Biomedical subjects

W J Mallon

Publications and source records attributed to W J Mallon.

At least 19 recordsLinked to original sources

PubMed1996

Suprascapular neuropathy after distal clavicle excision.

Two cases of suprascapular neuropathy after excision of the distal clavicle are reported. Both patients were treated successfully with neurolysis of the suprascapular nerve starting at the upper trunk of the brachial plexus. Anatomic dissections revealed that the suprascapular nerve is quite close (<1.4 cm) to the posterior aspect of the distal clavicle, within 2 to 3 cm of the acromioclavicular joint. To avoid the complication of suprascapular neuropathy that could be associated with this close relationship, it is recommended that no more than 1 cm of the distal clavicle be removed posteriorly. It is also recommended that minimal periosteal elevation should be performed on the posteroinferior border of the distal clavicle.

Adult↗

PubMed1996

Total joint replacement and golf.

Definitive characterization of the effects of golf on a total joint replacement remains elusive. However, from our study of active golfers and solicitation of the opinions of orthopedists who specialize in joint replacements, and from a careful review of the literature regarding exercise and total joint replacement, it appears possible for patients to remain active golfers with no significant increase in either symptoms or rates of revision of implants following total hip, knee, or shoulder replacement.

Arthroplasty↗

PubMed1995

Acromioclavicular joint injury in competitive golfers.

We reviewed a series of professional and competitive low-handicap golfers with shoulder pain. All but one player (34/35) had pain in the left shoulder. A high incidence of problems (53%) related to the acromioclavicular joint was noted in these golfers with left shoulder pain. With proper treatment all but one (17/18 [94%]) of the golfers with acromioclavicular joint problems was able to return to competitive golf. By studying the mechanics of the golf swing, a possible mechanism for this high incidence of acromioclavicular joint problems is given.

Acromioclavicular Joint↗

PubMed1994

Mycoplasma hominis septic arthritis: two case reports and review.

Mycoplasma hominis is normally a commensal of humans. When the organism is pathogenic, it primarily causes disease in the genitourinary tract. Septic arthritis caused by M. hominis is a rare condition that occurs chiefly in the postpartum period, in immunosuppressed hosts, or in patients who have recently undergone urinary tract manipulation. Arthritis caused by M. hominis is clinically indistinguishable from septic arthritis caused by other bacteria. Diagnosis is often delayed because infection with this organism is not suspected or because it grows slowly, if at all, in routine culture media. Appropriate therapy often leads to a good outcome, although relapses and resistance have been reported.

Aged↗

PubMed1994

Total joint replacement in active golfers.

Total joint replacement is commonly done in an older population, for whom golf is often the only form of exercise. We studied active golfers after they had had a total joint replacement. Most golfers with a successful primary total joint replacement will not have pain while playing golf, but will likely have a mild ache in the hip or knee region after playing. Patients with total knee replacement appear to have slightly more postgolf pain than patients with total hip replacement. In addition, golfers with left total knee replacements have more difficulty with pain during and after play than do golfers with right total knee replacements.

Aged↗

PubMed1993

Total knee arthroplasty in active golfers.

The results of total knee arthroplasty (TKA) in patients who actively exercise have not been previously studied. Golf is a frequent form of exercise for the older population in whom TKAs are usually performed. Members of The Knee Society permit their patients with TKA to play golf, if they desire to do so. They recommend waiting approximately 18 weeks after surgery before beginning to play. Most members of The Knee Society stated that they have no preferences as to the model of knee arthroplasties in golfers, although 35.2% did state that they would use a posterior-cruciate sparing model. After TKA, active golfers in the authors' study (83) invariably experienced a significant rise in their handicap (mean +4.6 strokes) and also a decrease in the length of their drives. Most (86.7%) use a cart while playing, but still a small percentage (15.7%) will have a mild ache in the knee while playing and a larger percentage (34.9%) will have a mild ache in the knee after playing. In addition, golfers with left TKAs have more difficulty with pain during and after play (P < .01) than do golfers with right TKAs. Radiolucencies were also common in our study, occurring in 53.7% of all knees studied and 79.1% of cemented TKAs.

Aged↗

PubMed1993

The medial approach to the hip revisited.

Several muscular intervals have been described to approach the hip through a medial incision. We studied in detail the original descriptions of these surgical planes and found that several of them are nearly identical. We attempt to clarify the anatomic intervals available to the surgeon in hope of eliminating ambiguity in future reporting.

Hip Dislocation↗

PubMed1992

Total hip arthroplasty in active golfers.

