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Biomedical subjects

T McKinley

Publications and source records attributed to T McKinley.

5 recordsLinked to original sources
PubMed2005

Stance-phase aggregate contact stress and contact stress gradient changes resulting from articular surface stepoffs in human cadaveric ankles.

OBJECTIVE: Determine how stepoff incongruities of the distal tibia affect aggregate (whole-cycle) contact stresses and contact stress gradients for a complete motion cycle in human cadaveric ankles. METHOD: Ten human cadaveric ankles were subjected to quasiphysiologic forces during stance-phase range of motion. Each specimen was loaded intact, with anatomic reduction of the anterolateral quarter of the distal tibia, and with increasing stepoffs of the anterolateral fragment up to 4.0mm. Transient contact stresses were measured using a custom-built, real-time stress transducer that sampled stresses at 132Hz at 1472 separate foci (sensels). Aggregate stresses were calculated by summing the sequential transient stress values multiplied by the transient sampling duration for the complete motion cycle at each sensel. Transient contact stress gradients were calculated at each sensel using a central-differencing formula applied to adjacent transient stress measurements. Aggregate contact stress gradients were calculated by vector summation of sequential transient stress gradients multiplied by the sampling duration. RESULTS: Compared to the intact configuration, anatomic reduction of the fragment caused minimal changes in aggregate contact stresses and stress gradients (30% increase compared to intact values). In contrast, stepoffs caused substantial increases (200% increase compared to intact values) in peak and mean whole-cycle stresses and gradients. CONCLUSIONS: Aggregate contact stresses and stress gradients quantify loading history for the complete motion cycle. Incongruity-associated changes in aggregate stresses and gradients are a surrogate for "accumulated" damage over a motion cycle in stepoff specimens. These loading abnormalities may be important determinants of posttraumatic arthritis.

Ankle Injuries↗
PubMed2001

A new articulated elbow external fixation technique for difficult elbow trauma.

Articulated external fixation of the elbow allows aggressive elbow range of motion while protecting the joint and periarticular structures from excessive forces. A technique for aligning a monolateral-hinged fixator to the rotational axis of the elbow without the use of an invasive axis pin has been developed. Thirteen patients with acute and chronic post-traumatic elbow problems were treated over a four year period with this technique. An average arc of motion of 84 degrees was achieved in the frame. Frames were removed at an average of 7.6 weeks. Complications were confined to pin tract infections. In 11 patients followed for an average of 35 weeks the average arc of motion was 81 degrees. Further experience is required to determine the role of this device and to identify which elbows achieve the most benefit compared to conventional techniques.

Adult↗
PubMed1995

Traumatic hip dislocation: early MRI findings.

PURPOSE: Objective of this study was to present the spectrum of early magnetic resonance imaging (MRI) findings following traumatic dislocation of the femoral head, and to identify any associated injuries that may have therapeutic or prognostic significance and be better delineated by MRI than by conventional radiography. PATIENTS AND METHODS: Prospective MRI of both hips was formed on 18 patients (14 male, 4 female; age range 14-54 years; average age 30.5 years) within 5 weeks of a traumatic femoral head dislocation. The interval between the time of injury and the time of injury and the imaging studies ranged from 2 to 35 days (average 13.2 days). Posterior dislocation was present in 14 patients and anterior dislocation in 4 patients. In the majority of cases, we performed axial T1, coronal T1, and coronal T2* (MPGR) sequences. Images were retrospectively evaluated by consensus of three radiologists for possible abnormalities of the bone and cartilage, joint space, and soft tissues. Because all patients were treated with closed reduction, surgical correlation was not obtained. RESULTS: All patients had a joint effusion or hemarthrosis. Of the 14 patients with posterior dislocation, isolated femoral head contusions (trabecular microfractures) were identified in 6 patients. Four patients had small femoral head fractures, and one had an osteochondral defect. Acetabular lip fractures were seen in six patients, and one patient had a labral tear. Four patients had intra-articular loose bodies and one had ligamentum teres entrapment. Twelve patients had iliofemoral ligament injury. All patients had muscle injury involving the gluteal region and medical fascial compartment, and 13 patients had anterior fascial compartment muscle injury. Seven patients with posterior dislocation had posterior fascial compartment injury. Of the four patients with anterior dislocation, two had bony contusion, two had cortical infraction, one had a labral tear, and all four had an iliofemoral ligament injury. All four patients in this group had muscle injury of the gluteal region and of the anterior and medial fascial compartments. CONCLUSIONS: MRI can effectively identify and quantify the muscle injury and joint effusion that invariably accompany traumatic hip dislocations. It is also useful for demonstrating trabecular bone contusion (trabecular injury) and iliofemoral ligament injury, which occur commonly with acute hip dislocation.

Acetabulum↗