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Biomedical subjects

A P Weiss

Publications and source records attributed to A P Weiss.

At least 19 recordsLinked to original sources
PubMed1995

Wrist arthrodesis for traumatic conditions: a study of plate and local bone graft application.

This study demonstrates the ability to obtain a predictable and complete wrist arthrodesis using local bone graft and a dorsal plate. The donor site morbidity often seen in using iliac crest graft is eliminated with this method. We examined the use of local distal radius bone grafting alone with dorsal plate fixation and its ability to provide a predictable fusion. Twenty-eight consecutive patients underwent wrist arthrodesis by a standard plate fixation technique. Average patient age was 34 years with an average period of symptom duration of 2.1 years. The cohort had undergone 17 previous wrist surgical procedures prior to wrist arthrodesis. The average followup examination period was 2 years. Grip strength, x-ray films, and range of motion were evaluated. All patients had a solid wrist arthrodesis at final follow-up examination. Grip strength, pronation/supination, and digital motion did not change significantly from the preoperative status. No patients complained of wrist pain or instability. Complications included extensor tendinitis at the distal aspect of the plate in four patients requiring plate removal, carpal tunnel syndrome requiring decompression, and distal radioulnar joint pain requiring intra-articular injection of corticosteroid.

Adolescent↗
PubMed1995

Growth factor modulation of the formation of a molded vascularized bone graft in vivo.

Peptide growth factors are potent regulators of osteoblast differentiation, proliferation, and maturation. Two of these growth factors, transforming growth factor beta (TGF-beta) and basic fibroblast growth factor (bFGF), were used in an attempt to stimulate osteoneogenesis and angiogenesis in a molded vascularized bone graft in the rat. Custom chambers containing cancellous autograft bone and agarose beads and incubated with TGF-beta, bFGF, or a control solution, were closed around the femoral artery/vein pedicle for 2-4 weeks. Control grafts were completely necrotic and without mechanical integrity. TGF-beta grafts demonstrated active osteogenesis around necrotic bone, osteoclastic activity, and limited angiogenesis. Basic FGF grafts demonstrated substantial angiogenesis with limited osteoblastic activity. This study suggests that TGF-beta and bFGF stimulate populations of cells in the formation of a molded vascularized bone graft. TGF-beta induces the proliferation and/or activity of osteoblastic cells, while bFGF stimulates cells involved in angiogenesis. Despite these findings, an insoluble demineralized matrix component may be required for complete transformation and graft consolidation.

Animals↗
PubMed1995

Prospective, randomized trial of splinting after carpal tunnel release.

To determine the possible beneficial effect of postoperative splint immobilization after open carpal tunnel release, we performed a prospective, randomized study comparing 2 weeks of postoperative wrist splinting versus a bulky dressing only. Forty patients with 43 carpal tunnel releases were evaluated. There were no statistically significant differences between the two groups using subjective parameters of patient satisfaction with their outcome and objective parameters of grip and lateral pinch strength, complication rates, and digital and wrist range of motion. No clinical evidence of bowstringing could be noted in either group of patients. We found no beneficial effect from postoperative splinting after open carpal tunnel release when compared to a bulky dressing alone.

Adult↗
PubMed1995

Diagnostic imaging and arthroscopy for chronic wrist pain.

This article discusses a current overview of the diagnostic imaging techniques available to the orthopaedic surgeon trying to establish an etiology of chronic wrist pain. A discussion on the use of arthroscopy in conjunction with or as a replacement for these imaging techniques is also presented. A discussion of the advantages and disadvantages of each of these techniques is provided to try to aid the reader in establishing a cost-effective and efficient treatment algorithm for these difficult diagnostic dilemmas.

Arthroscopy↗
PubMed1995

Carpal tunnel syndrome. Etiology and endoscopic treatment.

Carpal tunnel syndrome involves classic symptoms of numbness and paresthesias in the radial three and one-half digits, most frequently nocturnal, with pain associated with this anatomic distribution. Thenar weakness and autonomic dysfunction occurs late in these patients and are usually seen in advanced cases. The wrist flexion test and local percussion sensitivity tests done on physical examination can be helpful in determining and confirming the diagnosis of carpal tunnel syndrome. The likelihood that operative treatment will be required for resolution of symptoms is heightened if the patient is involved in daily manual repetitive activities of the hand or wrist. Surgical decompression can be accomplished by either a limited open or new endoscopic carpal tunnel release techniques. Currently, the advantages and disadvantages present in both procedures and careful controlled studies conducted in a prospective and randomized fashion will be required to further delineate the indications for either procedure. Carpal tunnel release remains an operative procedure with the most predictable outcome with relief of symptoms for the patient.