Total hip arthroplasty (THA) is commonly performed in an older population, for whom gold is often the only form of exercise. Members of the Hip Society do not feel that golfers have increased rates of complications after THA when compared to nongolfers and permit their patients to play gold with a THA. Most golfers will see their handicaps increase after total joint arthroplasty, although this does not appear to be a function of drive length. Most golfers with a successful primary total joint arthroplasty will not have pain while playing golf but will likely experience a mild ache in the hip region after playing. Hybrid and uncemented primary THAs appear to have lower rates of radiographic loosening in active golfers when compared to cemented THAs. However, symptoms of pain while playing or after playing do not differ among these groups, despite this radiographic difference.

Aged↗

PubMed1992

Radiographic and geometric anatomy of the scapula.

In an effort to study anatomic parameters of the scapula that may be of clinical importance, scapulae were harvested from cadavers and stripped of their soft tissues. For each scapula, three roentgenograms then were obtained: a Y-scapular view, an axillary lateral view, and a glenoid fossa (or true anteroposterior) view. Computed tomographic pneumoarthrograms and randomly selected antero-posterior chest roentgenograms of skeletally mature adults were studied also to measure further roentgenographic parameters of the normal scapula. The geometric anatomy of the scapula is of fundamental importance in the pathomechanics of rotator cuff disease, total shoulder arthroplasty, and recurrent shoulder dislocation. This study presents in detail the exact geometry of scapula anatomy, giving precise figures for distances, angles, and radii of curvature of the scapula. All results then are discussed in terms of their clinical relevance to the above problems.

Arthrography↗

PubMed1991

Digital ranges of motion: normal values in young adults.

Analysis of the range of motion of fingers was done in young (eighteen to thirty-five year old) adult volunteers with no history of previous injury to their hands. The data show that there are slight differences between the individual digits. Notably, metacarpophalangeal flexion and total active motion increase linearly in proceeding from the index to the small finger. There were also minor differences in comparing sexes. Women have greater extension at the metacarpophalangeal joint in both active and passive motion and have a greater total active motion at all digits as a result. A significant tenodesis effect was found at the distal interphalangeal joint in normal subjects. No differences were found that could be attributable to handedness.

Adult↗

PubMed1991

Rupture of the posterior tibial tendon associated with closed ankle fracture.

Rupture of the posterior tibial tendon has rarely been associated with closed ankle fractures. All previous cases have been in association with pronation-external rotation type fractures in which the medial malleolus has been fractured. This case represents the first such report of a severed posterior tibial tendon in the absence of a medial malleolar fracture and reemphasizes the importance of critically evaluating intraoperative radiographs following the open reduction and internal fixation of closed ankle fractures to assess the possibility of soft tissue interposition. In the event of an acute rupture of the posterior tibial tendon, the authors recommend primary tendon repair.

Adult↗

PubMed1990

Luxatio erecta: the inferior glenohumeral dislocation.

Luxatio erecta, or inferior glenohumeral dislocation, is a rare shoulder dislocation usually caused by a hyperabduction injury to the arm. We have reviewed the literature consisting of 80 cases of luxatio erecta and also discuss six additional cases that we have treated. The literature shows that either a fracture of the greater tuberosity or a rotator cuff tear was associated with this injury in 80% of patients; 60% of the patients reviewed sustained some degree of neurologic compromise, most commonly to the axillary nerve. These injuries usually resolved; the time for recovery varied from 2 weeks to 1 year. Only 3.3% of the cases demonstrated significant vascular compromise, but this is the highest incidence for any shoulder dislocation. Doppler studies of the affected arm or observation of the patient overnight are recommended because of the potentially disastrous complications of vascular insufficiency. If there is any indication of a vascular problem, immediate arteriogram is indicated. Although usually fairly easily reduced by overhead traction, the lesion is so rare that few physicians are familiar with the technique of reduction. Fluoroscopy was used in our most recent cases and was helpful in obtaining a complete and safe reduction.

Adolescent↗

PubMed1989

Diagnosis of ganglion in Guyon's canal by magnetic resonance imaging.

Compression of the ulnar nerve at the wrist can be caused by a multitude of intrinsic and extrinsic factors. The exact diagnosis and location of compression can frequently be difficult to determine. Magnetic resonance imaging can be a useful method in diagnosing the cause and location of ulnar nerve compression. A case is presented of ulnar nerve compression caused by a ganglion in Guyon's and diagnosed preoperatively by magnetic resonance imaging.

Aged↗

PubMed1989

Intra-articular talar fractures: repair using the Herbert bone screw.

Intra-articular fractures of the talus remain a problem because of the difficulty in achieving and maintaining anatomic reduction, and because of the risk of degenerative arthritis of the hindfoot if such reduction is not achieved. We report our experience with three cases in which intra-articular talar fractures were repaired by use of the Herbert bone screw. In addition, we discuss the biomechanical features of the Herbert bone screw which make it particularly well suited for intra-articular fractures of the talus.

Adult↗

PubMed1989

The Grice procedure. Extra-articular subtalar arthrodesis.

