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W D Arnold

Publications and source records attributed to W D Arnold.

At least 19 recordsLinked to original sources

The bowel management tube: an effective means for controlling fecal incontinence.

Regular bowel washout enemas have been used as a method of management of fecal incontinence. The effective administration of a washout enema to a child with weak anal sphincters is often a problem. Using a new silastic balloon-tipped enema catheter (bowel management tube [BMT]) of our design, we prospectively studied its effectiveness in a group of children who suffered fecal incontinence. Thirty-one children were studied over a 1-year period. Their diagnoses included meningomyelocele (19), postoperative Hirschsprung's disease or imperforate anus (10), and other (2). Before and after starting the BMT enema system, clinical assessment and a diary, which graded the degree of fecal incontinence and satisfaction with the system, were completed. Five patients failed to benefit because of noncompliance (3) or balloon extrusion (2). Three more patients discontinued the use of the tube system. Twenty-three patients achieved successful results with this system as evidenced by a significant amelioration in their fecal incontinence and their unwillingness to give up the use of the BMT. We conclude that the use of a regular washout enemas with BMT can be an effective method for control of fecal incontinence in children.

Adolescent

The effect of early weight-bearing on the stability of femoral neck fractures treated with Knowles pins.

I compared the effects of early weight-bearing on the stability of femoral neck fractures following Knowles-pin fixation with data on a similar group of patients who were studied ten years previously, in which weight-bearing had been delayed until radiographic evidence of fracture-healing was apparent. The results concerning stability were essentially comparable, indicating that early weight-bearing did not adversely affect the stability of a properly reduced and pinned displaced fracture of the femoral neck. Factors that did adversely affect stability following fixation with Knowles pins included the degree of initial displacement of the fracture (Garden Type IV), failure to adequately reduce or fix the fracture, and severe demineralizing bone disease as measured in an iliac-crest biopsy specimen obtained at the time of surgery.

Adult

Simultaneous fractures of both femoral necks: review of the literature and report of two cases.

Simultaneous fracture of both femoral necks is extremely rare. Delay in diagnosis may be avoided by noting the association of these fractures with two conditions: violent skeletal trauma and major motor seizures. Treatment of two patients is reported in addition to a review of seven cases previously reported. The author's experience indicates that accurate reduction and percutaneous Knowles pinning provide adequate fixation and permit early weight-bearing.

Adult

Haemophilic arthropathy in the joints of the hands and feet.

Radiographs of the hands and feet of 72 haemophilic patients were reviewed for peripheral joint involvement. Fifty patients or 69% had changes in the small joints of their hands and/or feet with a total of 160 abnormal joints. In the hands the metacarpo-phalangeal joints were predominantly involved (42 of 50 joints), and in the feet, the metatarso-phalangeal joints (68 of 110 abnormal joints), as well as the posterior subtalar joint (36 of 110 joints). Röntgen abnormalities were characterized by irregularity and/or flattening of the articular cortices. The involvement of the small peripheral joint in haemophilic patients has not been a primary consideration in previous clinical and radiographic studies because of the more common and more debilitating changes in the large joints. The recognition of involvement of the small joints is described to avoid misinterpretation of the röntgen findings and to appreciate the incidence of involvement, especially with the increased availability of replacement therapy.

Adolescent

Fractures in thalassemia.

Fractures occur frequently in patients with homozygous beta-thalassemia. A study was made of the fractures noted in a group of patients who were followed at the Thalassemia Clinic at The New York Hospital-Cornell Medical Center. Results indicate that these patients often sustain fractures which are multiple and which frequently heal with resultant deformities.

Adolescent

Synovectomy.

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Factor VIII

Osteoid osteomas in siblings. Case reports.

Osteoid osteomas occurred in siblings with a nearly simultaneous onset of symptoms, and with some unusual neoplastic characteristics. The combination of simultaneous occurrence and neoplastic change suggests that a viral or other infectious etiology is possible.

Adolescent