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Biomedical subjects

H A Wissinger

Publications and source records attributed to H A Wissinger.

At least 19 recordsLinked to original sources
PubMed1986

Periprosthetic femoral fractures following total knee arthroplasty.

Supracondylar and distal femoral fractures involving total knee arthroplasties present a relatively new and challenging problem. The alignment of the total knee components prior to and subsequent to the fracture, as well as the patients' range of motion, symptoms, and level of function following their treatment, were investigated in 14 cases. Ten of the patients had nonoperative treatment. Four had had an operative procedure. Osteoporosis, notching of the femur, and revision arthroplasty were identified as predisposing factors with femoral fractures. The results of treatment depended primarily on reduction of varus deformity and/or posterior displacement of the femoral component. Nonoperative treatment was most successful in this regard.

Aged↗
PubMed1978

Carpal tunnel syndrome in pregnancy.

Occurrence of the carpal tunnel syndrome in pregnancy was studied by examining 100 consecutive obstetric admissions. Twenty-one patients reported paresthesias or hypesthesia in the median nerve sensory distribution of the hand during the pregnancy; eight of these had decreased sensation subjectively at the time of examination one to three days after delivery; two had trophic changes, loss of sudomotor function, thenar atrophy, and decreased two-point discrimination; and one had a delay in motor conduction time across the carpal tunnel. Of the 21 patients, 18 became asymptomatic before or shortly after delivery. The remaining three were asymptomatic three months after delivery. We conclude that the incidence of symptoms is probably greater than usually appreciated, but that few patients require treatment. Steroid injection may occassionally be necessary, but the need for surgical intervention is rare.

Carpal Tunnel Syndrome↗
PubMed1977

Abductor digiti quinti opponensplasty.

Fifteen neurovascular pedicle transfers of the abductor digiti quinti to the base of the proximal phalanx of the thumb were performed: seven for laceration of the median nerve, seven for neurological disease, and one for congenital absence of the thenar muscles. Fourteen of the transfers were viable, and twelve gave excellent results. The three failures all had had inadequate release of contractures of the thumb. This transfer offers the following advantages over other opponensplasties: (1) an intrinsic muscle with correct amplitude and direction of pull replaces intrinsic muscles; (2) the tension of the muscle transfer is automatically correct; and (3) the appearance of the hand after this procedure is superior to that after other types of opponensplasty.

Adolescent↗
PubMed1976

The acute carpal tunnel syndrome: nine case reports.

Nine cases of acute carpal tunnel syndrome are reported. Etiologies include: bleeding secondary to chronic lymphatic leukemia; Colles' fracture of the wrist (2 cases); Epiphyseal fracture (Salter II) of the distal radius; Bleeding secondary to giant cell tumor of the tendon sheath; Unstable distal radio-ulnar joint; Displaced intra-articular fracture of the distal radius; Rheumatoid synovitis and vasculitis; Trans-scaphoid, perilunar fracture dislocation of the wrist. Early recognition of median nerve compression in the carpal tunnel is vital. The signs of median nerve compression should be looked for in all cases of wrist trauma. In our opinion, immediate surgical decompression is frequently indicated.

Acute Disease↗
PubMed1975

Prophylactic anticoagulation in total hip replacement.

In the prevention of thromboembolic complications following elective total hip operations, warfarin is a safe and effective agent which causes minimal bleeding complications, if the drug is first administered on the first postoperative day and thereafter continued in various dosages to maintain a prothrombin time between one and one and one-half and two times that of the control. Dextran also is effective in preventing thromboembolic complications but causes more bleeding problems, especially when administered intraoperatively.

Aged↗
PubMed1975

Preliminary experience with a method of quadricepsplasty in recurrent subluxation of the patella.

Nineteen knees were treated for recurrent subluxation or dislocation of the patella by lateral and distal transfer of the vastus medialis with or without release of the lateral retinaculum. Fifty-eight per cent has good or excellent and 42 per cent had poor results after a mean follow-up of twenty-nine months. The factors that predisposed to failure were genu valgum greater than 15 degrees and, to a lesser extent, palpable synovitis associated with symptomatic chondromalacia patellae.

Adolescent↗
PubMed1975

Resection of the hook of the hamate. Its place in the treatment of median and ulnar nerve entrapment in the hand.

Poor results can be anticipated with conventional surgical decompression of nerves entrapped within the hand in (1) those with underlying systemic disease causing primary neuropathy, (2) those with combined median and ulnar nerve palsies, and (3) those who have been previously operated upon for nerve entrapment within the hand. Eighteen patients belonging in these categories were surgically treated by resection of the hook of the hamate and (in some) by intraneural neurolysis. Using this technique, we have decreased our failure rate from 20 percent to less than one percent. We believe that failures can be eliminated if the patients destined to have poor results from the usual treatment are identified preoperatively and a more aggressive surgical decompression is used on this "at risk" group.

Adult↗