Biomedical subjects
T B Dameron
Publications and source records attributed to T B Dameron.
Displaced supracondylar humeral fractures in children. A comparison of results and costs in patients treated by skeletal traction versus percutaneous pinning.
Clinical outcome and treatment cost were compared in 65 children treated by either percutaneous pinning or skeletal traction for displaced supracondylar humeral fractures. Clinical outcome was evaluated by loss of elbow motion and change in carrying angle. Results of treatment were basically equivalent in the two groups and were satisfactory in 90% or more. To determine treatment cost, the authors analyzed factors that vary according to the type of therapy. Cost of treatment was lowest in those who had percutaneous pinning and subsequent pin removal in the office. Compared to this group, the cost of treatment increased by 23% in those who had percutaneous pinning and removal of the pins as a surgical procedure, by 117% in those treated by traction with the olecranon pin inserted in the emergency room, and by 142% in those treated by traction with the olecranon pin inserted in the operating room.
The Wake County medical community realizes their dream of a center for health education.
Explore the source record for details and available documents.
External fixation of the clavicle for fracture or non-union in adults.
Explore the source record for details and available documents.
Continued change and constancy.
Explore the source record for details and available documents.
Displaced olecranon fractures in adults. Biomechanical analysis of fixation methods.
Four commonly used methods of internal fixation for displaced olecranon fractures were analyzed in a biomechanical model to determine strength of fixation. A transverse osteotomy in fresh cadaver specimens was internally fixed and was tested to failure by rapid loading. Screw plus wire in combination provided the greatest strength of fixation. Energy to failure averaged 31.0 Nm for cancellous screw, 32.0 Nm for figure-of-eight wire, 35.3 Nm for Arbeitsgemeinschaft fur Osteosynthesefragen (AO) tension band, and 39.4 Nm for screw-plus-wire combination. Comparison of screw and wire in combination to screw alone or to figure-of-eight wire demonstrated a significant difference (p less than 0.05). The difference between screw plus wire and AO tension-band fixation did not achieve statistical significance (0.2 greater than p greater than 0.1).
Displaced olecranon fractures in adults. Clinical evaluation.
Displaced fractures of the olecranon in adults were analyzed for pain, function, range of motion, and roentgenographic appearance. With one exception, the 38 transverse or oblique fractures were treated by reduction and internal fixation. Results were best in the group treated by screw plus wire in combination (average rating, 17.7 points). Other ratings averaged 17.2 for the intramedullary screw, 16.8 for figure-of-eight wire, and 16.7 for Arbeitsgemeinschaft fur osteosynthesefragen (AO) tension-band wire. Factors associated with poorer results included postoperative displacement or malreduction greater than or equal to 2 mm and articular involvement greater than or equal to 60%. Symptomatic metal prominence was particularly common after AO tension-band wiring, occurring in 80%. All seven comminuted fractures were treated by primary excision. The one comminuted fracture with greater than or equal to 60% articular involvement that was treated by excision had a poor result because of instability.
Adamantinoma of the appendicular skeleton.
Adamantinoma is a slowly developing tumor originating in the bones of the extremities and containing cells that resemble amelioblasts but do not produce enamel. Anamantinoma's clinically and histologically benign appearance is deceptive, for the recurrence rate is high unless surgical extirpation is complete. Thus, aggressive surgical excision of the involved area of bone should be performed at the time of diagnosis. Allograft substitution may be an effective alternative to amputation.
Management of acute ankle sprains.
Explore the source record for details and available documents.
Surgical treatment for nonunion of the scaphoid.
Fracture of the scaphoid is the most common injury of the carpal bones. Most scaphoid fractures heal after immobilization. When the fracture does not unite, degenerative arthritic changes and disability may occur. Twenty-four symptomatic nonunions treated surgically were reviewed. Based on presence of union, percent of normal motion, and patients' symptoms, results were rated good in 19 cases and fair in five. Nine of ten patients treated with bone grafting and styloidectomy had union of fractures with good results. All five patients with bone grafting and internal fixation had union. Excision of proximal fragments of more than one third to one half of the scaphoid, and internal fixation alone, had unsatisfactory results. A styloidectomy should excise approximately one half of the radius articulating with the scaphoid. If not enough styloid is excised, osteophytic overgrowth will occur; if too much is excised, the carpus will sublux radially.
Fractures and anatomical variations of the proximal portion of the fifth metatarsal.
Fractures of the tuberosity of the fifth metatarsal are frequent and with conservative treatment uniformly heal well. In contrast, fractures of the metatarsal shaft distal to the tuberosity heal slowly. Of 100 fractures of the tuberosity, almost all were clinically united within three weeks and roentgenographically united within two months. Of twenty fractures in the proximal part of the shaft, five required bone grafts and the time elapsed before roentgenographic and clinical evidence of union was variable and often prolonged.