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Biomedical subjects

S J Voto

Publications and source records attributed to S J Voto.

12 recordsLinked to original sources
PubMed1993

Role of the calcaneal heel pad and polymeric shock absorbers in attenuation of heel strike impact.

The capacity of the calcaneal heel pad, with and without augmentation by a polymeric shock absorbing material (Sorbothane 0050), to attenuate heel strike impulses has been studied using five fresh human cadaveric lower leg specimens. The specimens, instrumented with an accelerometer, were suspended and impacted with a hammer; a steel rod was similarly suspended and impacted. The calcaneal heel pad attenuated the peak accelerations by 80%. Attenuations of up to 93% were achieved by the shock absorbing material when tested against the steel rod; however, when tested in series with the calcaneal heel pad, the reduction in peak acceleration due to the shock absorbing material dropped to 18%. Any evaluation of the effectiveness of shock absorbing shoe materials must take into account their mechanical interaction with the body.

Biomechanical Phenomena↗
PubMed1989

Ankle arthroscopy: neurovascular and arthroscopic anatomy of standard and trans-achilles tendon portal placement.

Ankle arthroscopy is an accepted method of evaluating ankle disorders. Accurate arthroscopic portal placement is essential because of the proximity of superficial and deep neurovascular and tendinous structures of the ankle. In order to define this anatomy as it pertains to safe portal placement, five fresh frozen cadaver ankles were dissected after standard arthroscopic portals were placed anteriorly and posteriorly. All structures were identified. The distances to these structures from the most lateral portals were recorded. Five other ankles were arthroscoped using standard portals and evaluated. In addition, a trans-achilles tendon (TAT) approach was evaluated for portal use. Ankle arthroscopy can be performed in a safe, reproducible manner when the following recommendations are followed: (a) outline tendinous structures, and remain parallel to them with the knife blade to avoid laceration of underlying structures; (b) penetrate only the skin with the knife to avoid laceration of superficial nerves in the subcutaneous tissue; (c) perform pre- and postneurovascular examination; and (d) understand that anterocentral and posteromedial portals are potentially hazardous to their respective neurovascular bundles. The TAT approach, based only on cadaver studies, appears anatomically safe and offers the potential advantage of an additional posterior portal.

Achilles Tendon↗
PubMed1988

Arthroscopic surgical management of osteochondritis dissecans of the knee.

Surgical management of osteochondritis dissecans of the knee is indicated when the ununited fragment remains persistently ununited and the knee becomes symptomatic and does not respond to conservative measures of rest and immobilization. Traditionally, arthrotomy was done and either bone peg grafts, with or without fixation, or excision of the fragment and drilling of the base of the crater were performed. This paper presents a series of 29 patients who were treated surgically for symptomatic osteochondritis dissecans using arthroscopic techniques. In this series of patients, excision of fragment and drilling or abrasion of the crater were done. In the instances when the fragment had become a loose body, the loose body was simply excised and the crater was then either drilled or left alone. The plan of this study is to follow up these patients for a long time to determine the ultimate result. To our knowledge, this paper is the first report of the early results of this form of surgery in the treatment of this difficult lesion of the knee. The early follow-up indicates a 72% satisfactory result rate when both subjective and objective means of measuring the results are considered. An interesting finding during the study was the high incidence of significant intra-articular pathology (51%) other than the osteochondritis discovered when arthroscopic techniques are used. There were no complications from the arthroscopic surgery.

Acute Disease↗
PubMed1988

Retrotendinous calcification of the infrapatellar tendon: unusual cause of anterior knee pain syndrome.

Bilateral anterior knee pain is a common presentation to the orthopaedist. Correct diagnosis is based on careful history and physical examination aided by proper radiographs. Erroneous diagnosis may lead to improper treatment. This report describes a case of bilateral anterior knee pain syndrome of 3 years' duration. The teenaged patient was believed to be suffering from seronegative rheumatoid arthritis. Her pain persisted despite numerous antirheumatoid medications as well as a single injection of steroids into each infrapatellar tendon. The management of her case by means of arthroscopic surgical intervention is described.

