barlow are the standard methods of detection in the neonate, their value and their use in screening programs have been overemphasized. There is no evidence that the use of these tests in screening programs applied to large populations can consistently reduce the late sequelae of CDH. This overemphasis on neonatal screening results in a false sense of security with resultant lack of continued vigilance throughout the period of infancy.

Hip Dislocation, Congenital↗
PubMed1987

Slipped capital femoral epiphysis.

SCFE is one of the most potentially damaging conditions of the adolescent hip. The onset may be associated with minor trauma but is often insidious and may present as vague thigh or knee pain. The lateral radiograph is the most sensitive view for detection of a low-grade slip. The contralateral hip must be examined carefully as there may be bilateral disease with the pain and disability of the presenting side masking the symptoms of less involved hip. SCFE is occasionally associated with other metabolic and endocrinologic disease, and these should be screened for in the history and physical examination. Once a slip begins, the hip remains at jeopardy for acute progression until the physeal plate closes. We recommend immediate surgical stabilization and prefer a cannulated screw system. Proper technique is critical to safe and reliable surgery. The most common complications, AVN and chondrolysis, are often related to technical errors and should be minimized with attention to detail.

Adolescent↗
PubMed1986

Allograft bone in spinal fusion for paralytic scoliosis.

To determine the efficacy of allograft bone in spinal surgery, a retrospective study was carried out on thirty-two patients who had had spinal fusion with banked bone from the femoral head between 1977 and 1983. The diagnoses were paralytic and neuromuscular scoliosis. At final follow-up (average, 3.7 years), the infection rate was 9.3 per cent. There were no pseudarthroses, and all patients had well marginated trabecular markings by eighteen months. The rates of complications and of fusion were comparable with or better than those obtained using autogenous bone graft.

Adolescent↗
PubMed1984

Early casting of femoral shaft fractures in children.

Twenty-six children with fractures of the femur were entered into a prospective study to determine the efficacy of treating certain of these fractures by early spica cast immobilization. They were compared with 50 consecutive patients with similar fractures who were treated prior to the study to determine the potential cost savings and decrease in patient days in hospital. The clinical results of treatment were compared with results from the literature and the previous group where applicable. Our conclusion from this study is that most femoral shaft fractures in children under 10 years of age can be treated by closed reduction and early spica cast immobilization with results that are at least as good as those achieved by conventional methods, and with a 70% savings in hospital cost. Factors such as obesity, swelling, shortening, comminution, and fracture type can all combine to give relative contraindications for the use of this technique.

Casts, Surgical↗
PubMed1984

Hyperalimentation for superior mesenteric-artery (cast) syndrome following correction of spinal deformity.

The cast syndrome, recently called the superior mesenteric-artery syndrome, is a well recognized complication that can occur after a body cast has been applied. We are reporting the cases of three patients who had this syndrome following surgical correction of spinal deformity. The complication failed to resolve with the usual non-operative measures but did resolve with treatment by total parenteral nutrition.

Adolescent↗