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David Seligson

Publications and source records attributed to David Seligson.

40 records · Page 3Linked to original sources

Spinal anesthesia: exploring some common surgical myths.

OBJECTIVE: To evaluate and compare whether a difference exists between measurable factors such as heart rate, blood pressure, pulse, and anesthesia induction time in patients undergoing spinal versus general anesthesia. METHODS: A retrospective study of eighteen surgical cases on the leg from the knee and distally under spinal anesthesia were compared to identical or similar procedures performed with a patient under general anesthesia. Data for heart rate, blood pressure, oxygen saturation, and the time interval for anesthesia induction were studied. Heart rate and blood pressure values recorded from the intra-operative anesthesia record were compared with the recorded preoperative values obtained from the anesthesia record. Anesthesia induction time was obtained from the interval between the recorded time for beginning anesthesia and the surgery start time. RESULTS: Systolic blood pressure increased by an average of 12.3 mmHg in the general anesthesia (GA) group compared with a value of 12.9 for the spinal anesthesia (SA) group. Average intra-operative systolic pressure decreased by 10.9 mmHg in the GA group vs. a decrease of 7.7 for SA. Pulse rate for GA decreased by 3.7 bpm versus an increase of 3.2 in SA. Induction time for GA was 27.9 minutes compared to an average SA induction time of 29.8 minutes. CONCLUSIONS: The study found no significant differences in intra-operative patient vital signs when comparing patients under general anesthesia to those under spinal anesthesia. Additionally, although the literature states that spinal anesthesia takes longer if the patient is not prepared prior to the operating room being ready, this study found no significant delay in operation start times for general anesthesia versus spinal anesthesia.

Anesthesia, General↗

Biomechanics of external fixation of distal tibial extra-articular fractures: is spanning the ankle with a foot plate desirable?

OBJECTIVES: To compare the mechanical stability of external fixation with and without spanning of the ankle joint with a foot plate in an in vitro model of extra-articular distal tibia fractures. DESIGN: A laboratory investigation was performed to evaluate the mechanical behavior of external fixation of extra-articular distal tibia fractures using a fixator with and without a foot plate. Ten fresh-frozen lower extremities (5 pairs) with a simulated OTA 43-A3.3 fracture were stabilized with an Ilizarov hybrid fixator with and without a foot plate. SETTING: All mechanical testing was performed with a servohydraulic test frame (MTS Bionix 858, Minneapolis, MN). MAIN OUTCOME MEASUREMENT: Deformation characteristics as a function of load were compared for an Ilizarov fixator with and without a foot plate under identical conditions of forefoot loading from 0 to 100 N. Relative interfragmentary motions (vertical and horizontal translations and rotation) were measured. RESULTS: There was significantly more vertical translation (2.57 +/- 0.97 mm vs. -0.83 +/- 0.64 mm) and angular displacement (4.49 +/- 0.45 degrees vs. -1.15 +/- 0.61 degrees ) of the distal fragment in the arrangement without a foot plate compared with the construct with a foot plate. The anterior translation of the distal fragment was similar with (1.12 +/- 0.98 mm) and without a foot plate (1.19 +/- 1.23 mm). CONCLUSIONS: This study supports the mechanical importance of spanning of the ankle with a foot plate in most cases of external fixation for unstable extra-articular and periarticular distal tibia fractures. Further studies are needed to validate these results before widespread changes in clinical treatment can be recommended.

Aged↗

NuGen Fx bioabsorbable screws: a preliminary report of their use in foot surgery.

A single prospective group study in adults was performed using a new bioabsorbable screw, the NuGen Fx screw (Linvatec Biomaterials Ltd, Tampere, Finland). This multisite study included five sites and 50 patients (10 patients per site). The goal of this study was to evaluate the efficiency and safety of the NuGen Fx screw system in the fixation of osteotomies, arthrodeses, and fractures in the foot and ankle. We discuss our own results from 12 patients treated at the Kentucky Podiatric Residency Program at Norton Audubon Hospital, Louisville. The number of patients in the study, screw sizes, instrumentation, radiologic evaluation findings, and our overview of this implant are presented.

Absorbable Implants↗