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Biomedical subjects

J Menon

Publications and source records attributed to J Menon.

At least 37 records · Page 2Linked to original sources
PubMed1995

Partial trapeziectomy and interpositional arthroplasty for trapeziometacarpal osteoarthritis of the thumb.

Partial excision including the articular surface of the trapezium and interpositional arthroplasty using one half of the flexor carpi radialis tendon was done in 36 hands. The joint capsule was reattached to the trapezium and the thumb immobilized for 4 weeks post-operatively. No ligament reconstruction was done. 30 hands (83.6%) had complete relief of pain. The average post-operative pinch strength was 11 lb. Three patients who complained of weakness of pinch had hyperextension of the MP joint. Correction of MP hyperextension is recommended to improve pinch strength. The outcome of this operation is comparable to any of the techniques described in the literature. The technique is simple and easy to perform. Since the capsule is closed the operation is truly an interpositional arthroplasty.

Aged↗
PubMed1994

Endoscopic carpal tunnel release: preliminary report.

The surgical technique of endoscopic carpal tunnel release using the Concept Carpal Tunnel Relief Kit (Linvatec, Largo, FL) is described. This is a single-portal technique and can be performed with any standard (4-mm) arthroscope available in the operating room. The results of the first 100 cases treated by the author are reported. Ninety-four percent of the patients achieved relief of symptoms. No permanent neurological or vascular injury occurred in this series. The grip strength returned to preoperative level in 3-4 weeks in the majority of patients. Subjective evaluation showed a greater degree of patient satisfaction when compared with results of the open technique.

Adult↗
PubMed1993

Endoscopic carpal tunnel release: a single-portal technique.

A safe single-portal technique for performing endoscopic carpal tunnel release is described. The procedure can be done using equipment already available in any standard operating room. Evaluation of 100 cases done by the author using this method has shown encouraging results.

Carpal Tunnel Syndrome↗
PubMed1988

Recurrent osteoblastoma of the carpal hamate.

A case of recurrent osteoblastoma of the hamate is reported. Curettage and bone grafting is usually followed by recurrence. Wide excision of the tumor is the treatment of choice if anatomically feasible.

Adult↗
PubMed1987

Total wrist replacement using the modified Volz prosthesis.

Eighteen total wrist arthroplasties in sixteen patients were done using the modified Volz prosthesis. The length of follow-up ranged from twenty-four to sixty-six months, with a mean of forty months. A 100-point scoring system was used to evaluate the outcome. Muscle imbalance developed in five wrists, the carpal component became loose in three wrists, and two prostheses dislocated. In five patients six arthroplasties (33 per cent) were considered to have failed because one reoperation or more was required for loosening of the components in two wrists, dislocation in two wrists, and muscle imbalance in two wrists. Of the remaining twelve arthroplasties (eleven patients) eight (45 per cent) had an excellent result; two (11 per cent), a good; and two (11 per cent), a poor result. The over-all rate of complications was 44 per cent. Patients who had significant preoperative deformity did poorly postoperatively. The surgeon should be prepared to perform other types of arthroplasty or an arthrodesis if the extensor tendons are structurally inadequate, as this may lead to progressive flexion deformity postoperatively.

Adult↗
PubMed1985

Role of synovial fluid cells in the healing of flexor tendons.

A 1-cm segment of repaired rabbit flexor tendon was first subjected to 10,000 rads of x-radiation and then placed in the synovial cavity of a rabbit's knee joint. Macroscopic examination revealed healing at the repair site and rounding of the tendon ends without adhesions. Light- and electron-microscopic studies revealed cells resembling fibroblasts at the repair site and the periphery laying down collagen. Healing of this irradiated nonviable tendon was brought about by the cells present in the synovial fluid.

Animals↗
PubMed1984

Isolated tears of the triangular fibrocartilage of the wrist: results of partial excision.

Sixteen patients who underwent partial excision of the triangular fibrocartilage (TFC) to treat chronic wrist pain were studied retrospectively. Eleven patients (69%) had no symptoms at follow-up: Five other patients later underwent distal ulnar resection. All patients over 40 years of age did poorly after the operation. The patients who had no symptoms showed no significant alteration in wrist function after partial excision of the TFC. Removal of a perforated TFC is contraindicated in the presence of radiocarpal or distal radioulnar arthritis.

Adolescent↗
PubMed1983

Reconstruction of the metacarpophalangeal joint with autogenous metatarsal.

