Spontaneous remodeling of the spinal canal after conservative management of thoracolumbar burst fractures.

Study Design: Forty-two conservatively treated patients with a burst fracture of the thoracic, thoracolumbar, or lumbar spine with more than 25% stenosis of the spinal canal were reviewed more than 1 year after injury to investigate spontaneous remodeling of the spinal canal.

Objectives: To investigate the natural development of the changes in the spinal canal after thoracolumbar burst fractures.

Summary Of The Background Data: Surgical removal of bony fragments from the spinal canal may restore the shape of the spinal canal after burst fractures.

Lay attitudes to dental appearance and need for orthodontic treatment.

In provision of advice about aesthetic treatment need, visual stimuli as a tool in communication may have some advantages compared with verbal descriptions, in particular when children are addressed. The Aesthetic Component (AC) of the Index of Orthodontic Treatment Need is an illustrated scale for rating of dental attractiveness developed in the UK and based on lay adults' ratings of dental photographs. This scale has also been recommended for use in patient education.

Peroneus longus and tibialis anterior muscle activity in the stance phase. A quantified electromyographic study of 10 controls and 25 patients with chronic ankle instability.

The electromyographic activity of the peroneus longus and anterior tibial muscles of 25 patients with chronic ankle instability (18 patients with bilateral symptoms and 7 patients with unilateral complaints) and 10 controls was registered during the stance phase under different walking conditions. With balance secured by external support, there was a variable amount of peroneal activity, most of which was found in the third quarter of stance. A high increase in peroneus longus activity starting after foot-flat was found when subjects had to maintain balance in a natural way.

Potential for recurrence of hallux valgus after a modified Hohmann osteotomy: a biomechanical analysis.

On the basis of a biomechanical model the present study investigates whether a foot-widening effect, which may result in recurrence of bunions, can be demonstrated in operated patients. Therefore, the medial deviation of the first metatarsal head as a result of flexion forces on the hallux was measured in eight patients with clinical idiopathic hallux valgus, who underwent a modified Hohmann osteotomy, and in eight "normal" persons. We found that (1) before osteotomy, all forefeet broadened while pressing the big toe downward, and (2) after surgery, widening of the forefeet on average had significantly diminished, but still existed, which might explain the development of recurrences.

Stress radiography of the talocrural and subtalar joints.

The object of this investigation was to determine a possible subtalar component in a group of 33 patients with chronic ankle instability. A group of 10 subjects without ankle/foot symptoms acted as controls. A standardized radiographic assessment of talar and simultaneous subtalar tilt was made.

The surgical anatomy of the superior gluteal nerve and anatomical radiologic bases of the direct lateral approach to the hip.

In view of the increasing popularity of the direct lateral approach to the hip joint for hemi- or total hip arthroplasty, the location of the superior gluteal nerve (SGN) was studied. This nerve is in danger when using a transgluteal incision. In 20 embalmed specimens the relation of the SGN to the tip of the greater trochanter (TT) was studied as well as the relation to the iliac crest.

Central grafting for persistent nonunion of the tibia. A lateral approach to the tibia, creating a central compartment.

We report the operative technique and results of a new method of central grafting for persistent nonunion of the tibial shaft. The operation is performed through a lateral approach, anterior to the fibula. Fresh autogenous bone from the iliac crest is used to form a central bridge between the tibia and fibula above, below and at the level of the nonunion.

Effect of intravenous fluid administration on recovery after running a marathon.

After the Rotterdam Marathon on 21 April 1991 (ambient temperature 5.8 degrees C, relative humidity 74%, wind velocity 5 m s-1) data from 66 athletes were analysed for information concerning total recovery and recovery from pain, stiffness, loss of appetite, sleep disturbance and fatigue. The pulse rate, body weight and temperature were measured.

Rupture of the pectoralis major muscle in body-builders.

Rupture of the pectoralis major muscle is rarely encountered. However, among body-builders this lesion, commonly called the "pec-tear", is well known. The bench-press exercise is a common cause.

Medial deviation of the first metatarsal head as a result of flexion forces in hallux valgus.

