Biochemical Changes in the Devascularized Femoral Head

A review of the literature indicates that there have been many attempts to determine the viability of the femoral head after trans cervical fracture of the neck of the femur. These methods have included the use of radioactive isotopes, venography, arteriography and intramedullary pressure determinations. None of these methods have proved entirely satisfactory. The purpose of this investigation was to determine some of the biochemical changes taking place in the devascularized femoral head. Nineteen dogs were used for the experiments. The femoral neck was fractured transcervically and devascularized. Total devascularinations were performed in the majority of the animals. The animals were allowed to live from 35 minutes to 59 hours after surgery. They were then sacrificed and the contents of the femoral head analyzed for lactic acid, glutathione and alkaline phosphatase. The unoperated aide was used for a control. The totally devascularized specimens show an abrupt rise in the lactic acid content leveling off at about 3 hours after devascularization. The mean of the control specimens was 18. 4 mg, lactic acid per 100 gm. of tissue while the mean of the test specimens after 3 hours was 111 mg. lactic acid per 100 gm. of tissue. The glutathione content of the totally devascularized specimens drops from a mean of ZZ, 5 mg. per 100 gm. of tissue in the control to 3. 9 in the test after 13 hours. The alkaline phosphatase shows a marked drop after 24 hours. The partially devascularized specimens show the same tendency but the changes take place more slowly. The results from Eve femoral heads (four women and one man) removed for prosthetic replacement were included. It was shown that the lactic acid determination could be shortened for the type of specimen used in this study. It was concluded that if a method could be found for securing the specimen from the femoral head in man, the biochemical analysis of Eli® specimen could aid the orthopaedic surgeon in his decision as to the method of caring for transcervical fractures of the neck of the femur

Rehabilitation interventions for foot drop in neuromuscular disease

"Foot drop" or "Floppy foot drop" is the term commonly used to describe weakness or contracture of the muscles around the ankle joint. It may arise from many neuromuscular diseases