Biomedical subjects

Angela A Wang

Publications and source records attributed to Angela A Wang.

7 recordsLinked to original sources

PubMed2003

Full-thickness skin necrosis of the fingertip after application of superglue.

We present the case of a 39-year-old woman who applied superglue to her fingertip as a treatment for dry skin. She developed full-thickness necrosis of her thumb pad complicated by a secondary superinfection. This necrosis occurred from the degradation of the cyanoacrylate in the superglue compound to formaldehyde, causing local histotoxicity. This injury necessitated a local flap for coverage, which healed uneventfully and without lasting sequelae.

Adhesives↗

PubMed2003

Bilateral simultaneous open carpal tunnel release: a prospective study of postoperative activities of daily living and patient satisfaction.

PURPOSE: The purpose of this study was to determine patient function and satisfaction prospectively after bilateral simultaneous open carpal tunnel release (CTR). METHODS: Twenty patients (40 CTR) completed a questionnaire regarding postoperative activities of daily living (ADL), return to work, procedure satisfaction (visual analog scale), and willingness to have the surgery again. RESULTS: The average patient age was 43 years (range, 23-73 y). The hardest task was opening a jar; the easiest task was using the bathroom. Other tasks on the list in descending order of difficulty included driving, household chores, carrying groceries, buttoning, bathing, cooking, writing, dressing, shopping, holding a book, eating, computer use, and holding a phone. Average return to work was 2.6 weeks (range, 3 d-6 wk). Average satisfaction with the surgery was 9.6 of 10 (range, 8-10); 20 of 20 patients (100%) would have the bilateral simultaneous surgery again. CONCLUSIONS: These data are useful for patient education and decision making when considering surgery in patients with bilateral carpal tunnel syndrome, and show that bilateral simultaneous open CTR is a feasible and useful procedure.

Activities of Daily Living↗

PubMed2003

Pain levels after injection of corticosteroid to hand and elbow.

The goal of this study was to examine temporal pain response after injection of corticosteroid to the upper extremity (hand and elbow). Visual analog pain questionnaires were prospectively distributed to 133 consecutive patients, and pain levels were recorded for 5 days after injection. Ninety-four patients (71%) completed the questionnaire. Forty-seven (50%) of the 94 patients did not have increased pain after injection; the other 47 patients had increased pain after injection. The increased pain in 39 (83%) of the 47 patients resolved by day 5, lasting a mean of 1.2 days, and these 39 patients eventually had mean pain improvement of 71%. At day 5, 8 (17%) of the 47 patients had increased postinjection pain levels equal to or greater than their preinjection pain. The percentage of patients who transiently experienced increased pain after corticosteroid injection is quite high (50%), but most symptoms abated by day 2. We believe that these data are important for patient education.

Adrenal Cortex Hormones↗

PubMedDate not supplied

Both-bone forearm osteotomy for supination contracture: a cadaver model.

PURPOSE: To quantify the magnitude of rotational correction possible when comparing a single forearm bone osteotomy and fixation with stepwise osteotomy and fixation of both bones in a cadaver model and to determine if the order in which the stepwise osteotomies are performed influences the amount of correction. METHODS: Ten fresh-frozen cadaveric forearms were fixed to a frame positioned in the field of view of a motion-capture system. An experimental supination contracture was induced in full supination. Cadaver forearms were assigned randomly to group I (ulna osteotomy, rotation, plating) or group II (radius osteotomy, rotation, plating). Cadavers in group I were used later in group III (ulna + radius) by completing a radial osteotomy, rotation, and fixation in the forearms with the plated ulna. Similarly the specimens assigned to group II were used later in group IV (radius + ulna) by completing an ulna osteotomy, rotation, and fixation in the forearms with the plated radiuses. Measurements of forearm pronation were made after single-bone (groups I, II) and stepwise both-bone (groups III, IV) rotational osteotomies. RESULTS: Stepwise rotational osteotomy and fixation of the ulna followed by the radius produced significantly more corrective pronation (101 degrees) than rotating the radius followed by the ulna (65 degrees). Rotating the radius gave only moderate correction (58 degrees) and minimal correction was produced by ulna osteotomy alone (15 degrees). CONCLUSIONS: Rotational osteotomy of both forearm bones can create approximately 100 degrees of correction when performed at the proximal ulna followed by the distal radius. If less rotation is needed then the distal radius osteotomy alone can provide approximately 60 degrees of correction.

