RESUMEN
Five hundred and thirty-eight cases of spine (298) and limb (240) pain problems were coded for spine x-ray abnormality (congenital, scoliosis, straightening, and degenerative joint disease). Analysis reveals that the limb pain cases (97 upper and 143 lower) when compared with the spine pain cases (45 cervical and 253 lumbar) have fewer normal spine x-rays with a greater incidence of degenerative joint disease in the limb pain cases and a greater incidence of straightening in younger spine and limb pain cases. Excluding 107 disability cases increases these tendencies. A group of 191 women who have had x-rays every five years are studied for controls and show a much lower incidence of x-ray changes. These data support a diagnosis of referred pain from the spine as a significant possibility in the idiopathic limb pain problem case.
Asunto(s)
Dolor/fisiopatología , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Adulto , Factores de Edad , Brazo , Artritis/diagnóstico por imagen , Dolor de Espalda/diagnóstico por imagen , Femenino , Humanos , Pierna , Masculino , Persona de Mediana Edad , Cuello , Radiografía , Enfermedades de la Columna Vertebral/fisiopatologíaRESUMEN
Eleven of 28 patients with a fracture of the acetabulum, pelvis, or sacrum were found to have electromyographic changes, apparently due to injury to the lumbosacral plexus. There appears to be a higher incidence associated with sacral fracture or sacroiliac separation (64%) than with acetabular fracture (24%). The EMG changes are diffuse and the clinical manifestations are subtle but the changes do interfere with the rehabilitation process.
Asunto(s)
Fracturas Óseas/complicaciones , Plexo Lumbosacro/lesiones , Huesos Pélvicos/lesiones , Acetábulo/lesiones , Adolescente , Adulto , Anciano , Niño , Electromiografía , Femenino , Fracturas Óseas/terapia , Luxación de la Cadera/complicaciones , Humanos , Ilion/lesiones , Luxaciones Articulares/complicaciones , Masculino , Persona de Mediana Edad , Examen Neurológico , Sacro/lesionesRESUMEN
Fifteen fresh cadaver impacts were conducted in simulation of pedestrian-automobile accidents. The test sled configuration simulated an automobile bumper and hood in "standard" and "nosedive" situations as well as "hard" and "soft" impact surfaces. Instrumentation and film demonstrated large axial compression forces in the struck leg and considerable angular velocity of the torso in all modes. Dissection revealed primary injury at the impact site at low velocities with added remote injury at high velocities. Fracture of the lateral tibial plateau was most common. Lowering the bumper height offered the greatest protection against injury at moderate impact velocities.
Asunto(s)
Accidentes de Tránsito , Automóviles , Heridas y Lesiones , Cadáver , Fracturas Óseas/etiología , Humanos , Traumatismos de la Pierna/etiología , Modelos Biológicos , Fracturas de la Tibia/etiologíaRESUMEN
The application of sonic energy to bone cutting problems is reported. The basic principle of the resonant tool, its adaptation for surgery, the experimental results of its use in animals, and clinical experience are reported. This sonic tool is found to introduce no significant tissue destruction. It does have several desirable characteristics for routine use in orthopedics.
Asunto(s)
Fusión Vertebral/instrumentación , Ultrasonido/instrumentación , Adolescente , Adulto , Animales , Artrodesis/métodos , Huesos/cirugía , Perros , Suministros de Energía Eléctrica , Calor , Humanos , Persona de Mediana Edad , Osteotomía/instrumentación , Ultrasonido/efectos adversosRESUMEN
The use of a commercially available Reduction-Retention apparatus for transfixation of nine cases of open fractures with severe soft-tissue damage is reported. Seven patients are walking, two with drop foot braces. Two required amputations, one because of infection and the other because he had suffered severe vascular injury. These two are walking on protheses and are able to work. Of the other seven, five have returned to their previous occupations; one is receiving a disability pension and the other is awaiting further surgery. The problems and advantages of this method of treatment are discussed.
Asunto(s)
Fijación de Fractura/métodos , Fracturas Óseas/cirugía , Fracturas Abiertas/cirugía , Férulas (Fijadores) , Accidentes de Tránsito , Adolescente , Adulto , Fracturas del Fémur/cirugía , Peroné/lesiones , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Trasplante de Piel , Fracturas de la Tibia/diagnóstico por imagen , Fracturas de la Tibia/cirugía , Tracción/instrumentaciónRESUMEN
This report has presented a discussion of the mechanics of the spine in terms of an analogy with a curved, tapered beam. We have identified the existence of critical frequencies and locations in the spine and discussed the evidence from clinical experience with low back problems. We have also discussed the extrinsic mechanisms for protecting the spine and the lumbosacral junction. The question of the sensitivity of the lumbosacral junction to shear forces has been raised and experiments described that show that the shear forces that will injure the posterior elements of the fifth lumbar vertebra are low and occur commonly. The report also describes an instrument to measure the stiffness of articulations of the spine.