Subject(s)
Bone Development/physiology , Bone Diseases/physiopathology , Growth Disorders/physiopathology , Biomechanical Phenomena , Bone Diseases/complications , Child , Folic Acid Deficiency/complications , Fractures, Bone/complications , Growth Disorders/etiology , Humans , Immobilization/adverse effectsABSTRACT
A wheelchair was designed specifically for manufacture, maintenance, and use in Third World countries. An experimental prototype was constructed and tested, and subsequently, a production model was manufactured after modifications to the original design were made.
Subject(s)
Wheelchairs/standards , Developing Countries , Equipment Design , Humans , Rural PopulationSubject(s)
Agriculture , Occupational Diseases/psychology , Workers' Compensation , Adult , Humans , Jamaica/ethnology , Male , Neurotic Disorders/etiology , United StatesABSTRACT
Out of a total of 1031 patients with homozygous sickle cell (SS) disease attending a sickle cell clinic in Jamaica, 52 patients were found to have changes of avascular necrosis of the femoral head in 76 hips. Hip involvement was unilateral in 28 patients (31 males and 21 females). The age of onset varied from nine to 45 years in the 40 patients in whom data appeared reasonably reliable and 82% developed this lesion between 10 and 29 years. Radiological change occurred, by definition, in the femoral head in all hips, in the acetabulum in 55 (72%) hips, femoral head migration occurred in 37 (49%) hips, and periosteal new bone formation in 24 (32%) hips. Two broad patterns of involvement were discernible according to the age at which avascular necrosis had occurred. Involvement of the immature femoral head epiphysis resulted in a flattened femoral head, epiphysio-metaphyseal overlap, a wide femoral neck and a mushroom deformity of the mature femoral head. In these lesions the articular surface and joint space was generally well preserved and little or no disability resulted in adult patients. Involvement of the mature femoral head was typical segmental, most commonly antero-superior, and with continued weight bearing resulted in collapse of the head and disruption of the articular surface. These lesions caused pain, limitation of movement, and commonly changes of osteo-arthrosis.
Subject(s)
Anemia, Sickle Cell/complications , Femur Head Necrosis/diagnostic imaging , Adolescent , Adult , Age Factors , Child , Female , Femur Head Necrosis/etiology , Humans , Male , Middle Aged , Radiography , Retrospective StudiesSubject(s)
Foot/blood supply , Ischemia/rehabilitation , Adult , Aged , Amputation, Surgical , Diabetic Angiopathies/complications , Female , Foot/surgery , Humans , Ischemia/complications , Male , Middle AgedABSTRACT
Twenty-six index patients with primary Madelung's deformity of the wrist were examined, as were sixty-five of their relatives. Standard radiographs were taken and measured to determine whether mesomelic dwarfism, a feature of dyschondrosteosis, was present. No case of mesomelia was found. No evidence of Madelung's deformity was found in the relatives of the index patients, who were all female. It is concluded that primary Madelung's deformity of the wrist is not an expressions of dyschondrosteosis, that it is not inherited, and that it does not occur in the male. One index patient with dyschondrosteosis was examined. Eight of her relatives were similarly affected, and three of these were male. It is suggested that previously recorded male cases of Madelung's deformity of the wrist were expressions of dyschondrosteosis or of secondary deformity.
