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Biomedical subjects

S J Kumar

Publications and source records attributed to S J Kumar.

At least 37 records · Page 2Linked to original sources
PubMed1990

Lesions of the patellar ligament.

We report 18 cases of pain and tenderness in the mid-part of the patellar ligament in athletes. The condition may be disabling, but it responds to surgery. Ultrasound and CT scans were positive in all 17 confirmed cases, but ultrasound gave a better distinction between the cysts, granulation tissue, metaplasia, mucoid degeneration and congenital defects found at operation.

Adolescent↗
PubMed1990

Calcaneonavicular coalition treated by resection and interposition of the extensor digitorum brevis muscle.

Seventy-five feet in forty-eight patients that had calcaneonavicular coalition were evaluated at two to twenty-three years after resection of the coalition and interposition of the extensor digitorum brevis muscle. The result was excellent or good in fifty-eight feet (77 per cent). Three feet that were rated initially as having a fair result improved over time, and at the last follow-up the result in those feet was rated as good. Only five feet (7 per cent) had a poor result. The best results were in patients who had a cartilaginous coalition and who were less than sixteen years old at the time of operation.

Adolescent↗
PubMed1990

Detection of talocalcaneal coalitions by magnification bone scintigraphy.

Fibrocartilaginous talocalcaneal coalitions are very difficult to identify on plain radiography in symptomatic children and adolescents before gross ossification occurs. Computed tomography (CT) has been successful in identifying osseous and some fibro-osseous coalitions. In this series, magnification imaging of the tarsus on bone scintigraphy in the medial-lateral projection correctly identified talocalcaneal coalitions, seven of the nine bars were fibrous or fibro-osseous. Three of the fibrous lesions were equivocal or normal on conventional radiography and CT. Physiologic accumulations of activity in the growing hind foot are also presented from a control pediatric population. Magnification scintigraphy of the hind foot is offered as an adjunct to plain radiography and CT in the diagnosis of elusive nonosseous subtalar bars.

Adolescent↗
PubMed1990

Amputation or limb-lengthening for partial or total absence of the fibula.

Thirty-two patients who had ablation of the foot by the Syme or Boyd technique for partial or total absence of the fibula, with subsequent fitting of a prosthesis, were compared with eleven patients who had lengthening of the lower limb by the Wagner method, to assess the long-term results of each procedure. The final results were evaluated on the basis of pain, limp, limb-length discrepancy, level of physical activity, and satisfaction of the patient. Of the thirty-two patients who had an amputation, twenty-eight (88 per cent) had a satisfactory result, compared with only six (55 per cent) of the eleven patients who had limb-lengthening. The amount of inequality between the lower limbs was classified as follows: Group I--the foot of the shorter extremity was at the distal third of the contralateral, normal limb, and the percentage of shortening was 15 per cent or less; Group II--the foot of the shorter extremity was at the level of the middle third of the contralateral, normal limb, and the percentage of shortening was between 16 and 25 per cent; and Group III--the foot of the shorter extremity was at the level of the proximal third of the contralateral, normal limb, and the percentage of shortening was greater than 26 per cent. Lengthening was best suited for patients in Group I who had stable hips, knees, and ankles and a plantigrade foot. Patients in Groups II and III were best served by ablation of the foot and fitting of a prosthesis.

Adolescent↗
PubMed1990

Sonography in the management of tibial hemimelia.

In the evaluation of tibial hemimelia, it is important to establish the presence or absence of the cartilaginous tibial anlage. When present, sonography effectively identifies and characterizes the tibial cartilage anlage and determines the presence and integrity of the patellar tendon.

Female↗
PubMed1989

Subtalar joint coalition in children: new observations.

Eleven children with clinical and radiographic findings suggestive of nonosseous subtalar coalition were found to have fibrous bridges at the time of surgery. A second group of 14 children with similar clinical and radiographic findings is being conservatively treated at present. This series of children suggests that a common site of nonosseous subtalar coalition is found posterior to the sustentaculum tali. Diagnosis of nonosseous coalition requires careful examination with computed tomography, with attention to subtle changes in the hindfoot, particularly posterior to the sustentaculum tali.

Adolescent↗
PubMed1988

Ultrasound evaluation of hip position in the Pavlik harness.

Fifty infants undergoing treatment in the Pavlik harness for congenital hip dysplasia (CDH) were serially evaluated with ultrasound. Comparison with clinical and radiographic examinations showed sonography to be 100% sensitive and highly specific. Discrepancies between the studies are attributed to the greater sensitivity of the technique compared with the physical examination and/or radiographs. Using this method, it is possible to significantly reduce radiation exposure to the infant being treated for CDH.

Hip Dislocation, Congenital↗
PubMed1988

Chiari pelvic osteotomy in children and young adults.

We conducted a follow-up study of twenty-four patients who had been treated with a Chiari osteotomy at the Alfred I. duPont Institute between 1966 and 1981. The length of follow-up ranged from three to twenty years, and the age at operation ranged from ten to twenty-three years. The indication for the operation was either painful dysplasia or gross instability of the hip. Twelve patients had had congenital dislocation of the hip; six, poliomyelitis; three, cerebral palsy; and three had had another disorder. A good or excellent result was obtained in twenty-one of the twenty-four patients. Preoperative pain and antalgic gait were consistently improved. In twenty-one patients, the osteotomy had to be displaced more than 50 per cent to provide adequate coverage of the femoral head, and bone-grafting was necessary at the site of the osteotomy to prevent problems with healing.

Adolescent↗
PubMed1984

Physeal, metaphyseal, and diaphyseal injuries of the lower extremities in children with myelomeningocele.

A study of 16 patients with myelomeningocele who sustained 37 fractures revealed that children with diaphyseal and metaphyseal fractures presented with local warmth, redness, swelling, and increased general body temperature, leukocytosis, and sedimentation rate. These fractures were the result of a single stress or trauma and healed uneventfully by splinting for approximately 4 weeks. In physeal injuries, which probably resulted from repetitive stresses, the systemic response was less pronounced. These injuries had to be immobilized more rigidly in plaster casts for a minimum of 8 weeks.

Adolescent↗
PubMed1984

Osteoid osteoma of the proximal femur: new techniques in diagnosis and treatment.

The nonspecific symptoms and radiographic findings associated with osteoid osteoma in the proximal femur mimic inflammatory conditions and delay diagnosis. A review of four cases showed high resolution computerized axial tomography in conjunction with a radioisotope bone scan best demarcated the location and size of the lesion. The combination of careful preoperative localization and intraoperative use of a radiation probe made adequate resection possible while limiting the amount of bone excised. This technique eliminated the need for internal fixation and reduced the duration of the recovery period.

Adult↗
PubMed1982

Posterolateral spinal fusion for the treatment of scoliosis in myelodysplasia.

Twenty-seven patients have undergone posterolateral spinal fusion for the treatment of scoliosis associated with myelodysplasia. Seventeen patients were girls, and 10 were boys. The average age at the time of surgery was 10.6 years in the girls and 11 years in the boys. The average preoperative curve was 78.52 degrees. All patients were fused at the sacrum; the upper level of fusion was at the fourth thoracic vertebra in 20 patients and at the third thoracic vertebra in 7 patients. Harrington instrumentation was used in 5 patients. The average improvement in curvature was 44.5%. Based on clinical and functional criteria, 16 patients had good results, 4 patients had fair results, and 7 patients had poor results.

Adolescent↗