Phil Blyth - Academia.edu (original) (raw)

Papers by Phil Blyth

PubMed, May 25, 2001

Aims: To study the adult trauma patient population at the Auckland Hospital in order to determine... more Aims: To study the adult trauma patient population at the Auckland Hospital in order to determine the age distribution of trauma, the prevalence and importance of co-morbid conditions and any effect of the latter on the length of stay in the hospital. Methods: Data were collected on 78 consecutive patients admitted to the Auckland Hospital under the Trauma team between December 1999 and January 2000. Data were collected by interviewing the patient, as well as reviewing patient's medical notes and the Trauma Registry. Results: The prevalence of co-morbidities was 14.7%. No co-morbidity was found below the age of 40 years, but the prevalence of co-morbidity increased with age. The average length of stay for patients with no comorbidities and an Injury Severity Score (ISS) >15 was 19 days while for those with co-morbidities was 24.5 days--an increase of 29%. Conclusion: This pilot study has found that a significant number of trauma patients being admitted to Auckland Hospital have a pre-existing co-morbid condition that may alter their length of stay. It is an important issue that warrants further investigation, in order to devise a more accurate prognostic scoring system.

$Research paper thumbnail of Lumbar transverse process fractures — a sentinel marker of abdominal organ injuries$

Injury-international Journal of The Care of The Injured, Dec 1, 2000

Fractures of lumbar vertebrae may be associated with abdominal organ injuries. Lumbar transverse ... more Fractures of lumbar vertebrae may be associated with abdominal organ injuries. Lumbar transverse process fractures are commonly thought of as minor injuries compared with body, pedicle and lamina fractures. To determine the significance of transverse process fractures as opposed to other lumbar vertebral fractures in relation to abdominal organ injury, a retrospective study was performed. One hundred and ninety-one patients

The Internet and Higher Education

Orthopaedic Proceedings, Feb 1, 2023

Cannulated screw fixation is currently the treatment of choice for slipped capital femoral epiphy... more Cannulated screw fixation is currently the treatment of choice for slipped capital femoral epiphyses (SCFE). A SCFE module of the Bonedoc simulator was created in order to test the ability of advanced trainees to place the screw in the correct position, and the practicality of using the simulator within the orthopaedic surgery training curriculum. Bonedoc (University of Auckland) is a virtual reality simulator of image guided orthopaedic operations1. This simulator runs in Internet Explorer (Microsoft, USA) using the Octaga (Octaga, Norway) plugin. The total download is around 4 MB. The SCFE module was created from a CT scan of a Grade 2 acute on chronic SCFE. DICOM images were imported into 3DView (www.rmrsystems.co.uk) and a mesh created. The generic femur from the DHS module was morphed within the CAD package Blender (Blender.org) to conform to this reconstructed SCFE mesh. Forty two advanced trainees operated on the same virtual SCFE during a training weekend. The trainees had 2...

A procedure is presented which allows the efficient production of a patient specific computer mod... more A procedure is presented which allows the efficient production of a patient specific computer model of the femur, for surgical planning. Similar models require long processing times and/or high performance computing. The method uses 24 key landmark points to customise a generic femur to patient data, using a desktop computer. By using non-linear elements a smooth, curved surface is obtained. A finite element mesh of a generic femur consisting of 384 elements was created using the analysis software CMISS (Bioengineering Institute, University of Auckland). A rectangular shaped host mesh was defined to enclose the generic femur. Datasets of 5 human femurs were obtained using a hand-held laser scanner on dry bones and the visible human dataset. Key landmark data points were selected on the generic femur along with corresponding target points on each data set. The host mesh was then deformed using a least squares algorithm, causing customisation of the generic femur to the patient specif...

Journal of Surgical Research, 2006

Journal of the Pediatric Orthopaedic Society of North America

A tablet-based fluoroscopy simulator offers the opportunity to practice percutaneous pinning of s... more A tablet-based fluoroscopy simulator offers the opportunity to practice percutaneous pinning of supracondylar fractures. Acquiring skills in visuo-spatial and hand-eye coordination are central to development of safe surgical technique. Mobility and ease of setup without the need for real fluoroscopy enables repetition of the procedure at a time to suit residents' schedule.

Correct sizing of knee arthroplasty implants avoids problems such as stiffness from too large an ... more Correct sizing of knee arthroplasty implants avoids problems such as stiffness from too large an implant, or periprosthetic fractures from undersizing. Currently most implants are based on a generic unisex population. Femoral component sizing is therefore based solely on the AP measurement after the distal femoral cut. In order to investigate the differences between the New Zealand population and other populations with reported anthropometrics we studied the anthropometrics of the male and female distal femur. The distal femur of 26 cadaveric knees was resected using standard cutting guides. Using a sizing guide the AP dimension was measured from the posterior condyle to the anterior cortex just proximal to the trochlea (posterior referencing). The ML dimension was measured at the cut surface in the coronal plane of the epicondylar axis. Overall AP measurement had a mean(standard deviation) of 62(±6.7) mm, the ML measurements had a mean (sd.) of 72(±6.6)mm yielding an ML/AP(100) rat...

