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Biomedical subjects

R W Hussey

Publications and source records attributed to R W Hussey.

15 recordsLinked to original sources
PubMed1993

Surgical decompression of impingement in the weightbearing shoulder.

Shoulder pain is a common affliction, posing particular limitations on the spinal cord injured person. Abnormalities of the rotator cuff mechanism are a common cause of shoulder injury in the general population and it has recently been observed that a large percentage of persons with paraplegia suffer from chronic shoulder pain. This report describes six cases of impingement syndrome in four spinal cord injured persons who depend on upper extremity function for the execution of activities of daily living and mobility. All had failed prolonged trials of conservative therapy and subsequently underwent anterior acromioplasty and when indicated, repair of the supraspinatus tendon. In each case, functional capacity that approached or equalled premorbid levels was achieved. Pain complaints also markedly decreased from preoperative levels. It is suggested that surgical decompression of shoulder impingement and rotator cuff repair may be beneficial in spinal cord injured persons who have failed conservative therapy. Further study is required to determine the long-term efficacy of surgical intervention in this population.

Chronic Disease↗
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

Analysis of fibrogenic processes in denervated tissues of spinal cord injury patients.

To test the hypothesis that altered collagen metabolism is a contributing factor in the apparent delayed wound healing in denervated regions of spinal cord injury (SCI) patients, a tissue implant (PVA) was used to directly measure collagen deposition. Sterile PVA implants were placed subcutaneously in the inner aspect of the upper arm above the cord injury (innervated) and in the inner aspect of the upper leg below the cord injury (denervated) of 20 spinal cord injury patients and compared to eight healthy volunteers. On day 14, the implants were removed and analyzed histologically by trichrome stain and biochemically for hydroxyproline as a measure of collagen deposition. No remarkable histologic differences were observed in the sponge material removed from the upper regions compared to the lower denervated regions of the spinal cord injury patients. Sponges from both areas were infiltrated with fibroblasts containing well-developed rough endoplasmic reticulum and large quantities of trichrome-positive collagen. Likewise, upper and lower histology of controls was identical and nondistinguishable from the corresponding sections obtained from the spinal cord injury patients. Quantitation of the hydroxyproline in the arms of the spinal cord injury patients (n = 20) showed 4.3 +/- 0.7 nmol hydroxyproline per milligram of sponge compared to 4.1 +/- 0.4 nmol/mg in the denervated regions of the lower limb. The hydroxyproline content in the arms of control volunteers was 5.2 +/- 0.7 nmol/mg compared to 3.9 +/- 0.8 nmol/mg in the leg (n = 8). These observations suggest that fibrogenic processes in denervated regions are not reduced significantly compared to innervated regions.

Adult↗
PubMed1984

Prostaglandin E2 excretion in spinal cord injury patients.

Hyponatremia has proven to be a common finding in spinal cord injured (SCI) patients. Mechanisms exist whereby SCI patients with either normal or impaired renal function may develop it. One such mechanism may be an impairment in prostaglandin (PGE2) excretion resulting in unopposed activity of antidiuretic hormone (ADH). Paired 24-hour urine collections for PGE2 were collected from SCI patients with varying degrees of renal dysfunction. There was a wide interpatient variability in the excretion of PGE2, with no significant correlation of PGE2 excretion in respect to either urine volume, urine sodium concentration, or the degree of renal dysfunction.

Adult↗
PubMed1983

Chronic hemodialysis of spinal cord injury patients.

Fifteen paraplegics with ESRD have been treated at the Richmond VA Medical Center. The cumulative one year survival was 57%. This is somewhat less than expected for chronic hemodialysis patients from the general population. No patients have received a kidney transplant or been supported with peritoneal dialysis for a long period. The rate of acquisition of patients in this center indicates the rate of treatable ESRD is significantly higher in the spinal cord injury population than in the general population.

Adult↗
PubMed1977

Quantitative assessment of para-osteo-arthropathy and its maturation on serial radionuclide bone images.

Paraplegics whose range of motion is limited by para-osteo-arthropathy (POA) may have difficulty in becoming independent unless the heterotopic bone mass is removed. The recurrence rate is high if the bony mass is not mature at the time of surgery. Radiography and alkaline phosphatase correlations are not trustworthy. In 3 paraplegics with POA, radiolabeled osteotropic agents demonstrated a steady decrease in the uptake ratio (heterotopic/normal bone) followed by a steady-state plateau, reflecting the most useful index of maturation and allowing surgical removal of bone without recurrence.

Adult↗
PubMed1977

Problem oriented medical record: a predetermined problem list for spinal cord injury.

The Problem Oriented Medical Record is ideally suited to the documentation and management of patients with spinal cord injury, with their involvement of multiple organ systems and need for long term follow-up. The classic format described by Weed has been modified by use of a predetermined problem list, subdividing spinal cord injury into eight problems. We find this method to be of value in organizing the records and managing patients, from the acute phase to the follow-up phase, and additionally in organizing the records of long term patients when seen in follow-up. The problems listed are: 1--neurologic injury; 2--spinal skeletal injury; 3--other injuries; 4--general medical conditions; 5--urologic; 6--gastrointestinal; 7--sexual function; 8--rehabilitation. As complications or other problems arise, they are added to this list. Presented are two case histories, one of a long term patient and the other of a patient with new acute spinal cord injury to illustrate the application of this method.

Adult↗
PubMed1977

Anterior fibular interbody fusion in the treatment of cervical spinal cord injuries.

A series of six patients with cervical spine fracture and spinal cord injury treated by removal of the fractured vertebral body and fibular strut graft is presented. There was no immediate mortality or major complication associated with the procedure. The stabilization achieved allowed early mobilization. Solid fusion was achieved in three months in all patients. Postmortem examination in one case showed union at the ends of the graft and bridging of the injured area by new bone. In selected patients interbody fusion is an important adjunct in the treatment of the fractured cervical spine.

Adult↗
PubMedDate not supplied

Forces in the halo-vest apparatus.

A previous study by Koch and Nickel (1978) determined the changes in the distraction forces in the halo-vest during different activities. The present study determined the variations of forces in different directions between the halo and the vest also during different activities. Clip-on strain gauges were used to measure the strains in the bars, while an on-line computer system was used to compute the forces. Anterior-posterior forces were found to be comparable with vertical ones. These forces and the changes during a particular activity were caused by gravity forces of the head in activities involving a change in attitude; and vest distortion from changes in body shape, direct pushing from the lower abdomen, the arms and shoulders, or from supporting surfaces. Activities producing the highest force changes included bending forwards from a seated position and reaching over sideways while lying. Medial-lateral forces were small in comparison with vertical and anterior-posterior forces. Implications of the study were that pin-skull forces were multidirectional, and that certain improvements in design could be effected by accounting for the factors causing high forces and consequently cervical motion.

Adolescent↗