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Pande KC, Nishat N, Afzal S, Ishak L. Humeral Shaft Fracture Sustained During Arm Wrestling with Review of Factors Contributing to its Causation. Malays Orthop J 2021; 15:15-20. [PMID: 34966490 PMCID: PMC8667248 DOI: 10.5704/moj.2111.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 02/21/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: Humeral shaft fractures are the most common injury sustained in arm wrestling, and its various biomechanical, anatomical, kinematic and electromyographic aspects have been studied and reported. We present a series of six cases of humeral shaft fractures in the arm wrestlers and a review of basic science studies to determine the factors contributing to their causation. Materials and methods: Six humeral shaft fractures associated with arm wrestling were treated between December 2018 and January 2020. The medical records and radiographs were retrospectively reviewed. In addition, the characteristics of the patients, their opponents, and the fractures were noted in a pre-designed data sheet. Results: There were six men with an average age of 27.5 years (SD ± 8.9). All were amateurs who were occasional arm wrestlers. Three fractures each were sustained in the sitting and standing position, four in the losing phase, one in the winning phase, and one in the stalling phase. The dominant side humerus was involved in all but one case. The fracture types were 12-A1 (n=4); 12-B1 (n=1); 12-A2 (n=1). Three fractures were treated by open reduction and internal fixation, while three were treated conservatively with satisfactory healing. Conclusion: Humeral shaft fractures in arm wrestling are common in amateurs. There is no association of the fracture with the position of the players or the phase of the match. However, arm wrestlers should be aware of this complication and should receive proper guidance to reduce the risk of humeral shaft fractures.
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Affiliation(s)
- K C Pande
- Department of Orthopaedics, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam.,PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam
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- Department of Orthopaedics, Suri Seri Begawan Hospital, Kuala Belait, Brunei Darussalam
| | - Sml Afzal
- Department of Orthopaedics, Suri Seri Begawan Hospital, Kuala Belait, Brunei Darussalam
| | - L Ishak
- Department of Orthopaedics, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam
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Abstract
Subcutaneous emphysema is the presence of gas or air in the subcutaneous tissue plane. The term is generally used to describe any soft tissue emphysema of the body wall or limbs, it can result from benign causes, most commonly secondary to trauma or from a life-threatening infection by gas gangrene or necrotising fasciitis. A case of subcutaneous emphysema involving the upper limb resulting from a trivial laceration to the elbow is reported and the importance of distinguishing between the two causes of subcutaneous emphysema is highlighted.
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Affiliation(s)
- S M Rabiul Islam
- Department of Orthopaedic Surgery, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Bandar Seri Begawan, Brunei Darussalam
| | - K G Mamman
- Department of Orthopaedic Surgery, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Bandar Seri Begawan, Brunei Darussalam
| | - K C Pande
- Department of Orthopaedic Surgery, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Bandar Seri Begawan, Brunei Darussalam
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Pande KC, Ishak HL. Epidemiology of burns in a major referral hospital in Brunei Darussalam. Singapore Med J 2012; 53:124-127. [PMID: 22337188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Burn injuries are a public health concern across the world, particularly in Southeast Asia, where epidemiological data is lacking. This retrospective study was conducted to assess the epidemiology of patients with burns treated at a major referral hospital in Brunei Darussalam, with particular reference to demographics and aetiology. METHODS All patients were referred to and treated at the Burns Unit, where data was recorded by the on-duty nurse on a pre-designed form at the first attendance. A total of 211 patients (111 male, 100 female), comprising 10 inpatients and 201 outpatients, were treated during the study period. RESULTS The average age of the patients was 19.6 ± 20.9 (median 10, range < 1-90) years. 67 (32%) patients were under two years of age. Scalding due to hot liquids was the most common cause (78.2%), followed by flame and contact burns. The majority of burns were sustained indoors either at home or at work (87.2%). The total body surface area (TBSA%) for the whole sample was 3.7% ± 7.9% (median 2%; range 1%-90%). Patients with flame burns (n = 19) were older and had larger TBSA% (p < 0.05). Inpatients had significantly higher TBSA% compared to outpatients (28.2% ± 26% versus 2.5% ± 2.1%; p < 0.005). CONCLUSION Scald burns sustained indoors are the most common across all age groups. Although the TBSA is small, a large number of children are affected. There is a need for burns prevention education programme in Brunei Darussalam.
