Biomedical subjects

J P Grossman

Publications and source records attributed to J P Grossman.

6 recordsLinked to original sources

PubMed1999

Puncture wounds of the foot. Evaluation and treatment.

Puncture wounds of the foot are a common injury, often occurring in the warmer months. Various objects have been described as the penetrating source in these wounds; however, nails and glass are the most common cause of pedal puncture wounds. All puncture wounds should be evaluated thoroughly and treated aggressively to reduce the risk of complications. Viewing this injury lightly may cause complications, and is often a source of litigation. A systematic approach to the evaluation and treatment of puncture wounds limits complications and results in a satisfactory outcome for the patient and physician.

Anti-Bacterial Agents↗

PubMed1997

Limb loss after lower extremity bypass.

BACKGROUND: Infrainguinal bypass now has a limb salvage rate approaching 90% at 10 years. This study helps elucidate the causes of limb loss despite bypass surgery. METHODS: A retrospective chart review of all patients undergoing a major lower extremity amputation after attempted bypass surgery. RESULTS: Between July 1987 and January 1997, 67 major amputations (52 below knee, 15 above knee) followed infrainguinal bypass for limb salvage in 64 patients. Of these patients, 53 (83%) were diabetic and 10 (16%) were on dialysis. The etiology of limb loss included thrombosed bypass (n = 33, 49%), lack of limb salvage despite patent bypass (n = 23, 34%), intraoperative bypass failure (n = 6, 9%), and exposed/infected bypass (n = 5, 8%). The 23 patients with patent grafts required amputations because of hindfoot necrosis (n = 6), persistent forefoot necrosis (n = 6), acute diabetic foot infection (n = 6), and various other reasons (n = 5). Using life-table analysis, survival for the whole group was 56% at 12 months and 17% at 48 months. Patients with limb loss despite a patent bypass fared the worst with survival of 21% at 2 years. CONCLUSIONS: Bypass thrombosis caused half of the amputations after limb salvage surgery. A patent bypass was functioning at the time of amputation in another third. Survival after failure of limb salvage was abysmal, especially in patients with patent bypasses.

Adult↗

PubMed1996

The Lapidus procedure.

Arthrodesis of the first metatarsal cuneiform joint has been described as a primary procedure for hallux abducto valgus repair since the early 1900s. Popularized by Paul W. Lapidus, this procedure has remained controversial since its introduction, falling in and out of vogue in the orthopedic and podiatric communities. The authors expound their experiences, using modified operative techniques and advanced internal fixation principles, with emphasis on proper patient selection and clinical results.

Adolescent↗

PubMedDate not supplied

Biological principles of bone graft healing.

Bone graft healing is a sequential process involving inflammation revascularization, osteogenesis remodeling, and incorporation into the host skeleton to form a mechanically efficient structure Successful incorporation is determined by the histocompatibility between host and donor. Although there is no antigenicity toward autografts, allogeneic bone may provoke an immune response. This response can be reduced through various bone processing techniques. Overall autogeneic and allogeneic bone transfers proceed to satisfactory results.

Antibody Formation↗

PubMedDate not supplied

Oblique medial malleolar osteotomy for the management of talar dome lesions.

The purpose of this retrospective study was to determine the efficacy of the oblique medial malleolar osteotomy for the management of medial talar dome lesions. Arthroscopy remains a viable option for the management of these lesions; however, the central and posteromedial lesions are often difficult to gain access to with arthroscopy and may require open arthrotomy. Fourteen oblique medial malleolar osteotomies were performed for the surgical management of medial talar dome lesions. Subjective data were collected through the process of questionnaire. Objective criteria consisted of radiographic evaluation and retrospective medical record review. Seven of the 14 patients related a history of trauma preoperatively. The oblique medial malleolar osteotomy demonstrated osseous union at an average of 6.6 weeks. There were no delayed unions or nonunions. None of the patients required a second operative procedure. Nine patients reported excellent postoperative results, two patients had good results, two had fair results, and one patient related a poor postoperative outcome with only 50% relief of pain. Patients greater than the age of 30 were found to have less favorable results. Follow-up ranged from 6 to 72 months, with a mean follow-up of 34 months.

Adult↗

PubMedDate not supplied

Off-loading techniques in the treatment of diabetic plantar neuropathic foot ulceration.

In the individual with diabetes mellitus, foot ulceration represents the single most important risk factor in lower-extremity amputation. The goal of treatment is to obtain a healed and closed wound that (1) eliminates a portal of entry for bacterial invasion and development of limb-threatening infection, and (2) allows for tissue loading. This manuscript reviews current off-loading approaches to the treatment of plantar neuropathic foot ulcers, along with advantages and disadvantages of those techniques.

Amputation, Surgical↗