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Biomedical subjects

A T Berman

Publications and source records attributed to A T Berman.

At least 19 recordsLinked to original sources
PubMed1992

Posttraumatic upper extremity wound coverage utilizing the extended deep inferior epigastric flap.

The extended deep inferior epigastric artery (DIEA) flap was used in 4 patients with traumatic mid upper extremity wounds. Although there are numerous flaps available for resurfacing upper extremity defects, including the groin, thoracoepigastric, and a host of microvascular flaps, in each of these patients a preoperative consideration necessitated a novel approach. The DIEA flap is based on an axial vascular watershed resulting in a long, thin, well-vascularized, supple skin flap, which proved extremely effective in solving the reconstructive needs of these patients. The flap is technically simple to elevate and quite versatile. In all patients, the flaps survived and healing of the wounds was achieved. The DIEA flap should be considered a valuable reconstructive alternative when faced with elbow and forearm defects.

Abdominal Muscles↗
PubMed1992

Surgical results in anterior cervical discectomy and fusion using a countersunk interlocking autogenous iliac bone graft.

The purpose of this study was to evaluate the surgical results of anterior cervical discectomy and fusion using a countersunk interlocking autogenous iliac bone graft. Two hundred thirty-two patients were followed for an average of 6.8 years. All patients suffered neck and arm pain. Two hundred twenty patients received conservative treatment for at least six months. Overall results were satisfactory in 202 patients (87%) and unsatisfactory in 30 patients (13%). The pseudoarthrosis rate was 6.5% which is significantly lower than previous reports. The premise of this technique is that the interlocking graft prevents migration, promotes fusion by providing immobilization, and restores the height of the interspace. Anterior cervical discectomy and fusion, using a countersunk interlocking autogenous iliac bone graft, is a satisfactory surgical procedure in which successful pain relief is to be expected.

Adult↗
PubMed1991

Evaluation of total knee arthroplasty using isokinetic testing.

Although total knee arthroplasty (TKA) has been studied extensively, objective muscle testing has not been reported. Isokinetic testing of 68 patients with degenerative joint disease scheduled for unilateral TKA revealed that marked muscular deficits in flexion and extension were present preoperatively in the involved knee. Postoperatively, hamstring peak-torque values were able to attain strength levels of the uninvolved knee within the period of seven to 12 months after surgery, whereas the quadriceps mechanism still showed a residual deficit at two years follow-up evaluation. In addition, the ratio of flexion to extension peak torques in the operated knee returned to normal values as the quadriceps mechanism was rehabilitated. A comprehensive evaluation system consisting of Cybex II isokinetic testing, gait mat analysis, and the Hospital for Special Surgery knee rating scale is also presented. Isokinetic testing correlated well with gait analysis. Patients with a nearly balanced quadriceps-to-hamstring ratio walked with a more symmetrical gait pattern. The knee rating scale was less reliable in assessing functional outcome. Functional testing and evaluation at the authors' institution has provided an important source of objective information that allows better planning and evaluation of TKAs. These isokinetic studies enable more critical planning of the rehabilitation program. Hamstring or quadricep exercises may be emphasized as required. The authors conclude that a balanced hamstring to quadriceps mechanism is needed for resumption of normal gait.

Biomechanical Phenomena↗
PubMed1991

Factors influencing long-term results in high tibial osteotomy.

Recorded here is a comprehensive review of the current literature on high tibial osteotomy with emphasis on postponing an inevitable total knee arthroplasty (TKA). Accompanying this review is a confirmatory, retrospective study of 35 patients with 39 high tibial osteotomies with an average follow-up study of 8.5 years (range, 3.8-15.1 years). Twenty-two of the patients (57%) had good results, seven (18%) fair, and ten (25%) poor at final follow-up examination. Nine of the 35 patients required TKA at an average of 4.7 years post-osteotomy. The percentage of good results diminished with time of follow-up study, starting at two years with 87% good results and ending at 15 years with only 57% of the patients remaining in that category. Patients lost an average of 8 degrees of flexion post-osteotomy, regardless of good, fair, or poor result. Patients with favorable results were usually younger than 60 years of age, and had less than 12 degrees of angular deformity, pure unicompartmental disease, ligamentous stability, and a preoperative range of motion are of at least 90 degrees.

Follow-Up Studies↗
PubMed1991

Quantitative gait analysis in unilateral and bilateral total hip replacements.

By qualitative and quantitative analysis of gait we evaluated the outcomes in 41 patients after total hip arthroplasty for degenerative arthritis. Patients with unilateral and bilateral degenerative hip disease were evaluated in an effort to characterize preoperative and postoperative gait characteristics. Patients were evaluated using a subjective hip-rating scale and a gait-evaluation mat. Data were compared with those obtained from a control group of 91 patients. All patients showed a marked improvement in both subjective ratings and measured quantitative gait parameters. Patients with unilateral hip disease improved to a greater extent than those with bilateral disease after arthroplasty. We have concluded that total hip arthroplasty can greatly improve the gait characteristics of patients with degenerative arthritis, and that this improvement can be quantified, documented, and followed by using a system of gait evaluation.