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Affiliation(s)
- K C Pande
- Department of Orthopaedics, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan BA 1710, Negara Brunei Darussalam.
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Abstract
OBJECTIVE Low bone mineral density (BMD) is a major risk factor for fragility fractures in osteoporosis. In recent studies, its use with clinical risk factors has been shown to enhance prediction of fragility fractures. The present study was done to assess BMD in Indian patients with fragility fractures using digital X-ray radiogrammetry (DXR-BMD). METHODS A total of 228 patients (64 male and 164 female) admitted to an Orthopedic Hospital for management of fragility fracture were recruited. For each patient, DXR-BMD was obtained from an anteroposterior radiograph of the non-dominant hand. RESULTS The number of subjects with hip fracture was 104 (40 male, 64 female). Vertebral fractures were seen in 67 patients (11 male, 56 female) and distal radial fracture in 57 patients (13 male, 44 female). The DXR-BMD (g/cm(2)) was significantly lower in subjects with any fragility fracture (0.51 vs. 0.58 in men and 0.41 vs. 0.54 in women). When compared to the age-matched normative reference data by decade, all subjects with fragility fracture had significantly lower DXR-BMD except male subjects in the age decade of 40-49 years. CONCLUSION This study confirms lower DXR-BMD in Indian subjects with fragility fractures. This may have a potential role in fracture prediction when used with clinical risk factors in the Indian population.
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Affiliation(s)
- K C Pande
- Sushrut Hospital, Research Centre and Postgraduate Institute of Orthopaedics, Ramdaspeth, Nagpur, India
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Pande KC, Kadir KAHA. Melioidosis of the extremities in Brunei Darussalam. Singapore Med J 2011; 52:346-350. [PMID: 21633768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Melioidosis caused by Burkholderia pseudomallei is an infectious disease endemic to Southeast Asia and northern Australia. It has a broad spectrum of clinical manifestations and high mortality, and can mimic other infectious diseases. The aim of this study was to review cases of melioidosis of the extremities in Brunei Darussalam. METHODS Culture-positive cases for Burkholderia pseudomallei in Raja Isteri Pengiran Anak Saleha Hospital were identified from records in the Microbiology Department. The case notes were reviewed to identify patients who were treated for problems affecting the extremities. 14 (13 males and one female) out of 48 patients were identified. RESULTS The median age of the patients was 45 (range 14-55) years. Septicaemia was the most common presenting feature in 11 patients. Multisystem involvement was noted in eight patients, diabetes mellitus in nine patients and other risk factors in two patients. Blood culture was positive in ten patients and pus culture in 11 patients. The presentations noted were cellulitis of the limbs, abscess, osteomyelitis (three patients each) and septic arthritis (five patients). Orthopaedic intervention (joint washout/incision and drainage/curettage) was required in 11 patients. The median hospital stay was 27.5 (range 13-63) days; two patients required admission to intensive care. No mortality was reported. CONCLUSION Melioidosis of the extremities is not uncommon in Brunei Darussalam. It is associated with significant morbidity, and a large number of patients require surgical intervention. Thus, a high index of suspicion is required for early diagnosis and institution of appropriate antibiotic therapy.
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Affiliation(s)
- K C Pande
- Department of Orthopaedics, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, BA 1710, Brunei Darussalam.