The Grice procedure is an extra-articular arthrodesis of the subtalar joint performed through a lateral approach using a corticocancellous bone graft. It is useful in multiple hindfoot deformities, especially in the growing child, in whom its use allows for full growth of the hindfoot and restoration of the original height of the collapsed hind-foot. When performed well and for proper indications, the procedure is relatively successful, with high fusion rates, high reported success rates, and little need for triple arthrodesis on long-term follow-up. Complications can occur, however, and these are best avoided by careful preoperative planning and evaluation.

Adult↗

PubMed1986

A comparison of absorbable and nonabsorbable sutures to vascular response in immature arteries.

Absorbable suture material for microvascular procedures may be superior to nonabsorbable sutures because no foreign body remains at the operative site after suture absorption. We compared Vicryl (polyglactin 910) to a nonabsorbable suture, Prolene, which has been noted to have minimal thrombogenic potency. Patency rates, aneurysm formation, histologies and growth of the distal limb were measured and compared in microvascular anatomoses of immature arteries. Using 8-week-old rats, both femoral arteries (mean external diameter .85 mm) were transected and reanastomosed, using 10-0 suture material (Vicryl and Prolene) on a BV75-3 needle. Thirty rats were included in the study and separated into three harvest groups which were harvested at 4, 8, and 12 weeks. Magnification arteriography of the femoral arteries was performed, as well as standard refill tests. Selected vessels were sent for histologic study using H & E stain. Foot lengths of the rats were measured and compared to preoperative lengths. Prior to harvest, the arteries in the growing animals increased in diameter by 35 percent. Overall patency rates were 68.2 percent for Vicryl and 59.1 percent for Prolene, a non-significant difference. Aneurysm formation was 9.1 percent for Vicryl, and 50.0 percent for Prolene, a significant difference (P less than 0.01). The arteries repaired with Vicryl showed less scar formation, less medial necrosis, and less subintimal hyperplasia. Distal limb lengths showed no difference in the Vicryl and Prolene groups, but both groups were statistically inferior with respect to the unoperated control group. Our study demonstrated Vicryl to be equivalent to Prolene with respect to patency rates, but superior with respect to aneurysm formation and histologic response.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMedDate not supplied

Reliability of radiographic assessment of acromial morphology.

The most widely used radiographic classification system for acromial morphology identifies three distinct acromial shapes: type I (flat), type II (curved), and type III (hooked). The purpose of this study was to measure the interobserver and intraobserver reliability of determinations of acromial morphology as defined by this system. Between 1990 and 1992, one hundred twenty-six supraspinatus outlet radiographs were obtained from 126 patients by technicians from Triangle Orthopaedic Associates in Durham, N.C. Six fellowship-trained shoulder surgeons independently reviewed each radiograph and classified it as type I, II, or III on the basis of established guidelines. Two surgeons classified each film a second time in random order. Analysis of variance was performed to obtain coefficients for interobserver and intraobserver reliability. Consensus ratings were then used to classify the 126 radiographs into consensus type I, consensus type II, or consensus type III groups. Percentages of type I, II, and III individual ratings within each consensus group were determined. The intraobserver reliability coefficient was 0.888, interpreted as good to excellent reliability. The interobserver reliability coefficient was 0.516, interpreted as poor to fair reliability. Of the 126 radiographs, 26 (20.6%) were rated as consensus type I, 76 (60.3%) were rated as consensus type II, and 24 (19.1%) were rated as consensus type III. The reliability of observer ratings was lowest when delineation between acromial types II and III was required. The low interobserver reliability makes comparisons of studies by different authors difficult to interpret and obscures the true incidence of acromial morphologic types. It also questions reported correlations between acromial type and shoulder pathologic conditions. It is concluded that a system that incorporates more objective classification criteria and acknowledges the continuous nature of acromial morphologic types may improve interobserver reliability and validate the system's use in making clinical and surgical judgments.

Acromion↗

PubMedDate not supplied

Multidirectional instability: current concepts.

Multidirectional instability (MDI) of the shoulder is a complex problem that is not yet well understood. Instability in several directions is termed MDI, but the precise definition, classification, cause, and optimal method of treatment remains elusive. The cause appears to be multifactorial, with biochemical and biomechanical abnormalities present in shoulders with MDI. The biomechanical factors responsible for preventing MDI include bony architecture, concavity-compression from the deepening of the glenoid by the labrum, stability from the ligaments, primarily the inferior glenohumeral ligament complex and the superior capsular structures, and muscular control by use of force couples, especially stabilization of the scapula. Current recommended treatment is initially nonoperative, with aggressive physical therapy aimed at strengthening the rotator cuff and the scapular stabilizers. Patients who fail to respond to a nonoperative regimen often improve with surgical stabilization, which is usually an inferior capsular shift or a variant of that procedure. After this surgery immobilization of the operated shoulder for 6 to 8 weeks is recommended by most authors.

Humans↗