One hundred fifty-nine patients were referred to the authors for evaluation of chronic exertional leg pain from 1978 1987. The records 131 complete and available retrospective review. Forty-five diagnosed as having a compartment syndrome (CCS) seventy-five had ruled out by intramuscular pressure recordings. only significant difference found between two groups on history physical examination was 45.9% incidence muscle herniae in with CCS, compared 12.9% those without syndrome. One-third over...

Intracompartmental pressures were measured by the wick catheter technique in sixty-five compartments of twenty-seven patients who clinically suspected having acute compartment syndromes. A pressure thirty millimeters mercury or more was used as an indication for decompressive fasciotomy. The range normal from zero to eight mercury. Eleven these diagnosed actually syndromes and patients, decompressed. Only two had significant sequelae. In sixteen (thirty-eight compartments) whose remained...

Surgical decompression remains the only effective treatment for ischemia of muscles and nerves leg that constitutes principal defect in compartment syndromes. Recently, partial fibulectomy has been proposed as a good way to decompress all four compartments instead older double incision. Both methods are satisfactorily reducing intracompartmental pressures, documented by our wick catheter measurements. However, double-incision technique is easier, faster, safer, choice when four-compartment...

The specific etiology of supracondylar humerus fractures in children is not well known. All treated at Children's Hospital and Health Center, San Diego (CHSD) over an 8-year period (n = 391) were reviewed to determine information about the manner which injury occurred. Girls tended sustain these more often, nondominant arm was often injured. Falls from a height accounted for 70% fractures. Children ≤3 years old fall off household objects (beds, couches, other 3-6 feet high), 4 older...

We performed a combined one-stage approach for the treatment of eighteen spastic subluxated or dislocated hips in eleven children who had cerebral palsy. All patients were between five and thirteen years old subluxation dislocation hip severe acetabular dysplasia. The operation consisted release adductors, psoas, proximal hamstrings; femoral-shortening varusderotation osteotomy; pericapsular pelvic osteotomy. osteotomy was designed to increase superolateral coverage femoral head elongated...

A review of 11 cases prolonged limb compression usually following drug overdose, revealed a spectrum disease from isolated compartmental syndromes to full crush with renal failure. Residual contractures were moderate or severe in 80 per cent the extremities involved. Five patients demonstrated significant, systematic manifestations, Stage II III syndrome by our definition. The severity systemic manifestations is related amount muscle tissue being subjected elevated pressure and length time...

To study muscle necrosis due to prolonged limb compression, we measured intramuscular pressure by inserting wick catheters into 10 volar forearms and anterior tibial compartments of adult volunteers. We then placed the subjects in positions which victims drug overdose are commonly found. Intramuscular pressures area direct compression on hard surfaces ranged from 26 240 mm Hg, averaged 101 Hg. Most remarkable was a mean 180 Hg forearm rib cage. These sufficient cause capillary ischemia local...

The anterior cruciate ligament (ACL) resists the combined abnormal motions of tibial translation and internal rotation that occur in pivot-shift phenomenon. placement a single ACL graft high proximal at femoral attachment posterior results vertical orientation. This position has limited ability to provide rotational stability. A more oblique orientation sagittal coronal planes achieved from central anatomic location provides an is better resisting Tibial tunnels are drilled independently;...

Skeletal-muscle necrosis was evaluated in previously pressurized canine compartments using technetium-99m stannous pyrophosphate and classic histological criteria. Intracompartmental quantitated the anterolateral muscle compartment of each dog by uptake 99mTc contralateral as an internal control. Representative specimens were sampled experimental control legs analyzed qualitative techniques. Muscle assessed forty-eight hours after pressurization to levels ten 120 millimeters mercury for...

We reviewed the records of treatment eighteen infants with congenital dysplasia, subluxation, or dislocation hip who had problems involved following Pavlik harness. The most common problem (seen in twelve patients a dislocated hip) was failure to obtain reduction. This attributed primarily improper use harness by physician. In some patients, three five months elapsed before physician recognized lack nine poor quality and construction added both physician's patient's problems, six patient...