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Pande KC, Pande SK, de Takats D, McCloskey EV. Modified calcaneal index: a new screening tool for osteoporosis based on plain radiographs of the calcaneum. J Orthop Surg (Hong Kong) 2005; 13:27-33. [PMID: 15872397 DOI: 10.1177/230949900501300105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSES To assess osteoporosis using plain radiography of the calcaneum by studying the performance characteristics of the modified calcaneal index through inter- and intra-observer agreement. To study the correlation of the modified calcaneal index to quantitative ultrasound of the calcaneus and bone mineral density (BMD) of the femoral neck and distal radius. METHODS Lateral calcaneal radiographs of 252 women who participated in a clinical trial for osteoporosis were reviewed. The BMD of the hip and distal radius was measured and the calcanea were assessed using ultrasound. The calcaneal radiographs were graded by 3 clinicians according to a previously described 5-grade calcaneal index. A modified 3-grade calcaneal index was then developed. RESULTS The highest scores of intra- and inter-observer reliability of the modified calcaneal index were 0.45 and 0.40, respectively, which were higher than those of the 5-grade calcaneal index. The correlation of the modified calcaneal index with other measures was significant (hip BMD, r=0.31; distal radius BMD, r=0.28; calcaneal speed of sound, r=0.20; broadband ultrasound attenuation, r=0.36) [p<0.005]. There were significant differences in hip BMD, distal radial BMD, calcaneal speed of sound, and broadband ultrasound attenuation between the 3 grades of the modified calcaneal index (Kruskal-Wallis 1-way ANOVA; p<0.0001). CONCLUSION The modified calcaneal index can be used to measure bone structure and skeletal strength and is a suitable screening tool for osteoporosis in places where advanced approaches to bone-status assessment are not available.
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Affiliation(s)
- K C Pande
- Sushrut Hospital, Research Centre and PGI Orthopaedics, Ramdaspeth, Nagpur, India.
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Pande KC, McCloskey EV. An age- and sex-controlled matched pair analysis of T scores in ethnic Indians with hip fractures. J Orthop Surg (Hong Kong) 2004; 12:133; author reply 134. [PMID: 15237136 DOI: 10.1177/230949900401200124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ashford RU, Luchetti M, McCloskey EV, Gray RL, Pande KC, Dey A, Kayan K, Ralston SH, Kanis JA. Studies of bone density, quantitative ultrasound, and vertebral fractures in relation to collagen type I alpha 1 alleles in elderly women. Calcif Tissue Int 2001; 68:348-51. [PMID: 11685422 DOI: 10.1007/s002230010010] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2000] [Accepted: 01/11/2001] [Indexed: 10/26/2022]
Abstract
Previous studies have demonstrated that an Sp1 binding site polymorphism in the collagen type I gene (COLIA1) is related to reduced bone mineral density (BMD) and osteoporotic fractures in certain populations, particularly in the elderly. We have examined the relationship among these COLIA1 Sp1 alleles, BMD, quantitative ultrasound properties of bone, and fractures in a population-based cohort of elderly women from the UK. The study group comprised 314 women aged 75 years and over who agreed to participate in a clinical study of bisphosphonate therapy in preventing bone loss at the hip. Women were enrolled regardless of the presence or absence of osteoporosis, but those with other diseases that might affect skeletal metabolism were excluded. The genotype distribution for the Sp1 polymorphism was in Hardy-Weinberg equilibrium (SS - 78%; Ss - 20%; ss - 2%) but the proportion of individuals who carried the "s" allele (22%) was significantly lower than previously observed in another study of the UK population (37.1%) (P < 0.001). There were no significant associations between COLIA1 genotypes and metacarpal cortical index, BMD of the forearm, tibial SOS, calcaneal SOS, or calcaneal BUA. While there was a trend towards lower BMD values at the hip in patients with Ss and ss genotypes, this was not statistically significant (SS = 0.721 +/- 0.14; Ss = 0.704 +/- 0.13; ss = 0.683 +/- 0.20 P = 0.6). Prevalent vertebral fractures occurred in 22% of subjects and prior fractures of the wrist, ankle, and hip were reported by 20%, but there was no significant difference in COLIA1 genotype distribution between fracture patients and controls. We conclude that COLIA1 Sp1 alleles are not significantly associated with BMD, ultrasound properties of bone, or fractures in this population-based sample of elderly women.
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Affiliation(s)
- R U Ashford
- The WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, England
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Abstract
We report unusual clinical and radiological features of Paget's disease of bone in three family members. All three patients had satisfactory biochemical and symptomatic response to treatment with an intravenous bisphosphonate (clodronate).