Adolescent↗
PubMed1988

Arthroscopic training using pig knee joints.

Arthroscopy can be a difficult technique for the resident and staff physician to master. Various models have been constructed to allow the training arthroscopist time to perfect the technique. Aside from cadaver knees, there has been only one report of a successful in vivo training model. Sectioned pig knee joints for teaching and practicing arthroscopy satisfy many of the points suggested by others: they are cost effective, easy to use, mount and store, provide a realistic approach, and have comparable structural anatomy to the human knee.

Animals↗
PubMed1986

Acute urinary retention precipitated by ethchlorvynol overdose.

A 75-year-old woman developed acute urinary retention after ingestion of 20 100 mg ethchlorvynol tablets in a suicide attempt. To the authors' knowledge acute bladder dysfunction has not been previously ascribed to ethchlorvynol, but has been described often with therapy with various psychotropic medications. The mechanism of such bladder dysfunction may be direct action on bladder muscle, or parasympathetic cholinergic blockade, but has not been clarified. The risk of acute bladder dysfunction and the possibility of underlying bladder disorder must be considered in all patients receiving sedative-hypnotic drugs, particularly the elderly.

Aged↗
PubMedDate not supplied

The chondroepitrochlearis muscle.

The chondroepitrochlearis is a rare muscle anomaly of the pectoral region in the human. The anomaly is an abnormal musculotendinous unit that is found to originate from the pectoralis major and inserts onto the medial epicondyle of the humerus. This muscle, at times, can be associated with the muscular arch of the axilla and can not be mistaken for the rare coracobrachialis longus. The authors are reporting a 2-week-old infant of normal gestational age with this exceedingly rare anomaly and the only known reported successful surgical release of this muscle with return to normal functional status and cosmetic improvement.

Humans↗
PubMedDate not supplied

Redisplacement after closed reduction of forearm fractures in children.

Reangulation and displacement after closed reduction of pediatric forearm fractures were reviewed in 90 patients treated with 1978-1984. All fractures were remanipulated and followed to union. No complications occurred and all had a functionally satisfactory result. Both intrinsic and extrinsic factors were identified as contributing to the complication of reangulation/displacement. Nonepiphyseal fractures were safely remanipulated up to 24 days postfracture, with the majority at 1-2 weeks. We conclude that 7% of pediatric forearm fractures treated by closed reduction are subject to reangulation and/or displacement following routine acceptable primary treatment, and that remanipulation provides a safe, effective means to obtain and maintain reduction.

Adolescent↗
PubMedDate not supplied

Use of pins and plaster in the treatment of unstable pediatric forearm fractures.

The treatment of unstable forearm fractures in children remains a challenging and controversial subject. There are times when more rigid fixation is needed to obtain and maintain fracture reduction. Open reduction/internal fixation or intramedullary nailing can be avoided by the use of the technique of pins and plaster. This study reviewed 20 forearm fractures treated between 1978 and 1984. All fractures healed uneventfully in satisfactory alignment. No complications were encountered. We conclude that the method of pins and plaster is a safe and reliable method to treat unstable pediatric forearm fractures.

Adolescent↗
PubMedDate not supplied

Treatment of osteoid osteoma by computed tomography guided excision in the pediatric patient.

An osteoid osteoma is a benign lesion that can occur in any bone. Controversy exists regarding treatment of this condition. This study demonstrates that the nidus of an osteoid osteoma can be disrupted and removed by use of the CORB biopsy system guided by computed tomography (CT) scan. Of nine patients followed for an average of 42.5 months (range 18-76 months), seven have had complete resolution of their pain after this procedure. The technique failed in two patients, who each required two separate en bloc excisions with bone grafting to resolve each lesion. CT-directed CORB appears to be useful in localization and removal of the nidus of an osteoid osteoma.

Adolescent↗