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Biomedical subjects

W G Stamp

Publications and source records attributed to W G Stamp.

At least 19 recordsLinked to original sources
PubMed1993

Transfibular compression arthrodesis of the ankle joint.

Eleven ankle arthrodeses were performed on ten patients using a transfibular technique. This technique employs a lateral approach in which the distal fibula is resected while preserving the peroneal tendon sheath, allowing excellent exposure and contouring of the tibiotalar joint. Compression is attained by using a T-plate placed across the tibiotalar joint with the aid of an AO compression apparatus. At 2.5 years after operation, fusion was achieved in ten ankles. Average time in immobilization was 11.8 weeks, and the fused ankle was cosmetically pleasing. Fusion occurred in nine of 11 ankles fused using other methods during this period. Pin tract infection occurred in three, the time in immobilization averaged 16.2 weeks, and the cosmetic result was inferior.

Activities of Daily Living↗
PubMed1988

Traction bow for acute reduction of fracture and/or dislocation of the thoracic or thoracolumbar spine.

Treatment of acute fractures and/or fracture dislocations of the thoracic or thoracolumbar spine has traditionally involved bedrest or the use of traction devices with external hanging weights, until surgical correction can be accomplished. A fiberglass tubular traction bow with continuous adjustable elastic tension has been designed for the application of skeletal traction. When used to treat thoracic or thoracolumbar fractures and/or dislocations, it can maintain distraction forces in an uninterrupted fashion. Ten patients with acute fractures and/or dislocations of the thoracic or thoracolumbar spine were treated with this traction bow. All of the spinal deformities showed dramatic improvement within the first 3 h of treatment. The patients all showed immediate lessening of acute severe pain, and those with incomplete neurologic loss showed improvement of their neurologic function. The patients all tolerated the device well and were able to undergo radiologic examination and, ultimately, spinal fusion while they were stabilized in the traction bow. We believe this device is especially valuable for immediate reduction of spine and care of patients with fractures or fracture dislocations of the thoracolumbar spine.

Adolescent↗
PubMed1988

The effect of halo-vest length on stability of the cervical spine. A study in normal subjects.

In order to study how the efficiency of the halo vest is affected by different lengths of the vest, an experimental headband was devised that allowed the head of a normal person to be held securely in the halo attachment. The vest was then modified to allow it to be adjusted to three different lengths (Fig. 2): a full vest extended to the iliac crests, a short vest extended to the twelfth ribs, and a half vest extended to the level of the nipples. Twenty normal, healthy adult men participated in the study. For each vest length, radiographs were made of each subject demonstrating rotation, flexion-extension, and lateral bending of the cervical spine. There was no rotation of the cervical spine, regardless of the length of the vest. There was a variable degree of motion in flexion or extension of the upper part of the cervical spine with all vest lengths, but this was not statistically significant. There was definite increase of motion caudad to the level of the fifth cervical vertebra regardless of the length of the vest. We concluded that a lesion of the upper part of the cervical spine can be treated effectively by halo traction with a half vest. This will improve the comfort and care of the patient and avoid the necessity of removing the vest if emergency cardiovascular resuscitation is needed. In the treatment of lesions of the lower part of the cervical spine (caudad to the level of the fourth cervical vertebra), the use of a halo vest that extends caudad to the level of the twelfth ribs does provide additional stability.

Adult↗
PubMed1986

Complications associated with the halo-vest. A review of 245 cases.

The cases of all patients treated with halo-vests for cervical trauma at the University of Virginia since 1977 were analyzed retrospectively. A standardized chart and radiographic review protocol were used to identify complications associated with the use of the orthosis. Two hundred and forty-five patients satisfied the criteria for inclusion in the study. No patient developed or suffered progression of a neurological deficit while immobilized. Complications included: pneumonia causing death (one patient); loss of reduction or progression of the spinal deformity (23 patients); spinal instability following orthotic immobilization for 3 months (24 patients); pin-track infection (13 patients); migration of anteriorly placed iliac-strut grafts (two patients); cerebrospinal fluid leakage from a halo pinhole (one patient); and miscellaneous (seven patients). The findings indicate several conclusions. The halo-vest protects patients with cervical instability from neurological injury. It does not absolutely immobilize the cervical spine nor does it prevent progressive deformity of malpositioned strut grafts. Even after a 3-month orthotic treatment period, surgery may be required on ligamentous and osseous injuries to provide spinal stability. Elderly kyphotic patients may require custom-made vests. A small subset of patients exists for whom the confining nature of the halo-vest is intolerable for 3 months.

Adolescent↗
PubMed1985

The effect of core decompression on femoral head blood flow in steroid-induced avascular necrosis of the femoral head.

Previous reports from this and other laboratories have shown that the histological changes in the femoral head that are associated with steroid treatment are consistent with avascular necrosis of the femoral head. In this experiment, we studied the effect of core decompression on femoral head blood flow in steroid-treated rabbits using the microsphere technique. The results showed that there was a gradual decline of femoral head blood flow in animals that received weekly injections of methylprednisolone without core decompression. The femoral head blood flow in animals that underwent core decompression after six weeks of steroid treatment showed a gradual normalization within four weeks after core decompression.

Adrenal Cortex Hormones↗
PubMed1984

Safety of anterior cement fixation in the cervical spine: in vivo study of dog spine.

There is increased use of methylmethacrylate in the treatment of neoplastic lesions of the spine. The advantage of this treatment is immediate stabilization, thus avoiding prolonged immobilization. In vivo study using a dog model showed that anterior fixation with cement, with or without Gelfoam as insulation material, produced no spinal cord injury.

Animals↗
PubMed1984

The nonsurgical management of odontoid fractures in adults.

