Biomedical subjects

T A Kile

Publications and source records attributed to T A Kile.

6 recordsLinked to original sources

PubMed2000

Stress radiography.

Although stress radiography has proven helpful in the past with regards to our understanding of mechanisms of injury and subsequent treatment, difficulty persists in defining consistent criteria for stress radiography of the foot and ankle. Until these have been clearly determined or proven, their validity and applicability in helping the physician arrive at a treatment decision may be questioned. It seems that a careful history, physical examination, and critical interpretation of routine radiographs may be most effective. Stress radiographs may be indicated in the elite athlete as a gauge for the severity of injury and rehabilitation course or in preoperative planning for ankle reconstruction when subtalar instability is a consideration.

Ankle Injuries↗

PubMed1996

Estimating the insertion site during retrograde intramedullary tibiotalocalcaneal arthrodesis.

Intramedullary tibiotalocalcaneal arthrodesis (IMTCA) is an increasingly used procedure for salvage of complex hindfoot and ankle disorders. To avoid injury to vital plantar neurovascular structures, it is important to begin with an appropriate insertion site during retrograde IMTCA. We use a simple, reproducible method to determine this site based on anatomic landmarks.

Arthrodesis↗

PubMed1995

The role of a composite, demineralized bone matrix and bone marrow in the treatment of osseous defects.

The efficacy of demineralized bone matrix (DBM) used alone and with bone marrow as a graft material in the treatment of osseous defects was evaluated in 48 patients. Of these 48 patients, 39 were available to follow up and review. Follow up averaged 19 months for all patients. In the entire series, 30 of 39 patients demonstrated osseous union for a 77% success rate. Patients with fracture nonunion represented the most recalcitrant group clinically, with union achieved in only 61% of these cases. Overall, the 39 patients grafted with DBM demonstrated healing that was comparable to results achieved with standard iliac crest bone graft. The results indicate the DBM and marrow composite grafting is a suitable alternative to autologous iliac crest bone graft for use in certain clinical situations, such as bone defects in children, comminuted fractures with associated bone loss, nonunited fractures, or to augment an intended arthrodesis site.

Adolescent↗

PubMed1994

Modified chevron osteotomy for hallux valgus.

The chevron osteotomy for hallux valgus was modified by addition of screw fixation and change of the osteotomy angle. Thirty-six patients underwent this modified osteotomy. All had mild to moderate symptomatic hallux valgus deformities. No other forefoot procedures were performed. Standing radiographs were taken before surgery, at 1 month after surgery, and, for the 15 patients who returned for long-term follow-up, at 1 year or more after surgery. Overall, 35/42 procedures were rated as satisfactory without reservations and 7 were rated as satisfactory with mild reservations. All patients stated that they had some improvement in their preoperative symptoms, which included pain, cosmetic concerns, and shoe wear difficulties. Radiographically, none of the capital fragments displaced and there were no malunions, nonunions, nor evidence of avascular necrosis. The average metatarsophalangeal-1 angle improved 8 degrees and the average intermetatarsal 1-2 angle improved 4 degrees. This modification is relatively simple, increases stability, and allows early weightbearing. In our experience, the modified chevron osteotomy has been a very reliable procedure for mild to moderate symptomatic hallux valgus deformity.

Adult↗

PubMed1994

Tibiotalocalcaneal arthrodesis with an intramedullary device.

An intramedullary fixation device was devised by the senior author (K.A.J.) to use in conjunction with a previously described method for tibiotalocalcaneal arthrodesis. Satisfactory results were obtained in approximately 87% of the initial 30 patients; union was radiographically or clinically evident in all but two patients. Many of these patients had been offered or were considering below the knee amputation; only two ultimately chose this reconstructive option at a follow-up that ranged from 4 to 27 months.

Adolescent↗

PubMed1994

Hallux valgus due to cuneiform-metatarsal instability.

We present a biomechanical rationale for the treatment of severe hallux valgus deformity by realignment and arthrodesis of the first cuneiform metatarsal (CM) joint. We think that this severe hallux valgus deformity represents instability at the CM-1 articulation, since normal motion at that joint is very small. A forefoot compression test was used to assess the foot preoperatively. This was found not only to realign the first metatarsal, but also to align the metatarsophalangeal joint. A surgical procedure has evolved to include a transverse screw between the first and second metatarsal bases, as well as a second screw from first cuneiform to first metatarsal base, along with a small-volume bone graft of the CM-1 articulation. This is a modern variant of the Lapidus procedure.

Arthrodesis↗