Arthroscopy↗
PubMed1995

Giant cell tumors of tendon sheath.

Giant cell tumor of tendon sheath represents a common disorder that can present a surgical challenge. This article discusses the clinical, histologic, and treatment options for this lesion and the technique of excision.

Fingers↗
PubMed1994

Treatment of de Quervain's disease.

This study compared the use of a mixed steroid/lidocaine injection alone, an immobilization splint alone, and the simultaneous use of both in improving symptoms in de Quervain's disease. Ninety-three wrists were included in the study, with an average follow-up examination of 13 months. Complete relief of symptoms was noted in 28 of 42 wrists receiving an injection alone, 8 of 14 wrists receiving both an injection and splint, and 7 of 37 wrists receiving a splint alone. No significant difference was noted between the injection alone and injection plus splint groups. A significant difference was seen between the injection alone and splint alone groups and the injection/splint and splint alone groups. Twenty of 45 wrists that underwent operative release demonstrated a septum at the first dorsal compartment. When the need for operative release was used as an outcome result for treatment failure, the injection alone and splint alone groups demonstrated significance. We recommend the use of a mixed steroid/lidocaine injection alone as the initial treatment of choice in this condition. No additional benefit is appreciated by the addition of splint immobilization and, in fact, patients are less restricted with a lower financial burden without its use.

Adolescent↗
PubMed1994

The management of dog bites and dog bite infections to the hand.

Dog bites account for approximately one of 200 emergency room visits. The majority of bites are from dogs known to the victim. Due to the numerous small compartments and the thin covering of soft tissue over the bones and joints, bite wounds to the hand are more likely to become infected that are bites to the arm, leg, or face. Improper management can result in significant morbidity and prolonged treatment. This article discusses the microbiology of dog bite wounds, antibiotic selection, and proper wound management.

Animals↗
PubMed1994

An experimental rat model allowing controlled delivery of substances to evaluate fracture healing.

We present a method to study the in vivo delivery of any substance in a rat femur fracture model that allows precise administration with control of both substance dosage and temporal application in a reproducible and predictable manner. This method is easy to perform, requires no expensive materials, and provides the benefit of internal stabilization of the femur fracture. In this model, all wounds are closed after surgery with no external ports or catheters, significantly reducing the infection rate and the risk of dislodgement due to animal intervention. This model allows the study of different substances given at different times in the same animal, providing the potential to improve our understanding of the interactions of various substances on normal fracture healing.

Animals↗
PubMed1994

The surgical approach in non-border digit complex dislocations of the metacarpophalangeal joint.

Complex dislocations of the metacarpophalangeal (MCP) joint of the hand are uncommon. Most are irreducible by closed means and require open reduction. The structure most frequently blocking reduction is the volar plate, which is often interposed between the metacarpal head and the base of the proximal phalanx by the partially torn deep transverse metacarpal ligaments and MCP collateral ligaments. A review of the literature reveals controversy concerning which surgical approach, dorsal or volar, should be used to reduce these dislocations. We present an unusual case of a closed dorsal complex dislocation of the middle finger MCP joint to advocate the dorsal approach.

Adult↗
PubMed1994

Soft tissue contractures about the elbow.

Hard and soft tissue injury to the elbow may be complicated by progressive secondary joint contracture. Motion-directed therapy often improves or eliminates elbow contracture if it is recognized early in treatment. Progressive soft tissue contracture, with or without the concomitant development of heterotopic ossification, is best treated by surgical release. This article discusses the operative technique and the results of treatment.

Adult↗
PubMed1994

Cubital tunnel syndrome. Part II: Treatment.

Conservative management has been successful for mild cases of cubital tunnel syndrome. If conservative treatment fails and clinical signs of nerve dysfunction or electrophysiologic abnormalities are present, surgical decompression should be considered. The indications for and results of simple decompression, anterior transposition (subcutaneous, submuscular, or intramuscular), and medial epicondylectomy, as well as associated complications, are reviewed.

Denervation↗
PubMed1992

Radial nerve rupture after a traction injury: a case report.

A case in which a patient sustained a closed rupture of the radial nerve at the lateral intramuscular septum from a traction injury is presented. No humeral fracture occurred, and the patient regained substantial function after delayed primary repair.

Adult↗