Education Sciences

Human-cadaveric material is a valuable resource for teaching anatomy, and a lot of research engag... more Human-cadaveric material is a valuable resource for teaching anatomy, and a lot of research engaging medical students shows they benefit, in a variety of ways, from engaging with this material. However, more and more students who study anatomy are non-medical. Thus, they may have different educational foci than that of medical students, and, therefore, different perspectives on the value of human-cadaveric material as a learning resource. The aim of this study was to explore the perceptions of science students studying anatomy, in the use of learning using cadaveric material. Two cohorts of undergraduate science students studying anatomy (second-year, third-year) completed two surveys; one at the start and another following the completion of their semester-long courses that utilised prosections (second-year) and dissection (third-year) as a primary way of learning anatomy. Likert-scale and open-ended responses were analysed using a general inductive approach, and common emergent the...

Este Debate fue propuesto para aportar diferentes puntos de vista y conocer la diversidad de circ... more Este Debate fue propuesto para aportar diferentes puntos de vista y conocer la diversidad de circunstancias involucradas en la procuración y uso de cadáveres para la enseñanza de la Anatomía, a estudiantes de pre y post-grado, en el mundo. Un grupo reducido pero representativo de profesores de Anatomía de todos los continentes fueron invitados a participar. Se distribuyeron algunos lineamientos para que los escritos tuvieran similar orientación, aunque los autores podían incluir cualquier concepto que consideraran de interés para los lectores. Además de los profesores de diversos países, el Prof.

Revista Argentina de Anatomía Clínica, 2016

La publicación del Debate sobre “Cuerpos Humanos para la Enseñanza de la Anatomía: Importancia y ... more La publicación del Debate sobre “Cuerpos Humanos para la Enseñanza de la Anatomía: Importancia y Procuración – Experiencia con la Donación de Cadáveres” en el último número llamó la atención de la comunidad anatómica internacional por la amplitud del enfoque y la diversidad de las situaciones mencionadas. Aunque es posible encontrar muchos otros artículos sobre el tema, generalmente se enfocan a una experiencia particular, un país o, eventualmente, a un continente. Este Debate dio una breve visión sobre diferentes continentes y provesó un rápido punto de vista sobre los acuerdos y diversidad de problemas que afrontan los profesores de Anatomía en una amplia variedad de culturas. Tal como se especificó en la primera parte, los comentarios, consultas y respuestas de los participantes iniciales y los lectores en general serían considerados para una segunda parte del Debate. Todas las contribuciones significativas han sido organizadas e incluidas en esta instancia. Los lectores podrán ...

Anatomical Sciences Education, 2020

Australian and New Zealand universities commenced a new academic year in February/ March 2020 lar... more Australian and New Zealand universities commenced a new academic year in February/ March 2020 largely with "business as usual." The subsequent Covid-19 pandemic imposed unexpected disruptions to anatomical educational practice. Rapid change occurred due to government-imposed physical distancing regulations from March 2020 that increasingly restricted anatomy laboratory teaching practices. Anatomy educators in both these countries were mobilized to adjust their teaching approaches. This study on anatomy education disruption at pandemic onset within Australia and New Zealand adopts a social constructivist lens. The research question was "What are the perceived disruptions and changes made to anatomy education in Australia and New Zealand during the initial period of the Covid-19 pandemic, as reflected on by anatomy educators?." Thematic analysis to elucidate "the what and why" of anatomy education was applied to these reflections. About 18 anatomy academics from ten institutions participated in this exercise. The analysis revealed loss of integrated "hands-on" experiences, and impacts on workload, traditional roles, students, pedagogy, and anatomists' personal educational philosophies. The key opportunities recognized for anatomy education included: enabling synchronous teaching across remote

Journal of Forensic Sciences, 2015

This study measured and assessed facial soft tissue depths (FSTDs) in adult female Chinese and Ne... more This study measured and assessed facial soft tissue depths (FSTDs) in adult female Chinese and New Zealand (NZ) Europeans (Caucasoids). Ultrasound was used to obtain depths at nine landmarks on 108 healthy subjects (51 Chinese, 57 NZ European), erect positioned, of same age group (18-29 years). Height and weight were also recorded. Statistical analysis focused on comparison of tissue depth between the two ancestry groups and the influence of Body Mass Index (BMI) (kg/m 2). Results showed mean depth differences at Supra M2 and Infra M2 landmarks significantly greater for Chinese than Caucasoid women for all three BMI Classes (BMI <20, 20 ≤ BMI < 25, 25 ≤ BMI < 30), even BMI <20. For both groups BMI positively correlated with FSTD values at all landmarks except Labrale superius. This study enabled ancestry and BMI influence on FSTDs to be observed and compared for two distinct groups. Results add to knowledge about facial tissue depth variation.