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Affiliation(s)
- K C Pande
- WHO Collaborating Centre for Metabolic Bone Diseases, Royal Hallamshire Hospital, Sheffield, UK
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Abstract
A total of 248 Orthopaedic Units in the UK were surveyed following two newspaper articles about broken drill bits being retained in patients' bones. Questions were asked about re-use of drills, guide wires and taps, as well as about informing patients when drill bit fragments were left in situ during trauma surgery. The response rate was 79.0%. The majority of hospitals are not using new drill bits for each case nor new guide wires. In the current medicolegal climate, the fact that the majority of consultants are informing patients soon after surgery that a drill bit has fragmented in their bone is applauded.
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Affiliation(s)
- R U Ashford
- Sheffield Metabolic Bone Unit, Royal Hallamshire Hospital, Glossop Road, S10 2JF, Sheffield, UK.
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Abstract
OBJECTIVE to develop a self-administered questionnaire (OPQ) to assess the patient's knowledge about osteoporosis. METHODS An initial item pool of 71 questions was developed with input from clinicians involved in the management of patients with osteoporosis. It was piloted in ten patients for face validity and comprehension. The questionnaire was then administered to 50 first-time attendees at a specialist osteoporosis unit. After item analysis using index of difficulty and index of discrimination, 20 items were selected for the final questionnaire (OPQ). These were in the areas of general information (5), risk factors (7), consequences and treatment (four each). RESULTS the average index of difficulty and index of discrimination (D) of the 20 items was 0.56 (>0.75 is suggestive of a poor discriminator) and 54.8% (D value of 50% is associated with highest level of item discrimination) respectively. This means that all the items actively discriminated between high and low scorers. The Flesch readability index was 74.3 (a score between 70 and 100 means a document is easily understood) and the reliability coefficient was 0.84 (acceptable range 0.8-0.9). Criterion validity (verification that the scale measures what it claims to measure) was confirmed by the method of contrasted groups where members of an osteoporosis awareness charity had a significantly higher score than the first time attendees (13.6 +/- 4.3 vs. 8.5 +/- 5.4; P=0.003). CONCLUSIONS we have developed a self-report, 20-item questionnaire (OPQ) to assess the patient's knowledge about osteoporosis. Psychometric analysis has shown that the items have a satisfactory index of difficulty and discrimination. The OPQ is internally reliable, valid and easily understandable. It can be used to identify individuals in need of educational interventions as well as assess the effectiveness of education efforts as a part of management of osteoporosis.
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Affiliation(s)
- K C Pande
- Department of Psychology, WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, S10 2RX, Sheffield, UK
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Abstract
Bone affected by Paget's disease is known to be dense but more prone to fractures. It is proposed that dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound (QUS) assess different aspects of the skeletal status. In this study, we used Paget's disease of the tibia as a model to explore this. Ten patients with Paget's disease affecting a single tibia were investigated with the normal side acting as the control within each individual. Tibial speed of sound (SOS) was measured at the midpoint of the affected and control tibiae using a Soundscan 2000 (Myriad Ultrasound System, Rehovot, Israel) device. Bone mineral density (BMD) of the tibia was measured at a level corresponding to the site of the tibial ultrasound using a QDR-2000+ (Hologic, Inc., Waltham, MA). The mean bone area and estimated volume in the pagetic tibia was greater than that in the normal tibia (bone area: 25.10 +/- 8.00 vs. 20.23 +/- 5.43 cm(2), p = 0.017; estimated bone volume: 68.79 +/- 41.99 vs. 43.62 +/- 22.56 cm(3), p = 0.02), reflecting the bone expansion characteristic of Paget's disease. The bone mineral content (BMC) was more markedly increased in the pagetic tibia (27.38 +/- 12.98 vs. 14.39 +/- 6.14 g, p = 0.003) and, consequently, areal bone mineral density (BMD) was also markedly increased in the pagetic bone (1.09 +/- 0.38 vs. 0.77 +/- 0.44 g/cm(2), p = 0.018). There was no significant difference in the estimated volumetric BMD between the pagetic and the normal tibia (0.48 +/- 0.24 vs. 0.47 +/- 0.51 g/cm(3), p = 0.96). In contrast, the mean tibial SOS in the leg affected by Paget's disease was significantly lower than in the unaffected leg (3228 +/- 234 vs. 3840 +/- 164 m/sec, p < 0.001). When expressed as a z score using the normal limb as reference, areal BMD was 0.72 SD higher in the affected limb, whereas tibial SOS was 3.72 SD lower. We conclude that tibial SOS detects important changes in bone quality in Paget's disease of bone, which are unrelated to calcium content.
