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Biomedical subjects

E G Zook

Publications and source records attributed to E G Zook.

At least 19 recordsLinked to original sources
PubMed1992

Strain-gauge evaluation of lunate unloading procedures.

A biomechanical study was undertaken to determine which procedure(s) most effectively relieve load from the lunate. Strain gauges were mounted on the lunates of 20 preserved cadaveric limbs. Three types of procedures were performed: scaphotrapeziotrapezoid arthrodesis, capitohamate arthrodesis, and ulnar lengthening. Load testing was performed both before and after the simulated fusions and ulnar lengthenings. Ulnar lengthening of 3 mm was the most effective method of lunate strain reduction. Capitohamate arthrodesis decreased compressive strain but increased shear strain. Scaphotrapeziotrapezoid fusion significantly increased both compressive and shear strain in the lunate. Of the three procedures that were tested, ulnar lengthening to create a neutral variance is the most reliable means of unloading the lunate.

Analysis of Variance↗
PubMed1992

Evaluation and management of upper extremity neuropathies in Charcot-Marie-Tooth disease.

The evaluation and treatment of five patients with upper extremity neuropathies secondary to Charcot-Marie-Tooth disease were reviewed with emphasis on age at onset of Charcot-Marie-Tooth disease and upper extremity deformities, clinical findings, signs of associated nerve compression, and outcome of surgical treatment. The onset of the disease generally occurred in the first or second decade of life. The onset of upper extremity symptoms lagged behind by an average of 8 years. All patients had intrinsic minus hands with decreased sensibility. Three of five patients had clinical or electrophysiologic evidence of associated nerve compression syndromes. Treatment with standard tendon transfers, nerve compression releases, soft tissue releases, and joint fusions resulted in subjectively improved function in three of four patients undergoing reconstruction. Release of six compression neuropathies in one patient provided excellent pain relief, but the underlying neuropathy progressed. Pessimism regarding reconstructive surgery in the patient with upper extremity neuropathies secondary to Charcot-Marie-Tooth disease is unwarranted.

Adult↗
PubMed1992

Osteoid osteoma of the distal phalanx of the finger: a diagnostic challenge.

Osteoid osteomas of the distal phalanx of fingers are uncommon. An extensive review of the literature indicates that the diagnosis of osteoid osteoma of the distal phalanx is often delayed for several months to years (average 34.3 months). Pain is the most common finding (92 percent), followed by swelling and clubbing (75 percent). Relief of pain by aspirin was indicated in 10 patients (42 percent). Multiple operations were done in 7 patients prior to the appropriate diagnosis and treatment. A typical case report is presented to illustrate the difficulties in diagnosis and treatment of this benign bone tumor. A better awareness of this tumor may prevent unwanted delays in diagnosis and unnecessary operations.

Adult↗
PubMed1991

Hand infections secondary to catfish spines: case reports and literature review.

Catfish are one of the few freshwater fishes known to be venomous. Although "finning" of the hand is a frequent injury incurred by catfish anglers that results in intense pain, it rarely results in any long-term sequelae. We present three cases in which acute soft-tissue infections developed, necessitating ray amputations in two patients. The unique habitat and anatomy of the catfish are described and preventive and therapeutic measures are discussed.

Acute Disease↗
PubMed1991

Fingernail deformities secondary to ganglions of the distal interphalangeal joint (mucous cysts).

Twenty-six nail deformities secondary to ganglions of the distal interphalangeal joint were retrospectively reviewed to assess the important aspects of their management. The patients' ages ranged from 41 to 79 years. The long and index fingers were most commonly involved. A depression or groove was present in 23 of 26 digits reviewed. Two had gross disruption of the nail. Fifty-eight percent of the cysts had spontaneously drained or had been drained by the patient or a physician preoperatively. Degenerative arthritic changes were seen in 87 percent of those with x-rays or a radiology report available. Most underwent surgical removal of the cyst and debridement of associated osteophytes of the distal interphalangeal joint. The cyst was located above the germinal matrix in all but two digits. Osteophytes were found in all 20 digits in which the joint was explored. No recurrences were seen in those available for postoperative follow-up (22 of 25). Normal nail growth was found in 14 of 22, although follow-up was short in one. All eight postoperative nail deformities were quite mild and of little concern to the patient. There was no correlation between preoperative cyst drainage and aesthetic postoperative nail growth. Nail removal at the time of surgery appeared to be unnecessary unless the nail was grossly disrupted.

Adult↗
PubMed1991

The extended pectoralis major myocutaneous flap: uses and indications.

The vascular territory of the pectoralis major muscle and overlying skin was studied by selective intraarterial dye injections in fresh cadavers. The area of skin overlying the anterior chest and abdominal wall beyond the limits of the pectoralis major muscle that can be elevated as an extended myocutaneous flap was determined. The cadaver injections were evaluated to determine the size and shape of the skin island used to reconstruct defects of the head, neck, and upper trunk with an extended skin paddle off the pectoralis major muscle. Pectoralis muscle flaps with variously shaped skin paddles, some extending beyond the limits of the muscle, were used in 27 patients to cover large soft-tissue defects of the upper thorax, face, and floor of the mouth and as a skin tube to reconstruct the cervical esophagus. The size of the skin paddle ranged from 5 x 7 cm to 26 x 16 cm. All flaps survived completely, and there were no major donor-site complications.

Adult↗
PubMed1991

Leaving the fold.

Explore the source record for details and available documents.

Faculty, Medical↗
PubMed1990

Malignant acrospiroma.

