PubMed Health⌕ Search

Biomedical subjects

E S Kilgore

Publications and source records attributed to E S Kilgore.

At least 19 recordsLinked to original sources
PubMed1989

The treatment of felons and paronychias.

Infections of the distal finger have a varied presentation, course, and treatment. As in other hand infections, initial treatment should always include elevation of the extremity and the avoidance of snug clothing or constricting jewelry. Immunosuppressive states and systemic diseases such as diabetes must be considered, for they will alter the action of the causative organisms as well as the intensity of treatment that a patient will require. Appropriate, specific antibiotic treatment can be part of the initial treatment of acute felons and paronychias, but it should never replace adequate incision and drainage. Finally, "minor" finger infections are only minor when diagnosed and treated properly. If mistreated, their consequences can have long-term implications for both the individual and for society. It is important to understand the natural history, bacteriology, and anatomy of the distal finger if we are to return patients to their jobs with expedience and minimal long-term sequelae.

Abscess↗
PubMed1987

Percutaneous desmotomy of digits for stiffness from fixed edema.

A simple technique, not previously described, has been successful in achieving increased motion of contracted metacarpophalangeal and proximal interphalangeal joints of the hand. The procedure involves percutaneous sectioning of collateral ligaments followed by joint manipulation. Experience with 65 stiff joints treated by this minimally invasive technique followed by physical therapy revealed an average final gain of 28 degrees for metacarpophalangeal joints and 19 degrees for proximal interphalangeal joints. Mean follow-up was 13 months. This compares favorably to the more aggressive technique of open arthrolysis, thus offering a simple and effective treatment alternative.

Adult↗
PubMed1986

Long-term analysis of patients having surgical treatment for carpal tunnel syndrome.

This retrospective study of 100 patients who had surgical treatment for their carpal tunnel syndrome was performed to determine what factors were associated with long-term success or failure. One hundred thirty hands were treated surgically with an average follow-up of 4 years (range, 2 to 6 years). All patients were given a course of conservative treatment that included steroid injection(s) and splinting until the patients were refractory to such therapy. Over 250 injections were given (117 wrists), with the average benefit time of 27 weeks (range 0 to 330). Most patients received two to three injections (maximum of nine). Variables associated with a failure to have long-term benefit after operation included weakness or atrophy of the abductor pollicis brevis muscle, presence of a predisposing condition, and failure to benefit from the initial steroid injection. Conversely, all 51 hands that had relief from median nerve paresthesia for more than 6 months by conservative therapy alone received long-term relief after surgery. Steroids were least effective in hands that had muscle involvement. Fifteen of the 40 hands with muscle involvement regained their muscle mass by the time of the final examination.

Adult↗
PubMed1985

Pseudotendon formation after flexor tendon injury.

The biologic reconstitution of a divided flexor tendon by scar tissue forming a "pseudotendon" is described in three cases. With close inspection, one is able to differentiate a pseudotendon from a normal tendon intraoperatively by its relatively light gray color and the lack of a glistening surface. A pseudotendon lacks the tensile strength of a normal tendon and should be replaced by tendon grafting or transfer if function is to be restored.

Adult↗
PubMed1977

Management of the burned hand.

Current concepts in the management of acute and chronic injury to hands due to thermal burns are presented. A review of relevant functional anatomy and its alteration by the burn process is outlined. The maintenance of wrist extension, metacarpophalangeal flexion, and an open thumb web is critical in the acute phase. The physical therapist, using splints and regular exercise, is the key person in maintaining this position. The use of antibacterial agents, surgical debridement, and skin grafting is discussed. Surgical methods of reconstruction in chronic burns, the long-term role of the physical therapist, and the use of compression garments to minimize scar are stressed.

Anti-Infective Agents↗
PubMed1977

Common injuries of the fingernail and nail bed.

The most common injury to the dorsal distal finger is a subungual hematoma. Relief of pain is promptly achieved by draining the hematoma. If a heated paper clip is used, however, the underlying fluid may be seared and the hole plugged. Local anesthetic block followed by puncture with an 18-guage needle is advocated. When nail avulsion occurs, the free-floating proximal portion should be removed so that it will not serve as an irritant or hide any underlying pathology.

Drainage↗
PubMed1976

Volkmann's ischemic contracture due to soft tissue injury alone.

Fifteen upper extremities, in 14 patients in whom incipient or actual Volkmann's ischemic contracture was present, were seen in a 5 year period. Nine patients were stuporous due to drug overdose and had laid on the extremity; two had received a recent injury of main arterial trunks; two had sudden severe compression; one with chronic myelogenous leukemia had each arm involved at different times in a bizarre autoimmune response causing massive swelling. No patient had a fracture or dislocation. Pain and tenderness, loss of sensibility, resistant muscle contracture, and rock-hard muscle compartments were warning signs. Immediate fasciotomy was done. Useful function was restored when treatment was carried out in the early stages of the ischemia.

Adult↗
PubMed1976

Post-traumatic trapped dislocations of the proximal interphalangeal joint.

This paper deals with the uncommon and frequently unrecognized problem of trapped dislocations of the proximal interphalangeal joint. These may be dorsal or volar. Soft tissue forming a noose, or interposed in the joint, is implicated. There is injury to one or more of the following structures: 1) extensor mechanism, 2) collateral ligament, 3) volar plate, 4) flexor tendon sheath, and 5) skin (compound dislocations). Open reduction and appropriate soft tissue repair are mandatory the essential features of diagnosis and management are discussed and four illustrative cases are presented.

Adolescent↗
PubMed1975

The accuracy of liver scanning in the detection of metastatic disease.

Isotopic scanning of the liver to detect hepatic metastases is a commonly used clinical tool in assessing the extent of malignant disease and the proper mode of therapy. Opinions vary widely as to the efficacy of this test. To determine the accuracy of our scanning technique the clinical and laboratory data on 429 patients who had hepatic scans (technetium sulfur colloid) between February 1971 and May 1973 was reviewed. Of these patients, 125 had a confirmatory procedure (needle biopsy - 15, abdominal exploration - 69, autopsy - 41) done within 6 weeks of their scan. Nineteen patients who had negative scans were proven to have hepatic metastases. Fourteen patients had positive scans which could not be substantiated by one or more of the above confirming examinations. Thus the frequency of error was 25%. Regarding other tests - alkaline phosphatase and bilirubin - no better correlation could be made with respect to the presence or absence of metastases. From the data available on this small group of patients the liver scan is sufficiently inaccurate to preclude relying upon it for the selection of therapy in cancer patients. When the presence of hepatic metastases changes the type of therapy a confirmatory laparotomy or biopsy should be considered.

Humans↗
PubMed1975

Treatment of felons.

The pitfalls of traditional concepts in the management of a felon are reviewed. A more rational and uniformly successful method is detailed. This consists of a midvolar, longitudinal incision of the fat pad where the majority of abscesses point. Other incisions are reserved for the few cases in which maximal tenderness is shown elsewhere. An abscess should always be drained where it points. It has not been our intent in this report to discuss the problems of extension of infection beyond the closed space of the distal fat pad or to deal with paronychias and eponychias that simulate a felon by their extension.

Adipose Tissue↗