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Biomedical subjects

E A Nalebuff

Publications and source records attributed to E A Nalebuff.

At least 37 records · Page 2Linked to original sources
PubMed1979

Dislocation of the distal radioulnar joint: anatomy and clues to prompt diagnosis.

The articular disk is a strong, complex structure responsible for the stability of the distal radioulnar joint. It is injured by a hyperpronation or hypersupination injury which disrupts the disk or its strong central attachment to the ulna. Prompt diagnosis is essential for a good result as no good late reconstruction is available. Reliance on radiographs for the diagnosis will seldom be rewarding, and they are mainly of value in ruling out associated fractures. A careful clinical examination and a high index of suspicion are the best tools available for diagnosis in this injury.

Female↗
PubMed1978

Interpositional arthroplasty for rheumatoid carpometacarpal joint disease.

Over the past 3 years the Swanson great toe prosthesis was used in an interpositional arthroplasty at the carpometacarpal joint in 21 thumbs of 19 patients with rheumatoid arthritis and three thumbs of two patients with lumpus arthritis. In selected patients with advanced disease, this prosthesis has the advantage of allowing for correction of deformity while preserving carpal stock which may be important if a surgical procedure is required at the wrist. Stable capsular closure does not require reinforcement by adjacent tendon. Twenty-two thumbs of 19 patients were improved, although in three the prosthesis was malpositioned. Two patients required reoperation and removal of the prosthesis: one for infection, and one for failure to correct deformity. Overall functional results often were affected by the status of disease in other joints, but in general were acceptable.

Adult↗
PubMed1977

Distal radial fracture with tendon entrapment. A case report.

Entrapment of the extensor pollicus longus tendon can occur in distal radial fractures of the Smith type. This can be recognized by failure to obtain good reduction and inability of the patient to extend the thumb after reduction. The treatment is surgical and should be through a dorsal approach which allows repositioning of the tendon and internal fixation of the fracture.

Adult↗
PubMed1976

Sarcoidosis presenting as a wrist tumour.

A forty-year-old male with a painless, indurated mass on the volar surface of the wrist, was proved to have Boeck's Sarcoid. The surgery and pathology of the mass is described and the literature reviewed.

Adult↗
PubMed1976

Opera-glass hand in rheumatoid arthritis.

Characteristic deformities occur in the fingers, thumb, and wrist in the opera-glass hand in rheumatoid arthritis. Shortening and instability are the result of bone resorption and dislocation and can be severely disabling. Early spontaneous fusion of the proximal interphalangeal joint preserves digital length. Functional improvement can be obtained in the fingers by interphalangeal joint arthrodesis and metacarpophalangeal prosthetic arthroplasty and in the thumb with metacarpophalangeal and/or interphalangeal arthrodesis. With interphalangeal arthrodesis, interposition grafts often are required in order to restore length and secure fusion. "Prophylactic" arthrodesis of interphalangeal joints should be considered when resorption seems imminent.

Aged↗
PubMed1976

Stiffness of the proximal interphalangeal joints in rheumatoid arthritis. The role of flexor tenosynovitis.

In nineteen hands (seventy-four fingers) of eleven women and one man with rheumatoid arthritis there was restriction of active and passive motion of the proximal interphalangeal joints, with signs of flexor tenosynovitis but no clinical or roentgenographic evidence of involvement of the joint. The nineteen hands were treated by flexor tenosynovectomy (palm only in nine, palm and carpal tunnel in five, both palm and digits in four, and digit, palm, and wrist in one) combined with manipulation of the joint under regional anesthesia. After an average follow-up of twenty-one months (range, six to thirty-six months), the average range of active motion had increased from 40 to 84 degrees and the average range of passive motions, from 57 to 87 degrees. Only three patients had unsatisfactory results, one because of persistent unexplained swelling and two because of recurrence of the tenosynovitis.

Adolescent↗
PubMed1975

Surgical treatment of the swan-neck deformity in rheumatoid arthritis.

Swan-neck deformities vary not only in origin but also in the extent of functional loss. Careful examination used to determine the degree of flexion in all positions as well as x-ray examination of the joint has allowed us to group these patients into four types. Various surgical procedures are recommended according to this classification, which has made the treatment of these patients more orderly and rewarding.

Arthritis, Rheumatoid↗
PubMed1975

Surgical treatment of the boutonniere deformity in rheumatoid arthritis.

The rheumatoid boutonniere deformity does not limit hand function significantly until it becomes severe. For this reason the surgical procedures used should not risk or sacrifice existing function. For the mild cases one can improve the digital balance by a simple extensor tenotomy combined with dynamic splinting. In more advanced stages with passive correction possible, the deformity can be improved by reconstruction of the extensor mechanism. With fixed deformities one can choose between proximal interphalangeal joint fusion and arthroplasty. The decision is influenced by several factors, including the digit involved and the status of adjacent joints. After a careful evaluation of the patient's capabilities and needs, it is possible to improve these deformities by the methods discussed.

Arthritis, Rheumatoid↗
PubMed1975

Preventive surgery - tenosynovectomy and synovectomy.

The goal of preventative rheumatoid hand surgery is the eradication of the diseased synovium or tenosynovium before irreparable joint or tendon destruction occurs. Although there is general agreement that both dorsal and flexor tenosynovectomy are reliable and effective procedures to prevent the complications of tenosynovitis, the case for synovectomy is less well established. We have discussed the indications for both tenosynovectomy and synovectomy and described the surgical techniques used for dorsal tenosynovectomy and flexor tenosynovectomy in the wrist, palm, and digits. In addition, the treatment of both extensor and flexor tendon ruptures has been presented.

Arthritis, Rheumatoid↗
PubMed1975

Infection after silicone prosthetic arthroplasty in the hand.

After 2105 silicone prosthetic arthroplasties in the hands of 631 patients, infections occurred in ten. The average time from operation to onset of signs and symptoms of infection was seventeen days, and in seven of the ten patients the infecting organism was Staphylococcus aureus. Seven patients ultimately were treated by removal of the prosthesis, intravenous antibiotics for about five days, and oral antibiotics for about two weeks. At follow-up, twelve to fifty-six months after operation, nearly all of the patients had stable, somewhat stiff but pain-free joints, the results being similar to those after resection arthroplasty.

Adult↗
PubMed1975

Reconstructive surgery in the rheumatoid hand.

Reconstructive hand surgery is an established, proved, and effective method to correct deformities and increase function in rheumatoid patients. As more experience has been gathered, the indications for both arthrodesis and arthroplasty have been better established, and a better approach to reconstructive hand surgery has developed. In this discussion we have evaluated in detail the surgical treatment indicated for wrist, metacarpophalangeal joint, and thumb deformities. The treatment of swan-neck deformities and boutonniere deformities is discussed in other sections in this volume.

Arthritis, Rheumatoid↗