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Biomedical subjects

A L Dellon

Publications and source records attributed to A L Dellon.

At least 19 recordsLinked to original sources
PubMed1992

Reinnervation of distal sensory nerve environments by regenerating sensory axons.

This study investigated the specificity of sensory nerve regeneration in a primate model. In adult cynomolgus monkeys, the femoral nerve was explored in the groin and two sensory branches identified. A sensory branch was sectioned and introduced into the proximal channel of a Y-shaped silicone chamber. This proximal sensory nerve stump was given distal choices of distal sensory nerve graft or distal sensory nerve which was intact to the distal sensory cutaneous receptors. After eight months, histological analysis confirmed axonal growth directed towards both the distal nerve graft and the distal nerve intact to the distal cutaneous receptors. However, the number of nerve fibres directed towards the distal nerve was significantly greater than the number of nerve fibres directed towards the nerve graft (P less than 0.004). These results suggest that while both distal nerve graft and distal intact nerve act as specific targets to regenerating proximal primate nerve, the presence of an intact distal end-organ positively enhances sensory regeneration.

Animals↗
PubMed1992

Deepithelialized pedicle flap placed subcutaneously for fingertip reconstruction.

Fingertip injuries are common, but treatment may produce misshapened, clubbed, and painful results. The technique described here has given consistently excellent results in fingertip coverage in 74 patients with 96 fingertip injuries from 1976 through 1986. In this technique deepithelialized pedicle flaps provide soft tissue coverage before skin closure.

Finger Injuries↗
PubMed1992

Gnostic rings: usefulness in sensibility evaluation and sensory reeducation.

The benefit of additional clinical tools for quantifying patients' ability to recognize objects is clear, as well as its correlation with the moving two-point discrimination test. The recognition of letters is such a tool. The authors describe gnostic rings, an additional technique, that is useful for clinical sensibility testing, as well as for sensory reeducation.

Discrimination, Psychological↗
PubMed1992

Functional limb salvage combining gastrocnemius neurotization and posterior tibial nerve grafting: a case report.

Functional limb salvage requires motor and sensory reconstruction of the extremity. An avulsion of the tibial nerve in the popliteal fossa after arthroscopy is presented. Functional limb recovery necessitated intraoperative nerve mapping by awake stimulation, neurotization of the gastrocnemius muscle bellies, and interfascicular posterior tibial nerve grafting. Eighteen-month follow-up demonstrated good gastrocnemius motor function and protective sensation on the plantar surface. The patient is ambulatory without the need of an assistive device.

Adolescent↗
PubMed1992

The sensational transverse rectus abdominis musculocutaneous (TRAM) flap: return of sensibility after TRAM breast reconstruction.

Normal breast sensation was objectively quantitated with a biothesiometer, Semmes-Weinstein monofilaments, and two-point discrimination in 10 patients. Ten patients, 2 to 7 years after pedicled transverse rectus abdominis musculocutaneous flap (TRAM) breast reconstruction, were tested in a similar manner. The majority of these patients were found to have recorded measurable sensibility in the TRAM reconstruction. Recovered sensation was best in the medial and superior quadrants and improved with time. Although sensibility was present, it was still significantly different from normal sensory thresholds. A method to improve sensation by intercostal nerve repair is described. Three patients who have undergone this reconstruction have better sensibility in the reinnervated breast compared with the control breast. Sensory reeducation programs may also improve subsequent sensibility return.

Adult↗
PubMed1992

Epidermal nevus: surgical treatment by partial-thickness skin excision.

A child with epidermal nevus, systematized, is reported in which diffuse areas of pruritic and bleeding tissue were treated by partial-thickness skin excision, a technique reported to have been successful in other forms of benign dyskeratosis, such as psoriasis. At age 5 years, a test region of the anterior thigh was treated and remained disease free with an acceptable scar. At age 8 years, this technique was applied to the back, buttock, calf, and thigh. While the areas remain disease free, they have, unfortunately, healed with hypertrophic and keloid scars.

Child↗
PubMed1992

Soft tissue chondroma presenting as a painful finger: diagnosis by magnetic resonance imaging.

Benign cartilage tumors of the hands and feet are uncommon soft tissue tumors that generally present as a painless swelling. The diagnosis is often made histologically, as the radiographic appearance of the soft tissues may be normal. In this report, we present a woman who demonstrates the need to consider soft tissue chondromas in the differential diagnosis of a painful finger. Magnetic resonance imaging was used to localize the tumor, suggesting that this imaging method may be useful in differential diagnosis of finger pain.

Adult↗
PubMed1992

Human pressure perception values for constant and moving one- and two-point discrimination.

