Subject(s)
Botulinum Toxins, Type A/administration & dosage , Neuromuscular Agents/administration & dosage , Shoulder Dislocation/drug therapy , Adult , Humans , Injections, Intramuscular , Male , Muscle Spasticity/complications , Range of Motion, Articular , Shoulder Dislocation/etiology , Shoulder Dislocation/surgeryABSTRACT
An experimental model has been designed to assess the effect of vascularisation on axon regeneration in nerve grafts. The vascular status of the grafts has been demonstrated by microangiography and histology. Rat sciatic nerve grafts in which the vascular pedicles were left intact retained a normal vascular pattern which was not adversely affected by wrapping the graft in a polythene sleeve. In devascularised grafts, revascularisation commenced at three days and was complete at nine days. If the devascularised grafts were wrapped in a polythene sleeve, revascularisation was impeded and at fifteen days the middle segment of the graft was avascular and infarcted. The rate of axon regeneration was measured electrophysiologically in the above four groups of nerve grafts. There was a linear relationship between the rate of axon regeneration with time post-graft, axon growth proceeding at a mean rate of 1.150mm/day (S.E. +/- 0.084) after a mean delay of 4.85 days. There was no significant difference in the rate of axon regeneration in the four groups.
Subject(s)
Axons/ultrastructure , Nerve Regeneration , Sciatic Nerve/transplantation , Animals , Microsurgery/methods , Neural Conduction , Rats , Rats, Inbred Strains , Sciatic Nerve/blood supply , Sciatic Nerve/pathologyABSTRACT
This paper describes the development, operative technique and results of an unconstrained total elbow arthroplasty. Forty-seven elbow replacements were carried out in 44 patients between 1974 and 1982. There was a high rate of loosening in the early condylar replacements. The results in patients with post-traumatic arthritis were poor. The later design employs an ulnar stem, with a humeral stem if the distal humeral bone stock is poor. When used in carefully selected patients with rheumatoid arthritis, pain is reduced significantly, stability and movement are preserved and function is improved.
Subject(s)
Elbow Joint/surgery , Joint Prosthesis , Adult , Aged , Arthritis, Rheumatoid/physiopathology , Arthritis, Rheumatoid/surgery , Elbow Joint/physiopathology , Female , Humans , Joint Instability/etiology , Joint Prosthesis/adverse effects , Male , Middle Aged , Movement , Osteoarthritis/physiopathology , Osteoarthritis/surgery , Postoperative Complications/etiology , Prosthesis Design , ReoperationABSTRACT
A retrospective survey was carried out to assess the results in the middle aged and elderly of an operation for hallux valgus which combined a basal osteotomy of the first metatarsal with a Keller's procedure. Mean follow up in 34 patients (54 feet) was 3.2 years. The correction of both the hallux valgus and the varus angle of the first metatarsal was found to be satisfactory. The advantages and disadvantages of the operation are discussed.