Several questions with regard to the hallux valgus complex, which includes metatarsus primus varus, give rise to discussion. How do bunions develop? Is disturbed muscle balance at the first metatarsophalangeal joint important in the pathogenesis of the hallux valgus complex? What is the relation between dynamic plantar load distribution and pain in the ball of the foot? What is the cause of recurrences of deformity after surgery? To answer these questions, we started with the biomechanical model of Snijders et al., which states that contraction of flexor muscles of the hallux worsens its valgus angle and causes medial deviation of the first metatarsal head.

CT scan prediction of neurological deficit in thoracolumbar burst fractures.

In 139 patients with burst fractures of the thoracic, thoracolumbar or lumbar spine, the least sagittal diameter of the spinal canal at the level of injury was measured by computerised tomography. By multiple logistic regression we investigated the joint correlation of the level of the burst fracture and the percentage of spinal canal stenosis with the probability of an associated neurological deficit. There was a very significant correlation between neurological deficit and the percentage of spinal canal stenosis; the higher the level of injury the greater was the probability.

Prevalence of trunk abnormalities in eleven-year-old schoolchildren in Rotterdam, The Netherlands.

The prevalence of trunk abnormalities was studied in 4,915 children aged 11 years (2,528 boys, 2,387 girls); 33% of the children were of non-Dutch origin. The following measurements were recorded: height, weight, signs of puberty, and menarche. Trunk abnormality was assessed in the erect child (asymmetry of shoulders, waistline, imbalance of the trunk, scoliosis, lordosis, kyphosis, swayback, and flexibility) and by the forward bending test (rib hump or lumbar prominence, persistence of scoliosis, kyphosis, deviant lateral aspect); 85.

Natural history of ultrasound hip abnormalities in clinically normal newborns.

One hundred one clinically normal newborn hips showed varying degrees of sonographic hip dysplasia according to the classification of Graf. None were treated, and after +/- 6 months, radiographs showed that only four had definite dysplasia. Of these, three had had risk factors such as breech delivery or familial predisposition.

Weight bearing after arthrodesis of the first metatarsophalangeal joint. A randomized study of 61 cases.

We performed a prospective randomized study of 61 cases of arthrodesis of the first metatarsophalangeal joint in 56 patients. In the first group, full weight bearing was allowed after 2-4 days and in the second group at 4 weeks. Radiographic union of the arthrodesis in the two groups did not differ.

Failure of tibial bone grafting for femoral head necrosis.

We treated 20 hips with femoral head necrosis in 16 patients using the Phemister tibial bone grafting procedure. After a mean follow-up of 3 years, the Harris hip score had improved in 15 out of 18 hips, however without radiographic improvement. In 2 hips, an arthrodesis and an arthroplasty were performed.

Patient characteristics and treatment variables associated with apical root resorption during orthodontic treatment.

Multivariate analysis of patient characteristics and clinical variables was carried out with the maximum single maxillary incisor apical root resorption for each patient as the dependent variable. Root lengths were measured in standardized intraoral radiographs from 485 consecutively treated patients, 11.5 to 25 years of age.

Oxidative phosphorylation in human muscle in patients with ocular myopathy and after general anaesthesia.

The fuel preference of human muscle mitochondria has been given. Substrates which are oxidized with low velocity cannot be used to detect defects in oxidative phosphorylation. After general anaesthesia, the oxygen uptake with the different substrates is much lower than after local analgesia.

Reconstruction of the tibia by dual grafting. 3 cases of tumor resection.

Large defects of the tibia can be bridged with autologous cancellous grafts between the remaining fibula and a contralateral tibial cortical graft. The long-term results of this technique in 3 cases after resection of a malignant tumor were either excellent or fair. It is concluded that this technique is an effective limb-saving surgical procedure.

Ultrasonographic detection of the patellar plica in the knee.

In 39 knees of 38 patients, an ultrasonographic investigation of the patellofemoral space was performed to detect a plica synovialis. By arthroscopic control, we found a sensitivity for the ultrasonographic method of 92% and a specificity of 73%. The method, materials, and results are discussed in this paper.

Incidence of osteonecrosis after renal transplantation.

The incidence of osteonecrosis was 24% in 248 patients who had received 262 kidney transplants 1971-1982. However, based only on patients at risk, i.e.

Bilateral locked facets in the thoracic spine.

Two cases of traumatic bilateral locked facets in the thoracic spine are reported. Both patients had only minor neurological signs. They both made a full neurological recovery after surgical reduction of the locked facets.