Despite the need to evaluate sensibility for accurate diagnosis and the need to record the degree of sensation achieved in the postoperative period, the clinician has been without the ability to measure human pressure perception accurately. Traditionally, the Semmes-Weinstein monofilaments were used to measure the static one-point discrimination threshold. A new sensory testing instrument, the Pressure-Specifying Sensory Device, was used to obtain normative data from the index and little finger of the dominant hand in 35 people ranging in age from 16 to 83 with no known neurologic impairment. Pressure perceptions for static one- and two-point discrimination (s1PD, s2PD) and moving one- and two-point discrimination (m1PD, m2PD) were recorded. The mean values (+/- SD) were 0.13 +/- 0.06, 0.24 +/- 0.12, 0.22 +/- 0.10, and 0.26 +/- 0.13 gm/mm2 for s1PD, s2PD, m1PD, and m2PD, respectively, on the index finger and 0.07 +/- 0.05, 0.16 +/- 0.12, 0.17 +/- 0.07, and 0.21 +/- 0.14 gm/mm2 for s1PD, s2PD, m1PD, and m2PD, respectively, for the little finger. The little finger was significantly more sensitive than the index finger (p less than 0.001). There was no significant change in pressure perception with increasing age.

Adolescent↗
PubMed1992

Impact of the journal Plastic and Reconstructive Surgery.

The "impact" of Plastic and Reconstructive Surgery was evaluated by bibliometric analysis. This technique considers the average frequency with which journal authors refer to articles published in Plastic and Reconstructive Surgery. The impact of Plastic and Reconstructive Surgery was compared with that of journals most commonly referred to within Plastic and Reconstructive Surgery as well as with that of journals read most commonly by Plastic and Reconstructive Surgery subscribers, such as the Annals of Plastic Surgery and the Journal of Hand Surgery (both American and British editions). The impact factor for Plastic and Reconstructive Surgery was at least twice as great as for any other journal related to this surgical subspecialty. With regard to other surgical subspecialties, while the impact factor for Plastic and Reconstructive Surgery was less than that of the Journal of Neurosurgery, Journal of Urology, and Journal of Ophthalmology, it was greater than those for orthopedics, otolaryngology, hand surgery, and dermatologic surgery.

Bibliometrics↗
PubMed1992

Treatment of Morton's neuroma as a nerve compression. The role for neurolysis.

The almost universal surgical approach for the treatment of Morton's metatarsalgia is to resect the neuroma through a dorsal incision. Considering that the mechanism for the metatarsalgia is chronic repetitive compression of the common plantar digital nerve between the metatarsal heads, this report explores the use of neurolysis in five patients with 11 involved nerves. In surgery, the intermetatarsal ligament is divided, intrinsic fibrosis is released, and the epineurium is opened. The mean follow-up period is 33 months. Complete pain relief was achieved in four of the five patients, with the fifth patient, 13 years after a crush injury to the foot, achieving good pain relief. All five patients resumed their usual jobs and athletic activities. One patient wears sneakers instead of regular shoes. The patient with the crush injury wears custom-made shoes.

Adult↗
PubMed1992

Inferior alveolar nerve reconstruction with a polyglycolic acid bioabsorbable nerve conduit.

A custom-designed polyglycolic acid (PGA) bioabsorbable nerve conduit was used to reconstruct a 25-mm defect in the right inferior alveolar nerve. The initial nerve injury, following a dental extraction, resulted in loss of lower lip sensation and severe facial pain. Sixteen months after tooth extraction, with no improvement in symptomatology, the alveolar canal was enlarged in diameter by means of mandibular osteotomy to accommodate a 2-mm-diameter polyglycolic acid tube. The proximal end of the inferior alveolar nerve was sutured into the polyglycolic acid tube. The mental nerve was sutured into the distal end of the tube. Pain of neural origin was relieved in the early postoperative period. Two years following nerve reconstruction, pain relief remains excellent and perception of pressure and vibration is similar to the thresholds for these perceptions on the contralateral lip.

Absorption↗
PubMed1992

Treatment of symptomatic diabetic neuropathy by surgical decompression of multiple peripheral nerves.

Symptomatic diabetic sensorimotor polyneuropathy is considered progressive and irreversible. The hypothesis that symptoms of diabetic neuropathy may be due to entrapment of peripheral nerves was investigated in a prospective study from 1982 to 1988 in which diabetics (38 type I, 22 type II) had surgical decompression of 154 peripheral nerves in 51 upper extremities and 31 lower extremities. Mean postoperative follow-up was 30 months (range 6 to 83 months). Considering the entire series, an excellent final result was noted for motor function in 44 percent and for sensory function in 67 percent of the decompressed nerves. Ten percent of the patients were not improved, and 2 percent were worse in sensorimotor function. Upper extremity nerve decompressions achieved better results than lower extremity nerve decompressions. Improvement in postoperative electrodiagnostic studies varied in relationship to the preoperative electrodiagnosis. Improvement was noted in 100 percent of those nerves with the preoperative diagnosis of "localized entrapment," 80 percent for "peripheral neuropathy with superimposed entrapment," and 50 percent for "peripheral neuropathy." Progressive neuropathy occurred in a nontreated limb of 50 percent of those patients whose surgically treated limb maintained improvement. The results of this study suggest that symptoms of sensorimotor diabetic neuropathy may be due partly to compression of multiple peripheral nerves. The results further suggest that surgical decompression of such nerves may result in symptomatic improvement.

Adult↗
PubMed1991

Plastic surgery.

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Animals↗