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Biomedical subjects

D S Weiner

Publications and source records attributed to D S Weiner.

At least 19 recordsLinked to original sources
PubMed1990

Hazards of internal fixation in the treatment of slipped capital femoral epiphysis.

We reviewed the records of 202 patients (308 hips) in whom a slipped capital femoral epiphysis had been fixed with pins or screws. A serious complication that was directly related to the use of internal fixation developed in eighty hips (26 per cent). The rate of complications in the 202 patients was 40 per cent. In thirty-six (18 per cent) of the 202 patients, an additional procedure was done to correct a pin-related complication. Forty-one hip joints had been penetrated by a pin. Other complications included avascular necrosis (fourteen hips), chondrolysis (nine), fracture (one), infection (one), further slippage (one), sciatic-nerve injury (one), and breakage of a screw (eight). Ways of decreasing the incidence of complications of fixation were explored.

Bone Nails↗
PubMed1985

Osteochondrosis of the tarsal cuneiforms.

The osteochondroses are a conglomerate of bony lesions that share similar clinical, radiographic, and pathologic features. While almost any bone may demonstrate the features of this disease process, involvement of the tarsal bone is very rare. Some type of disorder of enchondral ossification is thought to be the common etiologic link in the development and manifestation of tarsal cuneiform osteochondrosis. The course of the disease process is benign and self-limited. The treatment is symptomatic.

Child↗
PubMed1984

A 30-year experience with bone graft epiphysiodesis in the treatment of slipped capital femoral epiphysis.

A retrospective review was carried out of all cases treated by bone graft epiphysiodesis for slipped capital femoral epiphysis at Children's Hospital Medical Center of Akron between the years 1950 and 1980. Only those cases followed for a minimum of 1 year following treatment were included in the review and evaluated as to their status of avascular necrosis, acute cartilage necrosis, or other complications attendant to the surgical approach. One hundred seventy-six patients representing 207 hips underwent bone graft epiphysiodesis over this 30-year period. One hundred fifty-nine patients representing 185 hips were followed a minimum of 1 year and were included in this study. There were 25 cases of acute slipping representing 26 hips and 134 patients representing 159 hips involved with the chronic slipping process. In the acute group of patients representing 26 hips, there were two cases of avascular necrosis and one case of acute cartilage necrosis. In the chronic group of 159 hips, there were four cases of reslipping, one due to graft resorption, one due to placement of the graft short the growth plate, and two that went on to acute slipping. All cases were salvaged with good results. There was one case of avascular necrosis in the chronic group; not a single case of acute cartilage necrosis was encountered. Owing to the rapid nature of growth plate closure following bone graft epiphysiodesis, the avoidance of hardware removal or pin penetration, and the extremely low incidence of overall complications, we suggest that bone graft epiphysiodesis is at least as good as multiple pin fixation in the treatment of slipped capital femoral epiphysis.

Adolescent↗
PubMed1978

Proximal tibiofibular synostosis.

The occurrence of a proximal tibiofibular synostosis is indeed a rare condition with only 2 cases unassociated with other diseases reported to our knowledge to date. Two skeletally immature patients presented with a synostosis of the proximal tibiofibular region associated with shortening of the limb in the affected segments. Although the shortening and the synostosis seem interrelated no explanation of their relationship is evident from these 2 cases.

Child↗
PubMed1977

Congenital dislocation of the hip. The relationship of premanipulation traction and age to avascular necrosis of the femoral head.

A retrospective study involving 276 patients with 319 congenitally dislocated hips was undertaken to assess whether premanipulation fraction prevents avascular necrosis. Roentgenographic criteria were utilized and only cases of frank dislocation unassociated with other disorders were included. It was found that in a child less than one year old, premanipulation traction of twenty-one days or more substantially reduces the incidence of avascular necrosis. For the child more than a year old, however, the prognosis is not as good, even if premanipulation traction is prescribed for twenty-one days or more. We found a 14 per cent incidence of avascular necrosis in children less than three months old and suggest that the cartilaginous femoral head prior to the appearance of the ossific nucleus is particularly vulnerable to vascular injury.

Age Factors↗
PubMed1970

The use of chymopapain in degenerative disc disease: a preliminary report.

On the basis of the early results of the use of intradiscal injection of chymopapain in 15 patients with degenerative lumbar disc disease, the following statements are warranted: The injection can be beneficial in selected patients with lumbar disc disease. The relief of leg symptoms seems to be more striking than that of the accompanying low back symptoms although both are apparent. The exact mechanism by which pain is relieved is still obscure, but helpful information has been obtained from the early results of this investigation. The failure of chymopapain in carefully selected patients has resulted in only a brief time delay in operative intervention.

Adult↗