Biomedical subjects
Publications and source records attributed to J D Zoltan.
An arthroscope was used to diagnose and treat an intraarticular penetration of a cactus thorn in a pediatric knee joint. A review of previous articles describing plant thorn synovitis is given. Recent literature indicates that this is the first time an arthroscope has proven to be effective in the diagnosis and treatment of monoarthritis due to an intraarticular penetration by a plant thorn.
Magnetic resonance imaging (MRI) was used to diagnose acute and chronic intraarticular knee pathology in 23 knees. The results were compared with arthroscopic findings of meniscal, ligamentous, and articular cartilaginous pathology using a double-blind prospective protocol. The overall accuracy for meniscal tears was 78%, with a sensitivity of 88% and a specificity of 72%; for cruciate ligaments, MRI was 82% accurate, with a sensitivity of 67% [anterior cruciate ligament (ACL) only] and a specificity of 86%. In select clinical situations, MRI of the knee is a useful diagnostic tool.
Seven cases of femoral fractures in head-injured children with spasticity and/or decerebrate posturing and seizures were treated with external fixation. The fractures healed with good alignment, maintenance of length, and without infection. The technique is recommended both for its simplicity and lack of complications relative to other management approaches.
A young man with persistent pain beginning 2 days following reduction of an anterior subcoracoid dislocation was found to have a suprascapular nerve injury. The patient described was felt to have a neurapraxia of the suprascapular nerve. Possible causes of post-reduction subluxation are interposition of the shoulder joint capsule or biceps tendon, or rupture of the rotator cuff. EMG in 3 weeks, followup examinations, and active assisted motion 4 to 6 weeks postinjury are recommended.
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Ninety-nine ankle sprains were arbitrarily divided into a control (54 patients) and a study (45 patients) group. Both groups were treated with elevation, ice compression wraps crutches, and early mobilization. In addition, the study group underwent ankle joint aspiration and local injection of the involved ligaments with 4-10 cc of 1% xylocaine. The difference between recovery times in the control group (mean, 10.7 days) and in the study group (mean, 4.4 days) reached statistical significance at p less than 0.001 by Wilcoxon two-sample test. Because there are inherent risks in this treatment, it is not recommended for all patients. However, for those requiring early remission of symptoms to allow early return to pre-injury activities, this treatment is suggested by the author.
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