A 76-year-old woman was referred after results of the biopsy of an ulcerated mass of the right long finger suggested poorly differentiated squamous cell carcinoma. Excision and skin grafting were done and a diagnosis of malignant acrospiroma was established. These tumors are aggressive and 5-year survival rate may be as low as 30%. A ray amputation was subsequently done and the specimen was without residual tumor. At 14 months follow-up, the patient remains free of disease.

Adenoma, Sweat Gland↗
PubMed1990

Anatomy and physiology of the perionychium.

It is essential that practitioners, especially surgeons, understand the anatomy and physiology of the tissues they are treating. It is especially important in the nail bed because most practitioners know little about the specific anatomy and physiology of the nail bed. Only if such information is known and considered can new techniques and research in the anatomy, physiology, and care of the nail bed be used. In addition to the individual parts of the nail bed, developmental physiology, embryology, vasculature, lymphatics, and nerve supply are discussed.

Humans↗
PubMed1990

Reconstruction of a functional and esthetic nail.

The most common cause of nail bed deformity is trauma, but other causes are infection, tumor, ischemia, or congenital anomalies. This article includes discussions of nonadherence, split nail, reconstruction of the eponychium, crooked and hooked nail, bony irregularity, pachyonychia, ischemic deformities, and absence of the nail. New problems are encountered daily and other deformities have no method of correction recorded in the literature. For these cases, we provide suggested treatments based on the anatomy and physiology of the nail.

Amputation, Traumatic↗
PubMed1989

Sural nerve grafts for delayed repair of divided posterior interosseos nerves.

Sural nerve grafts were used in three patients to bridge gaps measuring 2 1/2 to 4 1/2 cm in previously transected but not repaired posterior interosseous nerves. The grafts were done at 4, 5, and 7 months after injury. Extension was weaker in all three than on the uninjured side, but the range of motion was complete, with the exception of a slight lag of index finger extension and partial return of extension of the extensor carpi ulnaris in the same patient. All three patients recovered full function of the involved hand 1 year after grafting. The properties of the posterior interosseous nerve (pure motor and short distance to the muscle) contribute to good results with nerve grafts in delayed nerve repairs. We believe that these results are better than tendon transfers, at least in young patients.

Adolescent↗
PubMed1989

V-Y advancement flaps for tumor excision defects of the eyelids.

Resection of cutaneous malignancies of the medial canthus and lower lid create challenging wound closure problems. The V-Y flap closure technique achieves wound closure using adjacent tissue while minimizing closure tension. Twenty-three patients underwent resection of basal cell carcinomas in these two anatomical regions. In 22 patients a single V-Y flap was used to close the defect. In 1 patient two flaps were used. There were 2 patients with transient ectropion. No tissue loss or other complications occurred.

Basal Cell Carcinoma↗
PubMed1989

V-Y advancement flaps for closure of nasal defects.

The nose is a difficult anatomic region in which to close defects resulting from resection of cutaneous malignancies. The V-Y flap is a technique for advancing adjacent tissue, thereby achieving wound closure while minimizing tension. A total of 120 V-Y flaps were used to close 114 nasal defects. The average defect size was 13.5 x 11 mm. Partial flap loss occurred in five patients, with total flap loss in one. One wound infection and two hematomas occurred.

Basal Cell Carcinoma↗
PubMed1988

Palmar wrist pain caused by ulnar nerve entrapment in the flexor carpi ulnaris tendon.

A 38-year-old female nurse was seen initially with several years' history of recurring intermittent ulnar wrist pain and paresthesias. The pain was aggravated by specific tasks using her hands, such as typing. Splinting and two steroid injections into the area gave only temporary relief. Surgical exploration revealed a segment of the ulnar nerve composing approximately 15% of its volume to split from the main trunk of the ulnar nerve, perforate the flexor carpi ulnaris tendon, and then rejoin the ulnar nerve. The nerve branch was extracted from the flexor carpi ulnaris by dividing approximately 15% to 20% of the tendon, allowing the nerve to be removed from the perforation, and anatomically relocated. The patient resumed her normal activities and has had no further discomfort in her wrist.

Adult↗
PubMed1988

Management of fingertip trauma.

Sound knowledge of fingertip anatomy and of the potential for long-term morbidity are essential in formulating an organized approach to fingertip injuries. An accurate assessment of the deficits created by the injury is then possible. The goal of treatment is to re-create normal anatomic relationships as closely as possible. Many fingertip injuries are easily managed by a nonspecialist. However, more complex procedures, such as the use of local or distant flaps, is beyond the realm of most primary care physicians, and appropriate referral to a hand specialist may be required.

Amputation, Traumatic↗
PubMed1988

Experimental evaluation of the antibiotic carrying capacity of a muscle flap into a fibrotic cavity.

A study was undertaken to determine the antibiotic carrying capacity of a transferred muscle flap into a fibrotic cavity using a tissue cage model in rabbits. Blood and chamber fluid antibiotic levels were determined after intramuscular hindlimb gentamicin injection up to 56 days following muscle transfer. This study suggests that muscle flaps increase the concentration of antibiotics that can be achieved within a fibrotic cavity. The measurable peak level decreases with time, probably due to increased scarring around the muscle. This model should enable the study of many different classes of antibiotics with different protein binding and other administration schedules using multiple timed doses or a combination of agents.

Animals↗
PubMed1988

Altered spatial perception following harvest of a posterior auricular skin graft.

A 57-year-old man blind since an early age lost significant ability to orient himself in space regarding surrounding objects after his left ear was retropositioned to close a retroauricular full-thickness skin graft donor site. Release of the ear to its former position corrected the disability. We warn readers that long-time blind persons develop alternate methods to vision and a seemingly insignificant change of ear position may alter spatial orientation.

Blindness↗