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Biomedical subjects

W G Clancy

Publications and source records attributed to W G Clancy.

At least 37 records · Page 2Linked to original sources
PubMed1983

Treatment of knee joint instability secondary to rupture of the posterior cruciate ligament. Report of a new procedure.

For the past five years we have attempted to correct knee instability due to rupture of the posterior cruciate ligament with a procedure that employs a free graft of one-third of the patellar tendon with its tibial and patellar attachments. This procedure was done for chronic instability in thirty-three patients and was combined with primary repair of an acute mid-substance tear of the posterior cruciate ligament in fifteen patients. Moderate to severe articular injury of the medial femoral condyle was found at operation in 48 per cent of the patients with chronic injury. Seventy-one per cent of the patients for whom the interval between injury and ligament reconstruction was two to four years, and 90 per cent of those for whom the interval was more than four years, showed articular injury of the medial femoral condyle. Only 31 per cent of the patients, however, had preoperative radiographic findings that indicated femoral articular damage. Twenty-three of the twenty-five patients with a minimum follow-up of two years returned for evaluation. All of the ten patients who had had a repair and reconstruction of an acute ligament injury (whose average follow-up was forty-one months) had a static and functional result that was graded as good or excellent. Of the thirteen patients for whom surgery was done for chronic instability (whose average follow-up was thirty-one months), the over-all static and functional result was graded as good or excellent in eleven. These results indicate that the use of one-third of the patellar tendon for reconstruction in patients with acute mid-substance tears as well as in patients with symptomatic chronic instability of the posterior cruciate ligament is an effective procedure for achieving static and functional stability of the knee.

Adult↗
PubMed1982

Anterior cruciate ligament reconstruction using one-third of the patellar ligament, augmented by extra-articular tendon transfers.

Eighty patients with persistent clinical and functional instability of the knee due to anterior cruciate ligament insufficiency underwent the operation reported, in which one-third of the patellar ligament substitutes for the cruciate ligament and extraarticular tendon transfers, medial and lateral, augment the substitution. The patients were followed for a minimum of two years, and fifty returned for personal evaluation. The average follow-up was thirty-three months, with a range of two to five years. There were thirty-five male and fifteen female patients. The average age was twenty-three years. The average interval from initial injury to the index operation was two years. Meniscal tears and articular changes were noted in most of the patients. Forty-three (86 per cent) of the fifty patients had at least one torn meniscus, twenty-seven patients (54 per cent) had significant degenerative articular changes, and fourteen (28 per cent) had patellar articular changes. In the procedure described, eccentric placement of the tibial and femoral tunnels for more accurate placement of the patellar ligament substitute is essential. The over-all results were graded as excellent in thirty knees, good in seventeen, fair in one, and a failure in two. One knee that was classified as a failure showed excellent stability, but the patient had significant pain from chondromalacia of the patella, while significant pain and hyperesthesia from a neuroma was the reason for failure in the second patient.

Adolescent↗
PubMed1982

Cross-country ski injuries.

Cross-country skiing is a reasonably low risk sport that can be enjoyed by athletes of all ages. It is an excellent cardiovascular fitness sport that at the same time offers rewarding scenery and solitude. The risk of injury can be decreased by taking lessons, taking care on downhill sections, using equipment that does not have too much heel fixation, wearing proper clothing, and being in condition prior to the start of the season.

Athletic Injuries↗
PubMed1981

Anterior and posterior cruciate ligament reconstruction in rhesus monkeys.

Although numerous procedures have been described for the reconstruction of the anterior and posterior cruciate ligaments, there has been little evaluation of the viability and strength of these substitutes. Using microangiographic, histological, and biomechanical techniques, we studied the vascularity and tensile strength of the medial one-third of the patellar tendon at intervals after it had been inserted as a substitute for either the anterior or the posterior cruciate ligament in twenty-nine young adult Rhesus monkeys. For the anterior cruciate reconstruction (nineteen knees), we used and medial one-third of the patellar tendon elongated by a portion of the patella. For the posterior cruciate reconstruction (ten knees), we used the medial one-third of the patellar tendon lengthened by attached portions of the patella and tibia as a free graft. Both the anterior and the posterior cruciate ligament substitutes were revascularized at eight weeks, and at one year they had approximately 80 per cent of the tensile strength that they had prior to transfer.

