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Biomedical subjects

E J Bieber

Publications and source records attributed to E J Bieber.

6 recordsLinked to original sources
PubMed1988

Failed distal ulna resections.

Twenty patients with complaints of pain and limitation of activities for more than 1 year after ulnar head resection (Darrach) were studied. Their ages ranged from 18 to 60 years (mean, 38 years). The initial indications for operation were posttraumatic derangement in 18 patients, radial growth anomaly in 1, and a lesion of the ulna in 1. Follow-up ranged from 29 to 135 months (mean, 61 months). The patients had an average of 2.2 additional operations, with up to seven procedures per patient. Radiographs were compared with those from an equal number of successful Darrach resections chosen randomly, and no significant differences were noted. All 20 patients continue to have difficulties despite several years of treatment. The Darrach resection can result in serious disability, especially in the younger patient and the patient with lax ligaments. Reoperation on these patients is rarely successful.

Adolescent↗
PubMed1987

Thumb avulsion: results of replantation/revascularization.

During a 9-year period, 39 thumb avulsions required emergency replantation/revascularization at our institution. Amputation was complete in 28 (72%) cases and involved the dominant thumb in 31 (80%). Farm machinery was the source of injury in 33 (85%) cases. Follow-up ranged from 7 months to 6 years. Only 10 of the revascularization attempts (26%) were successful; the remaining attempts required amputation at the level of the injury. In two (18%) of the 11 partial amputations and in eight (29%) of the 28 complete amputations, revascularization was successful. In eight (31%) of the 26 thumbs in which vein grafts were used, revascularization was successful, while one of the other two successes involved a transfer of the radial digital artery of the index finger. In six of the ten successful revascularizations, nerve repair was attempted, but without further procedures, none of the six digits regained two-point discrimination of less than 1 cm.

Adolescent↗
PubMed1986

Lipomas compressing the radial nerve at the elbow.

Four patients have been treated for compression of the radial nerve by lipomas at the elbow. The treatment of all cases was surgical excision with complete resolution. Lipomas are a very common tumor but infrequently cause nerve compression symptoms.

Arm↗
PubMed1986

Bone reconstruction.

The reconstruction of bone defects relies upon the reconstitution of bone in the area. The basic concepts of fracture healing are presented to better understand the mechanism of bone grafting. Conventional bone graft techniques are quite effective in reconstructing defects, including those up to 25 cm in length, provided an adequate vascular bed is available to allow vascularization of the grafts. If an adequate milieu is not available, then the use of a pedicle or free vascular bone graft can be employed. Just as skin and muscle flaps have provided the solution to soft-tissue loss, vascularized bone grafts provide the technique to deal with large bone defects not amenable to conventional treatment. Allografts additionally have a place in skeletal reconstruction but require appropriate management and consideration of host immune response.

Bone Transplantation↗
PubMed1986

Silicone-rubber implant arthroplasty of the metacarpophalangeal joints for rheumatoid arthritis.

Forty-six patients with rheumatoid arthritis underwent metacarpophalangeal-joint arthroplasty of the index through little fingers on 210 joints in fifty-five hands using the Swanson-design silicone-rubber spacer. The patients were followed for two to eight years (average, five and one-quarter years). They were evaluated both preoperatively and postoperatively for range of motion, deformity, subjective sense, grip strength, and prehension. In the initial postoperative evaluation, the majority of patients expressed a strong subjective impression of improvement. Ulnar drift improved from the preoperative average of 25 degrees to less than 5 degrees. The preoperative average extension deficit decreased from 56 to 10 degrees, while the average range of motion increased from 17 to 51 degrees. In the long-term postoperative evaluation, the average ulnar drift had increased to 12 degrees, the average extension deficit had increased to 22 degrees, and the average range of motion had decreased to 39 degrees. Grip strength and prehension did not significantly improve at either evaluation. There were no fractures of the prosthesis and no patient had synovitis. We have found the procedure to be useful for the correction of deformity, increasing range of motion of the fingers, and improving the patient's sense of well-being.

Adult↗