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G M Ginsburg

Publications and source records attributed to G M Ginsburg.

6 recordsLinked to original sources
PubMed1998

Hypoglossal nerve injury caused by halo-suspension traction. A case report.

STUDY DESIGN: A case report of injury to the hypoglossal nerve (CN XII) resulting from the use of halogravity traction in a child with severe cervicothoracic kyphosis after an anterior and posterior spinal release. OBJECTIVE: To describe one of the potential dangers of halo-suspension (gravity) traction, which has not been reported previously in the orthopedic literature. SUMMARY OF BACKGROUND DATA: Cranial nerve injuries resulting from halo-skeletal traction are a recognized complication of such treatment, especially in patients with myelomeningocele. Halo-suspension traction using the patient's body weight as counter-traction has been recommended to provide a less rigid force and to reduce complications. METHODS: The authors report on the mechanism of injury and clinical course in a 12-year-old boy with myelomeningocele and a bilateral CN XII injury caused by halo-suspension traction from onset to resolution. RESULTS: This patient had dysphagia and difficulty swallowing 5 days after surgery. His wheelchair traction at this point was approximately 40% of his body weight. The traction was reduced, and a corticosteroid was administered. The patient's symptoms began to abate 5 days later. At 6 weeks after injury, his cranial nerve function was normal. CONCLUSIONS: Although halo-suspension traction or halo-wheelchair traction may be less rigid, injury to the hypoglossal nerve can be produced with traction exceeding 40% of body weight. In the patient in the current report, resolution of this injury was complete within 5 weeks, an outcome that is consistent with those of other reported cases of CN XII injury.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Brown's procedure for congenital absence of the tibia revisited.

The results of reconstructive surgery in tibial hemimelia using a modified fibular transfer procedure as described by Brown were reviewed. A modified Brown's procedure was carried out on five patients with a total of seven affected limbs. A Syme's-type amputation of the foot was carried out in each case. All of the knees had quadriceps function preoperatively, which was considered a prerequisite for surgery. Average length of follow-up was 7 years, with a range of 2-12 years. The average age at time of surgery was 12.7 months, with a range of 7-26 months. At the time of review, all patients had reasonably good function of their lower extremities. All were ambulating with patellar tendon-bearing prostheses and thigh extensions for collateral support. The average arc of motion at review was 57.4 degrees, with further passive motion possible in all cases. Average extension was -18.5 degrees, and the average active flexion was 76 degrees. We found that a fibular centralization procedure in a patient with at least grade III+ quadriceps function can give good functional results that do not appear to deteriorate over time.

Abnormalities, Multiple↗