PubMed HealthSearch

Biomedical subjects

J E Kutz

Publications and source records attributed to J E Kutz.

15 recordsLinked to original sources

Improvement in motor function after brachial plexus surgery.

Motor functional recovery of 52 patients with brachial plexus surgery followed up for more than 2 years was evaluated. Fifty-eight surgical procedures were done, including autologous nerve grafting (38 cases), neurolysis (14 cases), and neurotization (6 cases). Overall results, evaluated according to the 0 to 5 formula of the Medical Research Council, were as follows: good, 58%; fair, 15%; and poor, 27%. Good results were evident in 58% of patients with nerve grafts and in 64% of those with neurolysis. In patients with neurotization, no good recovery and only one fair recovery were seen. Patients with open injuries showed good recovery, whereas the group with closed injury showed good recovery in only 48%. Patients with closed injuries caused by traffic accidents showed a worse recovery than those caused by other means. Patients with closed injuries and nerve grafting done within 3 months of injury or neurolysis within 6 months showed better recovery.

Adolescent

Venous flaps in digital revascularization and replantation.

This is a report on 15 patients who underwent replantation/revascularization of a single digit with a substantial dorsal soft tissue defect. The dorsal defect was covered with a venous flap, a free flap that has only venous inflow and outflow. Postoperatively, the venous flaps were warm, pink, and appeared to exhibit a blanch and refill phenomenon, clinically resembling capillary filling. The flaps from the dorsal aspect of an uninjured digit had a survival rate of 100 percent, with no partial necrosis, while the flaps from a forearm or dorsal foot donor site failed. The advantages of using venous free flaps are twofold. Not only does this technique provide for venous drainage, but it also provides flap coverage and avoids complications, such as vessel occlusion or hematoma formation, associated with skin grafting over a venous anastomosis, with subsequent loss of the skin graft.

Adult

The role of the epiphyseal and metaphyseal circulations on longitudinal growth in the dog: an experimental study.

An experimental model using the immature canine proximal fibular epiphysis was developed to isolate and investigate the effects of the epiphyseal and metaphyseal circulations on longitudinal growth. Experimental constructs studied the epiphyseal circulation, the epiphyseal and metaphyseal circulations, a devascularized growth plate, and a control group. Twenty-four limbs were studied by serial x-ray films and microangiographic and histologic analyses at time of death, 24 weeks after surgery. The data from this preliminary study show that both metaphyseal and epiphyseal circulations are necessary for predictable longitudinal growth.

Animals

Chronic exertional compartment syndrome of the forearm: a case report.

A 40-year-old man sustained a circumferential crush injury to his right forearm. Four months after injury, he experienced the onset of numbness and tingling in the distribution of the median nerve after exercise. Elevated compartment pressures of the palmar forearm and slowing of median nerve conduction after exercise suggested chronic exertional compartment syndrome. A flexor fasciotomy led to complete relief of symptoms, which allowed the patient unrestricted activity.

Adult

Free vascularized bone grafts in surgery of the upper extremity.

Free vascularized fibular grafts were employed in five patients with segmental bone defects following trauma or resection of tumors of the upper extremity with excellent results in three patients and satisfactory results in two. No donor site morbidity was experienced. A comparison with rib and iliac crest grafts indicates that the fibula is more suitable for reconstruction of long bone defects. The advantages of this technique are stability without sacrificing viability and a shorter immobilization period with more rapid incorporation and hypertrophy of the graft. The disadvantages are prolonged operating time, difficulty in assessing patency of anastamoses in the immediate postoperative period, and sacrifice of a major vessel in the lower extremity.

Adult

Arthritis of the trapezial articulations treated by prosthetic replacement.

This paper reviews experience with thirty-six trapezial replacements over a period of six years. The indications for replacement are given, the group of patients analysed and the technique outlined, with particular attention given to tendinous reinforcement of the capsular repair. The results with regard to pain, dislocation and other complications are recorded. The causes of dislocation and its prevention are discussed.

Arthritis, Rheumatoid

Primary flexor tendon repair followed by immediate controlled mobilization.

A study was made of the results of immediate repair and controlled mobilization in 156 severed flexor tendons in 68 patients occuring over an 18-month period. Eight patients with 16 tendon injuries could not be followed. Results were obtained from examinations done 6 weeks to 18 months (mean, 5.3 months) after repair. Thirty-one of the 60 patients were less than 20 years old, and 44 of the 60 were less than 30 years old. Seventy-nine (56%) of the injuries occurred in the area known as "no man's land"; 28 patients with repair of tendons in this area were rated by our standards as "excellent" or "good"--75% of patients as compared to 84.4% for the results of repair in other areas. In one fourth of the cases of severance of both tendons, because of local conditions in the wound, the superficialis was excised, but in all others it was repaired.

Adolescent

Microvascular procedures in reconstructive surgery.

The application of microvascular technics to problems in reconstructive surgery has enabled the surgeon to revascularize ischemic digits, replant amputated digits, and to transfer directly composite tissue from one area of the body to another for reconstructive purposes. The success of these procedures is directly dependent upon the ability to perform and maintain patent microvascular anastomoses. Representative cases are reported including the revascularization of an incompletely amputated digit, the replantation of an amputated thumb, the direct transfer of a toe to replace a missing thumb, and the transfer of a groin flap to cover a lower extremity defect. The principles of preoperative management, operative technics, and postoperative care are reviewed.

Adult

Free groin flap to the hand with end-to-side vessel anastomosis.

A single case of successful free groin flap transfer to the hand is presented. Its use demonstrates a distinct advantage of free flap transfer, preventing dependent edema and enforced immobilization of the hand necessitated by conventional technics. It also demonstrates a successful end-to-side microarterial anastomosis, thus allowing a continued normal blood supply to the hand.

Adult

Clear-cell carcinoma of the lung metastatic to the hamate: a case report.

Metastatic lesions of the hand are uncommon. A report of a solitary metastasis to the hamate seems not to have appeared previously in the literature. A 46-year-old factory worker presented a rare tumor, clear-cell carcinom of the lung, metastasizing to an unusual location, the hamate. The symptoms simulated sympathetic dystrophy and diagnosis was delayed because of the late appearance of radiographic changes over 6 months after symptoms first appeared. Early bone scanning in patients with chronic pain may provide useful information prior to the appearance of X-ray changes.

Adenocarcinoma