Restoration of the articular surface of a damaged or lost metacarpal head is necessary for adequate function of the metacarpophalangeal joint. Although several salvage procedures have been described, none has been as satisfactory as the metatarsal transfer. This report describes the functional outcome of a patient who had a metatarsal transfer to replace the metacarpal involved by giant cell tumors. Follow-up 2 1/4 years after the transfer showed good maintenance of the joint space and excellent joint function.

Adult↗
PubMed1983

The problem of trapeziometacarpal degenerative arthritis.

Trapeziometacarpal arthritis commonly afflicts women older than 40 years of age. This may be due to the inherent shallowness of the saddle joint and the laxity of the volar ligaments. Compressive forces across this joint may be as high as 120 kg during strong grasp; hence, it is not surprising that it is frequently the site of osteoarthritis. Pain and swelling over the trapeziometacarpal joint are the earliest symptoms. As the disease progresses, subluxation of the metacarpal base and, later, collapse deformity of the thumb develop. Surgical treatment is indicated if all nonsurgical treatment fails. A bewildering array of surgical techniques is available to treat trapeziometacarpal arthritis, each having its proponents. Each of these procedures provides some degree of pain relief in a majority of patients. However, none of them fulfills the criteria of an ideal arthroplasty. Criteria for good results in the literature differ among authors. Quantitative analysis of objective measurements, e.g., grasp and pinch, although valuable in comparing the results of different techniques, vary so much among individuals that they provide inadequate information about the functional status of the hand. Range of motion of the operated thumb is frequently omitted, while compensatory motion at the distal joints is not given proper credit. No procedure can claim absolute superiority over another. In comparison with other techniques, interpositional arthroplasty, using the flexor carpi radialis tendon, is less complex and radical yielding satisfactory results when compared both objectively and subjectively.

Age Factors↗
PubMed1980

The vascularity of the lunate bone and Kienböck's disease.

The extraosseous and intraosseous vascularity of the lunate was studied in 35 fresh cadaver limbs. The specimens were injected with latex, debrided by a nondissection technique, and cleared by a modified Spalteholtz method. The extraosseous vascularity was profuse through two to three dorsal and three to four volar vessels feeding dorsal and volar capsular plexuses. One ot two nutrient vessels were observed entering the dorsal and volar poles of the lunate from both plexuses. The intraosseous vascularity formed one of three consistent patterns with anastomoses of dorsal and volar vessels in each specimen. The vascular patterns support a theory of compression fracture from repeated trauma as the most likely cause of Kienböck's disease.

Adult↗
PubMed1980

The vascularity of the scaphoid bone.

The extraosseous and intraosseous vascularity of the carpal scaphoid was studied in 15 fresh cadaver specimens by injection and clearing techniques. The major blood supply to the scaphoid is via the radial artery. Seventy to eight percent of the intraosseous vascularity and the entire proximal pole is from branches of the radial artery entering through the dorsal ridge. Twenty to thirty percent of the bone, in the region of the distal tuberosity, receives its blood supply from volar radial artery branches. There is an excellent collateral circulation to the scaphoid by way of the dorsal and volar branches of the anterior interosseous artery. An explanation for the cause of scaphoid necrosis on the basis of the vascular anatomy is proposed. The volar operative approach would be least traumatic to the proximal pole's blood supply.

Arm↗
PubMed1980

Interphalangeal joint destruction: a complication of cryotherapy.

Chondrocytes of the digital epiphyses, physes, and articular cartilage are particularly susceptible to the direct lethal effects of extremely low temperatures. We have treated a 13-year-old patient with chondral necrosis of the proximal interphalangeal joint following cryotherapy. Focal contact with the probe tip caused isolated, asymmetric physeal destruction.

Adolescent↗
PubMed1980

The peripheral pulse following arterial injury.

There has been little attention paid to the persistence of the pulse following complete forearm arterial transection, and we found no report that has established the etiology or frequency of this phenomenon. Eighteen patients with documented complete radial or ulnar artery transections were evaluated. Nine of the 18 patients had persistently palpable pulse distal to the transections. Seven of the pulses were due to retrograde flow and two were due to transmission from the proximal arterial stump or large collaterals. The Allen test was accurate in demonstrating arterial occlusion in each case. Digital compression of the intact artery eliminated the pulse in those cases due to retrograde flow. Documentation of flow direction and collateral vessels was performed with the Doppler directional velocity meter. The fallibility of the peripheral pulse following complete arterial injury is stressed. The Allen test, digital compression of the intact artery, and Doppler studies should be performed on patients with suspected arterial injuries. The exploration of all wounds in the region of major arteries from which profuse bleeding has occurred is recommended.

Arteries↗