Pulmonary function was correlated with patient age and degree of thoracic scoliosis in 25 patients Duchenne muscular dystrophy a retrospective, longitudinal study. The observed forced vital capacity (FVC) found to peak at approximately the when standing ceases, then decline rapidly. Thoracolumbar curves were be insignificant adversely affecting pulmonary dystrophy. Percent FVC parameter that most strongly measurements. In addition, together better predictors percent than either one alone....

Forty-six separate gait studies were analysed for 21 ambulatory patients with Duchenne muscular dystrophy. Three groups defined on the basis of significant variables: early, transitional and late. Disease progression can be predicted 91 per cent accuracy by three cadence, dorsiflexion in swing, anterior pelvic tilt. The early group manifested a positive Gower's sign but changes subtle, being principally slightly increased hip flexion decreased swing reduction cadence. force line moved front...

The autosomal dominant pattern of osteochondritis dissecans and association with mild dwarfism were observed during a study 4 generations one family. Twelve 31 family members had proven 8 others appeared to have or (now deceased) it; 10 these 20 patients short stature (less than 5%). At the onset, children under 11 years age bilateral irregularities ossification. Three adolescents (13-19 years) development condition from ossification that could be traced in roentgenograph one. Two 3...

A consecutive series of patients undergoing thoracoscopic anterior spinal release and fusion for scoliosis or kyphosis was compared with a treated an open thoracotomy approach.To compare the early clinical results, costs, charges performing thoracic two approaches.The approach to spine is gaining acceptance, yet there are little data comparing technique standard methods treatment deformity.The first 14 cases performed at authors' hospital were 18 during previous 12-month period. In each case...

The incidence and predictors of premature physeal closure (PPC) after pediatric distal tibial fractures were investigated. PPC was defined as evidence growth plate disturbance on the injured side compared with uninjured side. Ninety-two reviewed at least 1 year follow-up, or until physiologic plates. Twenty-five (27.2%) complicated by PPC, confirmed CT scan in most cases. Salter-Harris III IV (medial malleolar type) resulted highest percentage fracture type (38%). I II 36% cases, followed...

Eighteen patients (28 compartments) with chronic exertional compartment syndrome and 14 normal asymptomatic volunteers (18 were studied. Evaluation included clinical assessment followed by quantitative determination of intracompartmental pressures as monitored wick or slit catheters before after exercise. Intramuscular measuring greater than equal to 10 mmHg at rest and/or 25 five minutes exercise defined abnormally elevated. The described reproducible anterolateral leg pain, 39% these had a...

The incidence and predictors of premature physeal closure (PPC) after pediatric distal tibial fractures were investigated. PPC was defined as evidence growth plate disturbance on the injured side compared with uninjured side. Ninety-two reviewed at least 1 year follow-up, or until physiologic plates. Twenty-five (27.2%) complicated by PPC, confirmed CT scan in most cases. Salter-Harris III IV (medial malleolar type) resulted highest percentage fracture type (38%). I II 36% cases, followed...

A delay in diagnosis of a traumatic radial-head dislocation the absence concurrent ulnar fracture is common. Published reports this injury imply an isolated to radius without involvement ulna. This hypothesis challenged by retrospective study all cases over 8-year period that demonstrates identifiable ulna every case. new radiographic sign, "ulnar bow sign," described assist proper recognition pattern. or subluxation should be suspected if posterior border on true lateral radiograph deviates...

Ninety-two patients with cerebral palsy underwent a special type of pericapsular acetabuloplasty designed to correct the hip dysplasia that occurs in palsy. The osteotomy was performed as part combined procedure (including femoral and soft-tissue releases). Retrospective analysis on 75 children (104 hips from 1982 through 1995) mean follow-up 6.9 years. Ninety-nine (95%) 104 remained well reduced at follow-up. There were no redislocations. If preoperative migration percentage >70% (severe...

Hip measurements using three-dimensional (3-D) images and computed tomography (CT) scans were evaluated. The 3-D proved more accurate than CT of femoral acetabular anteversion. Additionally, (> 99%) the neck-shaft angle provided. Acetabular anteversion determinations by systematically decreased as pelvic flexion increased, whereas accuracy was > 96% with images. software allows image rotation in all three reference planes, which minimizes positional errors. A case study is provided to...