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Dennis S Weiner

Publications and source records attributed to Dennis S Weiner.

5 recordsLinked to original sources
PubMedDate not supplied

A 50-year experience with bone graft epiphysiodesis in the treatment of slipped capital femoral epiphysis.

A "millennium" update of all cases of slipped capital femoral epiphysis treated by bone graft epiphysiodesis between 1950 and 2000 was conducted. All cases were followed for at least 1 year to evaluate the occurrence of re-slippage, avascular necrosis (AVN), chondrolysis, or complications secondary to the surgical approach. This study adds 109 patients and 133 hips to the initial report for a total of 268 patients and 318 hips. The patients include 43 patients with 45 acute slips and 225 patients with 273 chronic slips. The results include three cases of AVN, six cases of re-slippage, one case of chondrolysis, and no surgical approach complications in the acute group. In the chronic group, there were 4 cases of AVN, 17 cases of re-slippage, 4 cases of deep wound infection, and no cases of chondrolysis. The authors suggest that bone graft epiphysiodesis is a reasonable alternative in the treatment of slipped capital femoral epiphysis.

Bone Lengthening↗
PubMedDate not supplied

Remodeling of the proximal femur after upper femoral varus osteotomy for the treatment of Legg-Calvé-Perthes disease.

Upper femoral varus osteotomy of the proximal femur without rotation has been the surgical treatment of choice by the senior author (D.S.W.) in 124 cases of Legg-Calve-Perthes disease. There have been no previous studies documenting the nature of the remodeling process after this surgical procedure. The authors analyzed the radiographic changes that occur over time at the osteotomy site and the angle of inclination (neck-shaft angle). Inclusion criteria were a minimum of 2 years of radiographic follow-up. Patient follow-up ranged from 2 to 7 years (average 5.3 years). Goniometric measurements were performed at the osteotomy site as well as on the neck-shaft angle on preoperative, postoperative, and yearly AP radiographs. Results were recorded with reference to the percentage of correction per year. The authors also compared the results of patients younger than 8 years of age (group 1) with those older than 8 years of age (group 2). The average percentage of remodeling at the osteotomy site was 60% at 6 years, with 40% of the correction occurring within the first 2 years. The neck-shaft angle remodeled in a similar fashion: there was approximately two-thirds correction by 7 years, with most correction being evidenced within 3 to 4 years. There was no significant difference in remodeling based on the age of the patient at presentation. In conclusion, radiographically significant remodeling is to be expected after femoral varus osteotomy despite the diseased proximal femoral epiphysis.

Bone Remodeling↗
PubMedDate not supplied

Histologic and histochemical analysis of muscle specimens in idiopathic talipes equinovarus.

Congenital idiopathic talipes equinovarus is a relatively common disorder of uncertain etiology with a wide variance of clinical severity. Many theories have been postulated over the years without universal agreement in regard to the cause of this disorder. These hypotheses include vascular, viral, genetic, anatomic, compartment syndrome, environmental, and positioning considerations. A great deal of recent discussion has focused on a neuromuscular etiology for this condition. Muscle biopsies from the gastrocnemius, abductor hallucis, flexor digitorum longus, flexor hallucis, and tibialis posterior were obtained during posteromedial surgical release for idiopathic talipes equinovarus from September 1994 to October 2000 at the authors' institution. Ninety-five feet in 68 patients yielded a total of 431 muscle specimens. All of the specimens were processed and examined by light microscopy by an expert neuromuscular pathologist. In addition, 95 tissue samples were further processed for histochemical studies and electron microscopy. Three hundred seventy-two specimens (86.3%) showed no evidence of a pathologic diagnosis with normal fiber-type ratios and no type I fiber grouping indicative of neuromuscular pathology. Only 4 specimens (0.9%) showed type I fiber predominance, and 55 specimens (12.8%) revealed muscle fiber atrophy. The results of this study do not support the theory that a neuromuscular abnormality may be significant in the etiology of idiopathic talipes equinovarus.

Biopsy, Needle↗
PubMedDate not supplied

Increased chondrocyte apoptosis in growth plates from children with slipped capital femoral epiphysis.

Ultrastructural studies of slipped capital femoral epiphysis (SCFE) growth plates have shown diminished cellularity and marked distortion of the architecture in the proliferative and hypertrophic zones. Chondrocyte degeneration and death were noted at all levels of the hypertrophic and proliferative zones, suggesting an accelerated disturbance in the life-to-death cycle of the chondrocytes. The current study examines the mechanism responsible for the diminished cell number and whether increased programmed cell death (apoptosis) or necrosis was operative. Proximal femoral growth plates from patients with SCFE (three patients) were prepared and sectioned for histochemistry, in situ detection of apoptosis, and immunohistochemistry. The results showed that the diminished cell number is due to an abnormal frequency and distribution of chondrocytes undergoing apoptosis. Although it is unclear whether the increased apoptosis is occurring early or late in the disease, it is highly likely that it is directly linked to pathogenesis.

Adolescent↗