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Affiliation(s)
- K C Pande
- WHO Collaborating Centre for Metabolic Bone Diseases, Department of Human Metabolism & Clinical Biochemistry, University of Sheffield Medical School, Sheffield, UK
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Dey A, McCloskey EV, Taube T, Cox R, Pande KC, Ashford RU, Forster M, de Takats D, Kanis JA. Metacarpal morphometry using a semi-automated technique in the assessment of osteoporosis and vertebral fracture risk. Osteoporos Int 2000; 11:953-8. [PMID: 11193248 DOI: 10.1007/s001980070034] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Metacarpal morphometry represents a potentially cheap and widely available non-invasive assessment of skeletal status. In two cross-sectional studies, we compared the performance characteristics of a semiautomated technique (the Teijin Bonalyzer) with an in-house manual measurement, and with measures of skeletal strength at other sites. The metacarpal cortical index (mCI) was measured on hand radiographs of 178 osteoporotic women using both the Teijin Bonalyzer and a digitizing tablet. Measurements on the latter were consistently lower than with the Bonalyzer except for mCI (0.443+/-0.080 vs 0.364+/-0.060, p<0.001), although correlation coefficients between these two methods were highly significant (r = 0.62-0.83, p<0.001). The reproducibility errors of metacarpal bone mineral density (mBMD) were constant (1.1-1.2%) whilst those for mCI showed a marked operator-dependency (2.0-7.9%). In 379 elderly community-dwelling women, Bonalyzer mCI and mBMD showed a significant decline with age (r = -0.30 and -0.27 respectively, p<0.05). Both mCI and mBMD correlated significantly with forearm BMD (r = 0.50 and 0.57 respectively, p<0.001) and hip BMD (r = 0.48 and 0.53 respectively, p<0.001). After adjustment for age and weight, hip BMD demonstrated the best discrimination for prevalent vertebral fractures as judged by the gradient of risk for a 1 SD decrease in measurement (odds ratio (OR) 2.17, 95% CI 1.56-3.01). Similar but smaller gradients of risk were shown by Bonalyzer mCI (OR 1.32, 95% CI 1.00-1.75), mBMD (OR 1.35, 95% CI 1.02-1.78) and forearm BMD (OR 1.39, 95% CI 1.08-1.80). MCI, and in particular mBMD, may be useful assessments of bone mass and fracture risk. In our study, it is comparable to peripheral assessment of skeletal status by forearm densitometry.
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Affiliation(s)
- A Dey
- WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, UK
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Abstract
Osseous lipomata of vertebral bodies are rare. We present a very unusual case where adjacent vertebrae are involved and the plain radiographic and scintigraphic appearances gave cause for some concern. The findings on plain films, scintigraphy, computed tomography and magnetic resonance imaging are discussed.
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Affiliation(s)
- K C Pande
- Department of Spinal Studies, University Hospital, Queen's Medical Centre, Nottingham, UK
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Abstract
Vertebral osteomyelitis arising from an enteric fistula in patients with inflammatory bowel disease is rare. We report on a patient with Crohn's disease who developed an enteric fistula, resulting in a presacral abscess and vertebral osteomyelitis involving the L4 and L5 vertebral bodies and related disc spaces. This was managed by a defunctioning colostomy with drainage of the pre-sacral abscess. The vertebral lesion was successfully managed non-operatively.
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Affiliation(s)
- K C Pande
- Centre for Spinal Studies and Surgery, University Hospital, Queen's Medical Centre, Nottingham, UK
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Abstract
Extensive spinal epidural abscesses (SEAs) carry a high mortality rate. Traditionally they are treated non-operatively with long-term antibiotics and/or surgical decompression, but there is a continuing debate as to whether they should be managed by emergency surgical decompression. However, such decisions are made in the light of the clinical setting. We report the successful management of a female patient who presented with features of upper cervical cord compression and later developed septic shock and multisystem failure. Surgical decompression of the cervical spine and irrigation of the epidural space with a paediatric catheter was performed followed by tricortical strut grafting and plating. At review, 36 weeks after surgery, the patient remained asymptomatic, having made full neurological recovery. The purpose of this report is to highlight the importance of emergency surgical intervention for extensive SEA in the presence of progressive neurological loss associated with multisystem failure.