Biomechanical Phenomena↗

PubMedDate not supplied

The effect of corticosteroid injection for trigger finger on blood glucose level in diabetic patients.

PURPOSE: To determine how corticosteroid injections for trigger finger affect the blood glucose level in diabetic patients and the clinical results of those injections. METHODS: Eighteen diabetic patients receiving a methylprednisolone injection for a single trigger finger were studied. Six patients had type I (juvenile-onset) diabetes and 12 patients had type II (adult-onset) diabetes. Patients recorded their usual blood glucose measurements and then they recorded their blood glucose measurements for 5 days after injection. Clinical efficacy of the injections was measured by avoidance of surgery. RESULTS: There were 3 men and 15 women with an average age of 58 years. The blood glucose level increased after corticosteroid injection for all patients. The first morning after injection showed the biggest increase in blood glucose level: 73% more than the average preinjection levels. By the fifth morning after injection the blood glucose levels still were increased by 26% more than the preinjection levels. This trend was marked particularly in type I diabetic patients, who had an average blood glucose level increase the first morning after injection of 145%, which decreased over 5 days to 22% greater than baseline levels. Sixteen patients had follow-up evaluation over a period of 1 year and of these 16 patients 7 required surgery for this condition. CONCLUSIONS: A digital injection of the corticosteroid methylprednisolone acetate in diabetic patients with trigger finger causes a hyperglycemic effect that lasts for at least 5 days but can help prevent the need for surgery more than half the time. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level IV.

Adult↗

PubMedDate not supplied

The proximal ulna: An anatomic study with relevance to olecranon osteotomy and fracture fixation.

The purpose of this study was to define the proximal ulna anatomy with respect to olecranon osteotomy and fracture fixation. Thirty-nine cadaver elbows were dissected. The mean ulnar length (triceps insertion to ulnar styloid) was 26.0 cm (range, 27.1-29.0 cm). The mean distance from the triceps insertion to the ulna's varus angulation point was 7.6 cm (range, 6.5-9.0 cm). The distance ratio from the triceps insertion to the proximal ulnar angle to the overall ulna length was consistent, averaging 0.29 (range, 0.23-0.33). The mean diameter of the medullary canal at the ulnar angulation point could accommodate a 7.0- or 7.3-mm intramedullary screw. The mean width of the olecranon bare area (lacking articular cartilage) was 0.53 cm (range, 0.13-0.97 cm), and the mean distance from the triceps insertion to the corresponding area of the bare spot on the dorsal cortex was 2.1 cm (range, 1.4-2.5 cm).

Cadaver↗

PubMedDate not supplied

Use of the elbow compass universal hinge in pediatric patients.

The purpose of this study was to review the Compass Universal Hinge dynamic elbow external fixator in pediatric conditions. Eight patients with diagnoses of ulnar club hand (n = 2), proximal radial synostosis with hypoplastic coronoid (n = 1), pterygium cubitale (n = 2), and elbow arthrofibrosis (n = 3) were identified. Indications for fixator placement were to maintain elbow stability during forearm lengthening (two cases), protect a coronoid reconstruction (one case), increase range of motion via the fixator (two cases), and maintain stability and increase range of motion after open release (three cases). There were five boys and three girls with an average age at surgery of 11.5 (range 3-19) years. In each case, the goal for fixator use was achieved: both forearm lengthenings were completed without elbow instability, the coronoid reconstruction healed in good position, and four of five patients obtained increased range of motion via the fixator (average improved arc of motion of 31 degrees), with all elbows remaining reduced and stable. Complications included four pin tract infections, one of which became osteomyelitis; two broken/loose pins; and two cases of decreased elbow range of motion. Average follow-up was 29 (range 3-62) months. Use of the Compass Universal Hinge dynamic external fixator can be adapted to children and has proven useful in managing certain difficult conditions.

Adolescent↗