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Biomedical subjects

G M Weinraub

Publications and source records attributed to G M Weinraub.

5 recordsLinked to original sources
PubMedDate not supplied

Adult flatfoot/posterior tibial tendon dysfunction: outcomes analysis of surgical treatment utilizing an algorithmic approach.

A new classification scheme is presented along with an algorithmic surgical approach to the treatment of posterior tibial tendon dysfunction (PTTD). This classification scheme treats as separate entities the soft-tissue and osseous components of PTTD. The soft-tissue pathology is staged from tendinitis to tendinosis to that of complete rupture. The osseous element is graded as no planar deformity, reducible planar deformity, or rigid planar deformity. The stage of soft-tissue pathology is then combined with the grade of the osseous condition, leading to a comprehensive surgical treatment plan. Based on this classification, 13 patients were retrospectively evaluated. Only those patients falling into a specific classification (2A and 2B) were included in this analysis. The American Orthopedic Foot and Ankle Society clinical hindfoot-ankle scale was utilized. The mean preoperative clinical rating was 32.8. The mean postoperative clinical rating was 88.0. Pre- and postoperative radiographic criteria were also analyzed. Overall patient satisfaction utilizing this treatment algorithm was good to excellent.

Adolescent↗
PubMedDate not supplied

The Evans osteotomy: technique and fixation with cortical bone pin.

The use of a lamina spreader over converging pins facilitates opening of an Evans calcaneal osteotomy and allows for precise measurement of the recipient site. The technique of cortical bone pin insertion has been utilized when indicated by the authors a limited number of times (N = 10) and as such this will be the subject of a future scientific investigation. The authors feel the advantages of the cortical bone pins include ease of use, good resultant stability of the capital fragment, utilization of a material identical to that of the correcting graft, a more biologic form of absorbable internal fixation, and the avoidance of complications associated with percutaneous metallic fixation (Fig. 5).

Bone Nails↗
PubMedDate not supplied

Asymmetric "V" osteotomy: a predictable surgical approach for chronic central metatarsalgia.

Chronic metatarsalgia is a condition found through the years to present many treatment difficulties. These difficulties began with a lack of understanding, not only concerning the etiologic nature of this condition, but failure to appreciate the surgical treatment ramifications inherent to alterations in the metatarsal parabola. These failures have subsequently led to lesions under the adjacent metatarsal heads, stress fractures, flail toes, and other postoperative pathology. This often leads to further surgical intervention or accommodative modifications. The authors offer an analysis of surgical approaches to this problem and present a more predictable surgical technique to enhance the metatarsal parabola, while decreasing either excessive plantarflexion of a particular metatarsal or set of metatarsals. To date the senior author (E.L.) has performed the asymmetric "V" osteotomy on 30 patients for a total of 40 metatarsals. After a 12- to 18-month postoperative period, there have been no significant complications, including recurrences, transfer lesions, excessive secondary bone callous, malunions, or adjacent metatarsalgia. Delayed union with secondary bone callous has developed in two instances. The authors introduce an innovative surgical approach to structural metatarsal abnormalities as a distinct advantage to other previously described osteotomies with greater predictability, better anatomic reduction, primary bone healing, and faster return to normal activities.

Chronic Disease↗
PubMedDate not supplied

A new method for reattachment of the tendo Achillis following retrocalcaneal exostectomy.

Currently there are a number of surgical techniques being utilized to address the entity of symptomatic, recalcitrant retrocalcaneal exostosis. This article presents a mechanical study of a modified surgical approach which has been developed at the Northern Virginia Podiatric Residency Program for the purposes of complete resection of all offending exostosis and calcifications, and maintenance of the anatomic configuration of the Achilles tendon with resultant asymptomatic function and cosmetic healing. The centerpiece of the surgical modification is the way in which the portion of reflected Achilles tendon is reattached to the calcaneus, utilizing soft-tissue anchors in combination with a modified Krackow suture technique. In order to delineate the relative strength of this suture technique, a cadaveric study was performed using six specimens. Each specimen underwent tendon repair with both a modified Krackow technique and a modified vertical mattress coaptation technique for a total of 12 studies. The force required to displace the tendon for distances of 0.5 cm and 1.0 cm was then recorded, and the data were statistically analyzed, with the modified Krackow technique proving to have a significantly better ability to resist distractive forces at both 0.5 cm (p = .01) and at 1.0 cm (p = .02) compared to the vertical mattress coaptation technique.

Achilles Tendon↗