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Biomedical subjects

E E Berg

Publications and source records attributed to E E Berg.

69 records · Page 4Linked to original sources
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Posterior shoulder (glenohumeral) dislocation.

While shoulder dislocations are a common injury, dislocation in the posterior direction is unusual and often missed clinically. A traumatic posterior shoulder dislocation can be caused by a direct blow to the anterior shoulder or if a posteriorly directed force is axially applied through the forward flexed arm. A posterior shoulder dislocation can occur after a violent muscle contraction induced by an electrical shock or grand mal seizure. Posterior shoulder dislocations are commonly associated with posterior glenoid rim fractures and anterior compression fractures of the humeral head. This diagnosis should not be missed if a complete physical and radiographic exam are properly performed.

Adult↗
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Chinese foot binding.

Chinese foot binding embraced several modern principles of brace treatment. It was initiated in childhood while the foot was cartilaginous and moldable. Culturally, the practice attempted to shape the foot into a pointed lotus flower. The resultant cavus foot deformity was dysfunctional and crippling. This curious custom, outlawed by the Communist party, is ironically analogous in some ways to high-heel shoe wear.

Beauty↗
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Elbow dislocation with arterial injury.

Elbow dislocations are most often the result of a hyperextension mechanism with the forearm levered and displaced posterior to the humerus. Recurrent instability and arterial disruption are uncommon sequelae of this injury. Any asymmetry in distal pulses after joint reduction demands a study of arterial anatomy (arteriogram or duplex scan) to rule out avulsion or intimal damage.

Arteries↗
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Percutaneous Achilles tendon lengthening complicated by inadvertent tenotomy.

Thirteen percent (five of 37) of all Hoke percutaneous triple hemisection Achilles tendon lengthenings performed at a teaching hospital in a 4-year period were complicated by inadvertent Achilles tenotomy. Three of the five patients had bilateral procedures and served as their own controls. After 2 months of postoperative short leg walking cast immobilization, the results in patients with inadvertent Achilles tenotomy were indistinguishable from those in whom tendon continuity was maintained.

Achilles Tendon↗
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Bipolar infrapatellar tendon rupture.

Traumatic patella alta in children occurs either distal to the patellar tendon as a tibial tubercle apophyseal fracture or proximally as an osteochondral sleeve fracture of the inferior patellar pole. Acute surgical exploration in a pediatric case of a knee extensor mechanism rupture revealed both proximal and distal (bipolar) patellar tendon pathology.

Child↗
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The inside-out Bankart procedure.

Bankart capsulorraphy for recurrent shoulder instability produces predictable results. Time-consuming, technically demanding details of the procedure, however, discourage its use. A simplified technique and new instrumentation solving these limitations was used in 69 procedures, all performed by the same surgeon. Seventy-eight percent of these procedures were reviewed independently at a minimum of 2 years followup: 77% were asymptomatic, 12% had minimal symptoms, and 11% had residual problems. Instability recurred in six patients and was associated with a significant traumatic event in five. Thus, the inside-out Bankart modifications were effective.

Adolescent↗
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Patellar height ratios. A comparison of four measurement methods.

Three blinded observers on three separate occasions calculated four commonly employed patellar height ratios on the knees of 15 patients who had three lateral radiographs each. The observers used the same measurement instrument, a hand-held goniometer ruler, to determine the relative reliability of each patellar height ratio. The measurements by the three observers were examined, and the error and reliability of the four methods of measurement were tested statistically. Among the four methods of measuring patellar height that we studied, the Blackburne-Peel method most consistently reproduced the patellar height index. Interobserver measurement error averaged 0.06 for all ratios. Values greater than 0.06 represented real patellar height changes. The ratios were not significantly affected by the change of knee flexion angle from 30 degrees to 50 degrees. Side-to-side patellar height measurement differences averaged 0.16, which suggests that the healthy contralateral limb is not reliable as a control. Mild arthritic changes decreased variability of measurements by an average of 24% because small osteophytes better defined the articular margins of the patella.

Adult↗
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The lateral elbow ligaments. A correlative radiographic study.

Knowledge of the lateral elbow ligaments' normal anatomic relationships to osseous structures, as seen on standard radiographs, can facilitate the interpretation of arthrograms and an understanding of fracture mechanisms. We dissected fresh cadaveric elbows to isolate the entire lateral ulnar collateral and annular ligaments as well as their sites of osseous origin and insertion. We obtained radiographs of each ligament after painting them with a special radiopaque tantalum powder cyanoacrylic preparation. The resulting study allowed radiographic depiction of these important soft tissue structures in relation to the attendant osseous anatomy.

Cadaver↗
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Progress in orthopaedic surgery: the 1980s in review.

These are exciting times. Rapid progress has been made in all orthopaedic subspecialty areas over the past decade. The next decade promises to be one of even greater technologic triumph. With each successful development, new attendant problems and questions arise. Careful long-term, follow-up studies and continued scientific scrutiny always temper the intoxicating promise of innovation with the sobriety of scientific realism. But perhaps this is where the ongoing pleasure and challenge of orthopaedics lie.

Humans↗
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Open book (AP compression) pelvis fracture.

A simple pelvic fracture classification is presented based on the metaphor of a pelvis as a book. Resuscitative fluid and blood requirements can be estimated by knowledge of the pelvic fracture pattern. Open book (AP compression) pelvis fractures generally have the largest amounts of blood loss.

Adult↗