PubMed Health⌕ Search

Biomedical subjects

H J Levy

Publications and source records attributed to H J Levy.

16 recordsLinked to original sources
PubMed2001

Type III tibial avulsion fracture with associated anterior cruciate ligament injury: Report of two cases in adults.

Tibial spine avulsion fractures are more common in children than adults. Many reports have provided classification and treatment options, including fixation for displaced type III fractures. However, long-term follow-up on injury to the anterior cruciate ligament and knee joint stability in adults is not well documented. We present 2 cases of type III tibial avulsion fractures in adults with associated interstitial injury to the anterior cruciate ligament. Primary anterior cruciate ligament reconstruction was performed in both patients.

Adult↗
PubMed2001

Neural anatomy of the transverse carpal ligament.

Carpal tunnel syndrome is one of the most commonly diagnosed disorders of the upper extremity. The etiology of the neuropathy is known to be associated with many disorders, with the etiology of carpal tunnel syndrome mainly attributable to ischemia of the median nerve. The purpose of this study was to determine the presence of neural elements within the transverse carpal ligament. Fourteen transverse carpal ligaments were harvested from seven male and seven female fresh frozen cadavers with an average age of 76 years. The tissues were stained with S-100 using a standard immunoperoxidase technique used to localize neural tissue. The transverse carpal ligament consisted of interwoven bundles of fibrous connective tissue. It was found to have an intraligamentous and extraligamentous neural network consisting mostly of free nerve endings and pacinian corpuscles. Ruffini's corpuscles were not identified. This study showed that there is neural innervation to the transverse carpal ligament. Pacinian corpuscles have been shown to be mechanoreceptors which respond to changes in joint position, whereas free nerve endings have been identified as nociceptors. Neural innervation were present in the transverse carpal ligament, and the nociceptive information relayed by these neural elements may contribute to the pain associated with carpal tunnel syndrome. In addition to being a mechanical wrist stabilizer, the transverse carpal ligament also may play a role in proprioception of the wrist.

Aged↗
PubMed1999

Ring finger ray amputation: a 25-year follow-up.

The treatment of class III ring avulsion injuries remains controversial. This case report presents a 25-year follow-up of a class III ring avulsion injury treated with secondary ring finger ray amputation. This case shows long-term excellent functional and cosmetic results of ring finger ray resection without bony transposition.

Adolescent↗
PubMed1996

Neurohistology of the subacromial space.

Subacromial decompression is one of the most commonly performed shoulder procedures. Debridement of the subacromial soft tissues is a critical part of the procedure. However, the extent of soft tissue debridement is not well defined. The purpose of this study was to identify neural elements within the soft tissues composing the subacromial space. Using special immunohistochemical stains and electron microscopy, neural elements were identified within the subacromial bursa, rotator cuff tendon, biceps tendon and tendon sheath, and transverse humeral ligament. There was a significantly richer supply of free nerve fibers in the bursa compared with the other tissues. The nociceptive information relayed by these fibers may be responsible for the pain associated with impingement syndrome.

Acromion↗
PubMed1994

Arthroscopic subacromial decompression in the treatment of full thickness rotator cuff tears: a 3- to 6-year follow-up.

Arthroscopic subacromial decompression has become an accepted treatment for patients with impingement syndrome; however, its use for full thickness rotator cuff tears continues to be controversial. The purpose of this study is to determine if the results of arthroscopic subacromial decompression alone for full thickness rotator cuff tears deteriorate at long-term follow-up. We reevaluated all 25 patients with full thickness rotator cuff tears who underwent arthroscopic subacromial decompression from our original study group. Based on the University of California at Los Angeles shoulder rating, 68% of patients were rated as excellent or good at the present mean follow-up of 45.8 months (range 36-72 months). This represents a significant decrease from our initial report of 84% satisfactory results at a mean follow-up of 24.6 months. There was a significant decrease in ratings with regard to pain and function; however, no significant deterioration was noted with regard to motion and strength. Two additional patients required open rotator cuff repair since the time of initial follow-up for a total of six. Large and massive rotator cuff tears fared worse over time as compared with small and moderate size tears. Although 1- to 3-year results of arthroscopic subacromial decompression and rotator cuff debridement were favorable, the long-term follow-up demonstrates deterioration of results. We therefore cannot support the use of decompression and debridement alone in the treatment of repairable full thickness rotator cuff tears.

Adult↗
PubMed1993

Endoscopic carpal tunnel release: an anatomic study.

