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At least 577 records · Page 32Linked to original sources
PubMedDate not supplied

Dislocation following total hip arthroplasty. Management by special brace in selected patients.

Dislocation after total hip arthroplasty (THA) occurs in 1%-3% of the cases reported in the literature. Recurrent dislocations due to malpositioned components should be treated by revision arthroplasty. Dislocated hips that have optimally positioned components but weak abductors can be treated by a special brace that prevents extremes of flexion, adduction, and rotation. Two hundred and eighty-nine total hip arthroplasties were performed from 1975 to 1981. Nine patients, all of whom had optimal position of components and the brace treatment, had dislocations. In one patient who had a spastic muscle disorder the brace was used as prophylaxis. The short chair-back brace has a lateral joint with thigh cuff. The joint can be locked at a particular position to give the desired movement of the hip joint. The brace, applied after the second dislocation, is worn for six to nine months. Excellent results were obtained in nine patients. One patient is still using the brace. The brace is light and can be worn under normal clothing; ordinary activities are easily performed by patients wearing the brace. Patients should be trained to avoid positions and activities that predispose to dislocation.

Aged↗
PubMed1981

Hip adductor transfer compared with adductor tenotomy in cerebral palsy.

In a ten-year study in patients with cerebral palsy, fifty patients had ninety-eight adductor transfers and fifty-two patients had 102 adductor tenotomies with or without obturator neurectomy. The groups were similar with regard to severity of their disease, age, and associated concomitant surgery. Results were evaluated in three ways: functional change, change in passive motion of the hip, and change in stability of the hip. Our data support the view that although the adductor transfer operation takes longer and is associated with a higher incidence of postoperative drainage, the over-all improvement is greater and is maintained better than that after adductor tenotomy with or without neurectomy. The transferred muscle provides greater pelvic stability, decreases hip-flexion contractures, and reduces instability of the hip.

Adolescent↗
PubMedDate not supplied

Coxa vara in three patients with concommitant cerebral palsy.

Many theories have been advanced to explain the final neck shaft angle in the developing proximal femur. Muscle spasticity and delayed weight-bearing are the postulated causes of the development of the valgus deformity in patients with neuromuscular disease. Three patients with coxa vara exhibited some degree of spasticity and delayed weight-bearing. In spite of this, each child developed a varus rather than a valgus hip deformity. Existing theories seem not to adequately explain the development of the final neck shaft angle.

Cerebral Palsy↗
PubMed1994

[Endogenic vasomotor function and smooth muscle insufficiency in the vascular microcirculation].

The paper outlines the previously unknown smooth muscle insufficiency in terms of its etiology, pathogenesis, diagnosis and treatment. It has been shown that drug administration leads to smooth muscle insufficiency which is eliminated by serotonin both in vitro and in vivo. The clinical manifestations of smooth muscle (SM) insufficiency are eliminated by serotonin, irrespective of whether it has been caused by the use of drugs or impaired smooth muscle innervation. The mechanism of vascular rhythmic oscillations in the microcirculatory bed, the so-called endogenous vasomotility (EV) has been decoded. The mechanism of EV regulation is due to the fact that platelets constantly (continuously) adsorb serotonin from the enterochromaffin cells of the gastrointestinal tract and constantly (continuously) release it into the microcirculatory bed, thereby providing the continuum of entry of the stimulant to the SM fibers which are able to contract at this time. The summation of these contractions of smooth muscle contractions in the microcirculatory bed maintains their vascular tone and yields the pattern of EV. The paper also describes the earlier unknown properties of hemoglobin and myoglobin to cause smooth muscle spasm and to accelerate platelet destruction. A correlation between the EV and vascular platelet hemostasis is described in terms of these properties. The continuous mechanism of EV is impaired and it transforms to intermittent (final) vascular platelet hemostasis.

Animals↗
PubMed1979

Helping hemiparetics to help themselves. Sensory feedback therapy.

Despite the presence of some voluntary movement, the loss of discrete control impairs functioning of the arm and hand in most hemiparetics. Seventy hemiparetic patients, aged 12 to 78 years, were treated and followed up for six months to three years. Electromyographic activity monitored from dysfunctional primary movers during attempted movement was displayed to the patients as a continuous oscilloscopic trace, reflecting generated muscle activity and allowing its quantification. Coupled with operant conditioning techniques, these displays were modified gradually by reinforcing the patient's effort with auditory feedback during successive approximations to a desired level. Such therapeutic use of electromyographic displays often resulted in a progressive improvement of voluntary movement. More than half the patients acquired and retained purposive movements that meaningfully improved their functional capabilities.

Activities of Daily Living↗