Twenty-five odontoid fractures that were treated nonsurgically at the University of Virginia Hospital in the last 5 years were reviewed. Motor vehicle accidents were the major cause of this injury in our series. Early recognition and firm external stabilization of Type I and Type III fractures of the odontoid resulted in union in 100% of our patients. There were 12 Type II fractures with a nonunion rate of 42%. Thus, an overall rate of union of 80% was obtained. It is suggested in the literature and by this series that early recognition, reduction, and rigid external immobilization of Types I and III fractures of the odontoid should promote bony union. Type II fractures may also be managed successfully by closed methods, although the outcome is less certain.

Adolescent↗
PubMed1984

The use of bone allograft: a survey of current practice.

A questionnaire was sent to all chairmen of American orthopedic training programs, requesting information on their use of bone allograft and banking methods. Of the 93% who responded, 55% reported using bone allograft most commonly for benign tumor defects or spine fusions. Methods of procurement, preservation, and storage varied widely.

Bone Transplantation↗
PubMed1984

Comparative strength of anterior spinal fixation with bone graft or polymethylmethacrylate. Experimental operations and observations on dogs.

In 23 dogs, polymethylmethacrylate (PMMA) was safely implanted in the region of the spinal cord. The dogs were treated by bone or cement fixation after anterior excision of a single cervical vertebral body. Fixation was compared at 0-18 weeks, with control values obtained from 11 dogs. Anterior cement fixation did not displace after 18 weeks. The anterior bone graft appeared to achieve adequate fixation strength around six weeks. The strength of the bone-graft fixation increased, while that of cement fixation decreased somewhat with time. At all time intervals, the ratio of energy absorption to structural failure was somewhat higher with bone graft than with PMMA.

Animals↗
PubMed1983

Femoral head blood flow in long-term steroid therapy: study of rabbit model.

Using a rabbit model, previous studies showed steroid-induced hyperlipidemia with subsequent fatty embolization of the subchondral arteries and hypertrophy of the marrow fat cells, followed by elevation of femoral head pressure from the normal level of 25 cm to nearly 60 cm H2O after eight weeks of treatment. This has led us to believe that pressure changes lead to decreased blood flow in the femoral head. In our study of 22 New Zealand white adult rabbits, weighing an average of 4.0 kg, 14 received a weekly dose of 12.45 mg of methylprednisolone (Depo-Medrol), and eight served as control. Femoral head blood flow was established using the radioactive microsphere technique. Control and cortisone-treated rabbits had femoral head blood flow measured 6, 8 and 10 weeks after treatment. The average blood flow in the control femoral heads averaged 0.2039 +/- 0.076 ml/min/gm, with no difference in the left side and the right side. In the treated group, the average blood flow at ten weeks was 0.162 +/- 0.039 ml/min/gm on the right and 0.164 +/- 0.037 ml/min/gm on the left, which was significantly different. This is parallel to unpredictable clinical findings in human beings.

Animals↗
PubMed1983

Comparative strengths of various anterior cement fixations of the cervical spine.

In vivo study, using cadaveric dog cervical spine, was performed in which the middle segment of the vertebral body was removed producing anterior instability. Eleven various methods of stabilization utilizing polymethylmethacrylate and other fixation devices were employed, and their static strength in hyperextension was tested and compared. A portion of the same dog's cervical spine in each case was used as a control. The results indicate that all fixation methods failed to regain the normal structural strength in extension. Cement with wire or chain methods of fixation were superior to other methods in this study. Fixation rigidity approaching rigidity of the normal spine appeared to be a significant factor determining the strength of the reconstructed cervical spine. Combined anterior and posterior fixation did not provide further strength, although it did increase the rigidity of the fixation.

Animals↗
PubMed1983

Steroid-induced femoral head pressure changes and their response to lipid-clearing agents.

In rabbits, cortisone increases marrow fat cell size and intrafemoral head pressure, produces systemic fatty embolization, and probably is one of the causes of avascular necrosis of the femoral head. Clofibrate, a lipid-clearing agent, decreases the serum cholesterol level, reduces the marrow fat cell size changes, and decreases intrafemoral head pressure. This might be significant in improving femoral head venous outflow in long-term steroid-treated persons.

Adipose Tissue↗
PubMed1981

Cortisone-induced intrafemoral head pressure change and its response to a drilling decompression method.

Intramedullary head pressure changes were studied in a group of cortisone-treated New Zealand white rabbits. In addition to femoral head pressure measurements, serum cholesterol levels were followed serially and pathologic specimens from cortisone-treated femoral heads were obtained. Surgical decompression by a drilling method was performed and pressures were remeasured at four weeks following decompression. Persistent increases in cholesterol levels and in intrafemoral head pressures were noted, particularly from six to eight weeks after initiation of steroid treatment. Cholesterol levels were elevated to four times control values and femoral head pressures averaged 2 1/2 times the control values (60 cm of water vs 24.6 +/- 5.5 cm of water). Surgical decompression by drilling effectively reduced the once elevated pressures to control values. A relationship between increased fat cell size, increased intramedullary pressure and decreased femoral head blood flow in steroid-treated rabbits is postulated. The applicability of these data to humans with steroid-induced ischemic necrosis of the femoral head has yet to be demonstrated.

Animals↗
PubMed1980

Acromio-clavicular separation masked by muscle spasm.

Weight-bearing views in suspected acromio-clavicular separation may be misleading if there is extensive spasm of the deltoid and trapezius muscles. The effect of this spasm may be lessened by strapping the weights to the wrist rather than having them hand-held. However, if there is strong clinical suspicion of an acromio-clavicular separation and the stress films, however taken, fail to reveal an upward displacement of the clavicle or widening of the joint space, the study should be repeated after infiltration of the acromio-clavicular joint with local anesthetic.

Acromioclavicular Joint↗