Follow-Up Studies↗
PubMed1990

A comparison of the mechanical properties of fiberglass cast materials and their clinical relevance.

The mechanical properties of five synthetic fiberglass casting materials were evaluated and compared with the properties of plaster of Paris. Two of the tests were designed to bear clinical relevance and the third to determine intrinsic material properties. The effect of water on strength degradation was also evaluated. It was found that the synthetics as a group are far superior to plaster of Paris in all methods of testing and that, among the synthetics, KCast Tack Free, Deltalite "S", and KCast Improved were the stronger materials. Clinically, the most important results are that the synthetics attain their relatively high strength in a much shorter time frame than does plaster of Paris, and retain 70-90% of their strength after being immersed in water and allowed to dry.

Calcium Sulfate↗
PubMed1990

Comparison between intermittent (spring-loaded) and continuous closed suction drainage of orthopedic wounds: a controlled clinical trial.

A randomized prospective trial of a continuous vacuum system (VariDyne) and an intermittent spring type system (Hemovac) was conducted in 126 consecutive orthopedic surgical wounds between February 1988 and October 1988 in which postoperative suction drainage was required. Comparison between the two groups showed a statistically significant difference among total drainage removed by the vacuum units and wound drainage into the dressing following drain removal. Hip and knee arthroplasty patients receiving continuous vacuum suction experienced a greater average drainage volume and better wound healing than those receiving the spring-loaded device. Overall, all wounds which utilized continuous vacuum drained less serosanguinous or serous fluid than those wounds utilizing the intermittent system following drain removal. A clear advantage to using a continuous vacuum suction device over an intermittent spring-loaded device is seen with respect to hematoma evacuation, wound drainage, wound healing, and possible complications.

Adult↗
PubMed1989

Compression arthrodesis of the ankle by triangular external fixation: an improved technique.

In this preliminary report, the authors present a new application of an external tubular fixation system for compression arthrodesis of the ankle. A triangular ankle fusion frame was designed that provides rigid immobilization of the tibiotalar joint, with midfoot control provided by a metatarsal pin. Over the past 3 years, the authors have used this device to achieve solid tibiotalar arthrodesis in 12 of 14 patients. The surgical method, including step-by-step construction and application of the triangular ankle fusion frame, is presented. Early results suggest a nearly 90% union rate, including reoperative cases for failed primary fusion.

Adult↗
PubMed1989

Gene linkage in neurofibromatosis.

Neurofibromatosis (NF) is a disease of protean manifestations involving tissues of ectodermal and mesodermal origin. Modern terminology divides NF into NF-1 (classically peripheral NF) and NF-2 (classically central NF). Gene linkage will provide many answers to understanding the varied and unpredictable course of NF. Gene linkage may explain phenotypic variations among NF patients, malignant transformation potential of neurofibromas, increased likelihood of malignant sarcomas in NF patients, and possible insight into learning disability in NF patients. Chromosome location has been narrowed to the pericentric region of chromosome 17 for NF-1 and to the center of the long arm of chromosome 22 for NF-2.

Chromosomes, Human, Pair 18↗
PubMed1988

The orthopedic manifestation of neurofibromatosis. A clinical experience and review of the literature.

A retrospective review of 47 patients with neurofibromatosis was performed to evaluate the effects of that disease on patient function and disability. Clinical manifestations were distributed as follows: cafe-au-lait markings were the most prevalent manifestation (87%), followed by a positive family history (49%), scoliosis (53%), neurofibromata (19%), and pseudarthrosis of the tibia (19%). The classic scoliosis was resistant to brace treatment; bracing failed in 70% of patients, necessitating spinal fusion. Pseudarthrosis of the tibia can be subdivided into normal, narrow sclerotic, and cystic medullary canal groups. This study supported the theory that tibias with narrow sclerotic medullary canals should be prophylactically braced until skeletal maturity to prevent fracture. Once fractured, the incidence of non-union is high regardless of treatment mode. Eighty percent of patients with pseudarthrosis of the tibia did not heal with multiple bone grafts and were amputated below the knee. Many patients in this study were educable or only mildly mentally retarded, and performed quite well in activities of daily living.

Activities of Daily Living↗
PubMed1976

The Guillain-Barre syndrome in children. Orthopedic management and patterns of recovery.

Eleven cases of Guillain-Barre Syndrome in children between 1955 and 1973 demonstrate clinical course and residual permanent motor deficits. The rate of recovery from muscle paralysis and the long-term permanent muscle loss, and the resultant paralytic deficits may require treatment: tendon transfers, opponensplasties, spinal fusions, and Lambrinudi operations. The late permanent motor paralysis and residual joint deformities secondary to GBS in children has a higher incidence and severity than in adults, and an intensive rehabilitation program in imperative. Frequent, extended follow-up, and muscle testing records are absolutely essential in children.

Adolescent↗