Biomedical subjects

Craig S Phillips

Publications and source records attributed to Craig S Phillips.

6 recordsLinked to original sources

PubMed2006

Anatomy of the coronoid process.

PURPOSE: Coronoid injuries are classified according to the size of the coronoid fracture. The purpose of this study was to provide a detailed anatomic description of the coronoid process, with specific focus on the coronoid height, the coronoid width, and the olecranon-coronoid angle. METHODS: Thirty-five cadaveric arms were dissected. All soft tissue was removed and the ulna was disarticulated from the humerus, radius, and the carpal bones. A 3-dimensional digitizing system was used to locate 19 anatomic landmarks on each specimen. By using the 3-dimensional coordinates of the landmarks, the coronoid heights, proximal ulnar widths, and olecranon-coronoid angles were determined. RESULTS: The coronoid height, with its base defined by the trough of the trochlear notch and the slope change of the distal coronoid process, measured 15 mm and was 42% of the ulnar height. The coronoid height, with its base defined by the transverse groove of the sigmoid notch at the guiding ridge and the distal insertion of the brachialis muscle, measured 15 mm and was 43% of the ulnar height. The olecranon-coronoid angle ranged between 33 degrees and 38 degrees . CONCLUSIONS: For lateral radiographic classification of coronoid fractures, coronoid height is best defined by the trough of the trochlear notch and the slope change of the distal coronoid process. For anatomic studies, coronoid height is best defined by the transverse groove of the sigmoid notch at the guiding ridge and the distal insertion of the brachialis muscle. The olecranon-coronoid angle is best defined by the angle formed by the lines from the olecranon tip through the coronoid tip and through the slope change of the distal coronoid process. The coronoid anatomy measurements reported in this study may help to improve coronoid fracture classification.

Aged↗

PubMed2005

Flexor tendon pulley reconstruction.

Pulley reconstruction remains a challenging intellectual and technical exercise. When performed correctly, however, it can be a gratifying procedure that provides much improved function of the digit. As described in this article, there are many different techniques by which the pulley can be reconstructed. Each of these techniques has distinct advantages and disadvantages. The hand surgeon should be familiar with each of these techniques and the general principles of pulley reconstruction as laid out in this article. With this knowledge base, the treating surgeon is able to tailor the procedure performed to the exact anatomy and clinical situation of each patient. Although great strides have been made over the past half century, more clinical research is needed to determine the best technique, not just in the cadaver model, but also in the complex model of the living human hand.

Humans↗

PubMed2005

The future of flexor tendon surgery.

Clinical outcomes following flexor tendon repair have made significant improvements in the last 50 years. In that time standard treatment has evolved from secondary grafting to primary repair with postoperative rehabilitation protocols. Unfortunately, excellent results are not yet attained universally following treatment. Improving understanding of tendon healing at the cellular, molecular, and genetic levels will likely enable surgeons to modulate the normal repair process. We now look toward biologic augmentation of flexor tendon repairs to address the problems of increasing tensile strength while reducing adhesion formation following injury and operative repair.

Genetic Therapy↗

PubMed2005

The effects of forearm rotation on three wrist measurements: radial inclination, radial height and palmar tilt.

The purpose of this study was to evaluate and quantify the effects of forearm rotation on radial inclination, radial height and palmar tilt. Seventeen arms, nine cadaveric and eight volunteer, were examined using a radiolucent device that allowed for the controlled rotation of each arm. Lateral and posterior-anterior X-rays were taken at 5 degrees increments which were then measured by two physicians using standardised protocol. The results revealed that all three measurements were significantly affected by forearm rotation with forearm supination increasing the apparent measurements and forearm pronation decreasing the apparent measurements. This relationship was well characterised by linear trend modelling such that forearm pronation of 10 degrees decreased the apparent radial inclination, radial height and palmar tilt by 2.8 degrees , 1.6 mm and 4.4 degrees , respectively. This study demonstrates that forearm rotation is an important factor in the accurate evaluation of wrist measurements, and that slight rotation of the wrist during radiographic imaging may significantly alter management decisions given established surgical criteria.

Adult↗

PubMed2002

Diagnosis and treatment of post-traumatic medial and lateral elbow ligament incompetence.

Elbow instability may occur secondary to soft tissue or bony injuries. Predictable patterns of instability do occur. Identification of disrupted osseous or ligamentous constraints allows for an algorithmic and predictable treatment plan. Maintaining a high index of suspicion allows early recognition and treatment of elbow instability. Treatment based on recognized principles is the key to preventing recurrent instability and late arthrosis while maintaining functional elbow motion.

Biomechanical Phenomena↗

PubMedDate not supplied

Vascular problems of the upper extremity: a primer for the orthopaedic surgeon.

A focused history and thorough physical examination, combined with a working knowledge of the normal vascular anatomy, can help identify most vascular abnormalities of the upper extremity. Technologic improvements now allow accurate diagnosis by noninvasive methods. Most abnormalities can be categorized into one of five major diagnostic groups: traumatic, compressive, occlusive, tumoral (malformation), and vasospastic. Behavioral modifications and pharmacologic agents may improve symptoms. Appropriately selected surgical candidates often experience pain relief and functional improvement.

Arm↗