Endoscopic carpal tunnel release has been shown to decrease postoperative recovery time in patients undergoing surgery for carpal tunnel syndrome. There is, however, some controversy concerning the safety and reliability of the procedure. We performed endoscopic carpal tunnel release utilizing the two portal technique described by Chow on 20 fresh cadaver specimens. There were no injuries noted in any of the vital structures including the ulnar artery, superficial palmar arch, third common digital nerve or flexor tendons. The transverse carpal ligament was found to be completely transected in 95% of the specimens. Hyperextension of the wrist significantly displaces the vital structures both dorsally and distally. The use of a slotted cannula and specially designed blades protect the surrounding structures during the procedure. Based on this study, endoscopic carpal tunnel release using the technique described by Chow may be performed reliably without injury to any of the vital structures.

Carpal Tunnel Syndrome↗
PubMed1993

Arthroscopic assisted internal fixation of volar intraarticular wrist fractures.

Open reduction internal fixation of displaced volar intraarticular distal radius fractures traditionally require sacrificing the volar ligaments to visualize the articular surface. We present a modification of standard arthroscopy that facilitates visualization of the radiocarpal joint while preserving these ligaments.

Arthroscopy↗
PubMed1991

Arthroscopic subacromial decompression in the treatment of full-thickness rotator cuff tears.

Arthroscopic subacromial decompression has become an accepted treatment for patients with impingement syndrome; however, its use for full-thickness rotator cuff tears is controversial. We observed 25 patients with full-thickness rotator cuff tears treated by arthroscopic subacromial decompression and cuff debridement alone with a minimum of 1 year follow-up observation. Based on the University of California at Los Angeles shoulder rating, 84% of the cases were rated as excellent or good. There was significant improvement in pain, function, motion, and strength. Eighty-eight percent of the patients were satisfied with the procedure. Although all tear sizes improved significantly, smaller tears fared better than larger tears. The preliminary results of arthroscopic subacromial decompression with cuff debridement compare favorably to open techniques of rotator cuff repair with or without acromioplasty and should be considered in selected patients with full-thickness rotator cuff tears.

Acromion↗
PubMed1991

Bilateral osteochondral flaps of the wrists.

A case of bilateral osteochondral flaps of the wrists in a competitive weight lifter is presented. Diagnosis and treatment were both provided by wrist arthroscopy. osteochondral flaps should be considered in the differential diagnosis of chronic wrist pain.

Adult↗
PubMed1990

Arthroscopic assisted rotator cuff repair: preliminary results.

Arthroscopic assisted rotator cuff repair is a method of performing an arthroscopic subacromial decompression with repair of the rotator cuff through a limited deltoid splitting approach. We evaluated 25 patients with a minimum of 1 year follow-up. Based on the UCLA shoulder rating, 80% of the patients were rated as excellent or good. There was significant improvement in pain, function, motion, and strength. Ninety-six percent of the patients were satisfied with the procedure. Of the patients with small or moderate size tears, 100% received a satisfactory rating. Arthroscopic assisted rotator cuff repair is presented as an attractive alternative in treating symptomatic patients with complete tears of the rotator cuff.

Arthroscopy↗
PubMed1986

The role of Na-hylan in reducing postsurgical tendon adhesions.

Na-hylan, a chemically modified sodium hyaluronate jelly, was studied mechanically and histologically as a surgical device to diminish tendon adhesion in the rabbit long toe extensor three weeks after surgical abrasion. This device was found to be highly effective (55% of treated tendons formed no adhesions compared to 5% of controls, and only 18% formed severe adhesions compared to 62% of controls). No gross or histologic evidence of significant acute or chronic inflammatory reaction to the Na-hylan was found.

Animals↗
PubMedDate not supplied

Patellar tendon autograft harvesting using a mini vertical incision.

Patellar tendon autograft is a commonly used graft for anterior cruciate ligament reconstruction. Harvesting the patellar tendon graft typically entails using a longer incision than other graft options. We describe a technique for harvesting bone-patellar tendon-bone autograft using a smaller more cosmetic incision.

Anterior Cruciate Ligament↗
PubMedDate not supplied

Outpatient open Bankart repair.

We evaluated satisfaction in 25 consecutive patients who underwent open Bankart repair as an outpatient procedure. The average age of the patients was 22 years. There were 18 men and 7 women. Patients were evaluated postoperatively via a home assessment questionnaire that included the following: home environment, dominant versus nondominant extremity, effectiveness of oral pain medication, ability to perform activities of daily living, and overall satisfaction. Three of the 25 patients would have preferred an overnight hospital stay. There were no admissions to the hospital or postoperative complications. The total charges for outpatient Bankart repair as compared with an inpatient procedure at the same institution resulted in a total cost savings of 56%. We conclude that outpatient Bankart repair is safe and economical. The overall cost savings were significant and patient satisfaction was 88%.

Activities of Daily Living↗