Journal of Anatomy, 2009

This study elucidates the structure of the anal sphincter complex (ASC) and correlates the indivi... more This study elucidates the structure of the anal sphincter complex (ASC) and correlates the individual layers, namely the external anal sphincter (EAS), conjoint longitudinal muscle (CLM) and internal anal sphincter (IAS), with their ultrasonographic images. Eighteen male cadavers, with an average age of 72 years (range 62-82 years), were used in this study. Multiple methods were used including gross dissection, coronal and axial sheet plastination, different histological staining techniques and endoanal sonography. The EAS was a continuous layer but with different relations, an upper part (corresponding to the deep and superficial parts in the traditional description) and a lower (subcutaneous) part that was located distal to the IAS, and was the only muscle encircling the anal orifice below the IAS. The CLM was a fibro-fatty-muscular layer occupying the intersphincteric space and was continuous superiorly with the longitudinal muscle layer of the rectum. In its middle and lower parts it consisted of collagen and elastic fibres with fatty tissue filling the spaces between the fibrous septa. The IAS was a markedly thickened extension of the terminal circular smooth muscle layer of the rectum and it terminated proximal to the lower part of the EAS. On endoanal sonography, the EAS appeared as an irregular hyperechoic band; CLM was poorly represented by a thin irregular hyperechoic line and IAS was represented by a hypoechoic band. Data on the measurements of the thickness of the ASC layers are presented and vary between dissection and sonographic imaging. The layers of the ASC were precisely identified in situ , in sections, in isolated dissected specimens and the same structures were correlated with their sonographic appearance. The results of the measurements of ASC components in this study on male cadavers were variable, suggesting that these should be used with caution in diagnostic and management settings.

ANZ Journal of Surgery, 2006

Background: The carotid arterial system which consists of right and left common carotid arteries ... more Background: The carotid arterial system which consists of right and left common carotid arteries is the main arterial supply of the head and neck. Studies show that variations exist to the level of bifurcation of the common carotid artery. Knowledge of these variations is of importance for surgical approaches in the head and neck region, such as carotid endarterectomy, radical neck dissection, catheterization etc, thereby reduce the risk of operative morbidity and mortality in patients undergoing operations, involving the common carotid artery. Objective: The main purpose of the study was to assess height of the common carotid artery bifurcation in relation to the cervical vertebrae. Method: Observational based descriptive study was conducted on thirteen human preserved cadavers, which were obtained from the departments of human anatomy, Colleges of Medicine and Health Sciences, Gondar and Bahirdar Universities and Gamby College of Medical Sciences-Bahirdar after the approval of the ethical committee. Results: The bifurcation of the common carotid artery was found high in 12 (46.15%) of the cases among which the most common levels of bifurcation was at the level of C3 (42.3%). 14 (53.85%) of the cases was standard of which C4 (38.4%) was the most common and low bifurcation was not found. It was also found that in 61.5% of the cases the carotid bifurcation was asymmetrical between the right and left sides. Conclusions: The present study showed that standard level of bifurcations was found to be more common than high level and low bifurcation was not found. The level of bifurcation was generally asymmetrical between right and left sides. Thus anatomical knowledge of the variability of carotid bifurcation levels will be useful for clinicians, to avoid unnecessary complications.

Anatomical Science International, 2007

The accessory nerve is traditionally described as having both spinal and cranial roots, with the ... more The accessory nerve is traditionally described as having both spinal and cranial roots, with the spinal root originating from the upper cervical segments of the spinal cord and the cranial root originating from the dorsolateral surface of the medulla oblongata. The spinal rootlets and cranial rootlets converge either before entering the jugular foramen or within it. In a recent report, this conventional view has been challenged by finding no cranial contribution to the accessory nerve. The present study was undertaken to re-examine the accessory and vagus nerves within the cranium and jugular foramen, with particular emphasis on the components of the accessory nerve. These nerves were traced from their rootlets attaching to the spinal cord and the medulla and then through the jugular foramen. The jugular foramen was exposed by removing the dural covering and surrounding bone. A surgical dissecting microscope was used to trace the roots of the glossopharyngeal nerve (CN IX), vagus nerve (CN X) and accessory nerve (CN XI) before they entered the jugular foramen and during their travel through it. The present study demonstrates that the accessory nerve exists in two forms within the cranial cavity. In the majority of cases (11 of 12), CN XI originated from the spinal cord with no distinct contribution from the medulla. However, in one of 12 cases, a small but distinct connection was seen between the vagus and the spinal accessory nerves within the jugular foramen.

$Research paper thumbnail of Transfer validity of paediatric supracondylar humeral fracture pin placement practice on in-theatre performance by orthopaedic trainees using an augmented reality simulator: Protocol for a non-randomised intervention cohort with retrospective comparator pilot study (Preprint)$

JMIR Research Protocols, Mar 31, 2022