Animals↗
PubMed1979

Upper trunk brachial plexopathy in football players.

Ten football players seen from 1973 through 1977 at the University of Wisconsin Hospitals were found to have clinical and electrodiagnostic evidence of injury to the upper trunk of the brachial plexus. Each had upper limb paresis following one or more blows to the head or shoulders. The development of persistent weakness often was preceded by burning paresthesias in the upper limb. Our experience suggests that the syndrome of burning paresthesias and subsequent arm weakness frequently is secondary to stretching of the brachial plexus.

Arm↗
PubMedDate not supplied

Achilles tendonitis in runners: a report of five cases.

Achilles tendonitis is a significant disability in the runner and may often cause runners to lose an entire season of competition. The exact pathophysiology of the problem is uncertain. However, it is the belief of the authors that Achilles tendonitis in the runner often represents a microscopic tear in the tendon which, if not adequately treated, may lead to a macroscopic tear. We recommend surgical treatment in those patients with chronic symptoms who have not responded to conservative measures.

Achilles Tendon↗
PubMedDate not supplied

Upper trunk brachial plexus injuries in contact sports.

Cervical nerve pinch syndrome, a neurapraxia of the brachial plexus, is a common occurrence in contact football. The incidence at two universities was approximately 49%. The more serious injury, brachial plexus axonotmesis, has received little attention in the literature. We are reporting 13 cases of brachial plexus axonotmesis. Ten were documented by electromyography. All involved the upper trunk. All but one patient recovered within a 3- to 42-week interval. These brachial plexus axonotmesis injuries may initially present as a cervical nerve pinch syndrome. All significant or repeated cervical nerve pinch injuries should be reexamined at 2 weeks. Those patient with axonotmesis should not be allowed to return to competition until they have achieved normal strength in the involved muscles and the electromyogram shows no signs of active denervation.

Athletic Injuries↗
PubMedDate not supplied

Tartan Turf on trial. A comparison of intercollegiate football injuries occurring on natural grass and Tartan Turf.

We retro- and prospectively compared collegiate football injuries that occurred on the grass and Tartan Turf (3M Company, St. Paul, Minnesota) fields at the University of Wisconsin. Retrospective injury data were obtained from questionnaires returned by 235 of 450 athletes that competed from 1960 to 1973. Prospective injury data were obtained by examination of athletes injured from 1975 through 1977. Although the number of injuries occurring on each playing surface were not significantly different, the type and severity of injuries were significantly different. We found that significantly more serious sprains and torn ligaments occurred on grass than occurred on Tartan Turf. There were significantly more scrapes (minor injuries) on the Tartan Turf than on the grass. We conclude that we may be prematurely returning to natural grass playing surfaces, and--to the detriment of the athlete--ending production of one synthetic turf that helped reduce major injuries.

Athletic Injuries↗
PubMedDate not supplied

Surgical injury to the lateral aspect of the knee. A comparison of transverse and vertical knee incisions.

We retrospectively evaluated postoperative straight lateral and anterolateral rotatory knee stability in patients having a lateral meniscectomy through vertical and horizontal capsular incisions. The knees of 20 patients with transverse (Bruser) and 20 patients with vertical (parapatellar) incisions were clinically and mechanically evaluated. Varus-vagus and anterior drawer measurements were obtained from our knee stress machine and clinical examinations. We found that (1) horizontal and vertical lateral capsular incisions do not produce straight lateral or anterolateral rotatory instability in patients with intact anterior cruciate ligaments, (2) a transverse lateral capsular incision may contribute to anterolateral rotatory instability, and (3) a vertical lateral capsular incision provides better visualization of the knee joint than a transverse incision.

Adult↗