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Affiliation(s)
- K S Lam
- Centre for Spinal Studies and Surgery, University Hospital, Queen's Medical Center, Nottingham, UK
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Abstract
We present a retrospective analysis of 684 patients operated on for a herniated lumbar intervertebral disc. Of the 87 patients with a failed back syndrome, 12 were confirmed to have tuberculous infection of the same disc interval. These patients responded satisfactorily to bracing and a short course of anti-tubercular chemotherapy. Histopathological confirmation of the disease was obtained by CT guided biopsy, and only a few of the patients required repeat surgery. This study highlights one of the atypical presentations of tuberculosis of the spine as a herniated lumbar intervertebral disc and a cause of a failed back syndrome. Advanced imaging techniques such as MRI and CT scans are helpful in the early detection of such conditions.
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Affiliation(s)
- K C Pande
- Susurut Hospital, Research Centre, Nagpur, India
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Abstract
We have reviewed 104 patients who had partial resection of the fibula for use as a graft. Only 44 were completely free from symptoms, and six had developed significant ankle instability which had required reconstruction by a sliding graft. This procedure successfully restored ankle stability in all six cases.
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Babhulkar SS, Pande KC, Babhulkar S. Ankle instability after fibular resection. J Bone Joint Surg Br 1995; 77:258-61. [PMID: 7706342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We have reviewed 104 patients who had partial resection of the fibula for use as a graft. Only 44 were completely free from symptoms, and six had developed significant ankle instability which had required reconstruction by a sliding graft. This procedure successfully restored ankle stability in all six cases.
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Bott RW, Eaborn C, Pande KC, Swaddie TW. 233. Organogermanium compounds. Part III. Relative inductive effects of trimethylsilyl and trimethylgermyl groups. ACTA ACUST UNITED AC 1962. [DOI: 10.1039/jr9620001217] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Eaborn C, Pande KC. 1006. Aromatic reactivity. Part XXI. Effects of strongly deactivating substituents in protodetriethylgermylation. ACTA ACUST UNITED AC 1961. [DOI: 10.1039/jr9610005082] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Eaborn C, Pande KC. 53. Aromatic reactivity. Part XII. Cleavage of aryltriethylgermanes by aqueous-methanolic perchloric acid. ACTA ACUST UNITED AC 1961. [DOI: 10.1039/jr9610000297] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Eaborn C, Pande KC. 722. Aromatic reactivity. Part XVII. Cleavage of aryltricyclohexylplumbanes by aqueous-ethanolic perchloric acid. ACTA ACUST UNITED AC 1961. [DOI: 10.1039/jr9610003715] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Eaborn C, Pande KC. 643. Organogermanium compounds. Part I. Preparation of substituted triethyl- and tricyclohexyl-phenylgermanes. ACTA ACUST UNITED AC 1960. [DOI: 10.1039/jr9600003200] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Johnson AW, McCaldin DJ, Bartels-Keith JR, Turner WB, Aylett BJ, Ellis IA, Briggs LH, Colebrook LD, Miller HK, Sato Y, Brettle R, Hair ML, Robinson PL, El-Abbady AM, Baddar FG, Labib A, Clancy MJ, Eaborn C, Leyshon K, Pande KC. Notes. ACTA ACUST UNITED AC 1960. [DOI: 10.1039/jr9600003412] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Pande KC, Mehrotra RC. Titanium Salts of mono carboxylic acids. Reactions of Titanium-ethoxide and -isopropoxide with fatty acids. Z Anorg Allg Chem 1957. [DOI: 10.1002/zaac.19572910109] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Pande KC, Mehrotra RC. Titanium salts of mono-carboxylic acids. II. Reaction of Titanium Isopropoxide and ethoxide with acetic anhydride. Z Anorg Allg Chem 1957. [DOI: 10.1002/zaac.19572900111] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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