Biomedical subjects

J Sosner

Publications and source records attributed to J Sosner.

6 recordsLinked to original sources

PubMed1996

Odontoid fracture and C1-C2 subluxation in psoriatic cervical spondyloarthropathy. A case report.

STUDY DESIGN: Case presentation and review of pertinent literature. OBJECTIVES: To present an unusual case and alert other physicians to possible missed diagnoses. SUMMARY OF BACKGROUND DATA: An unusual case is presented of a young man with server psoriatic spondyloarthropathy and fusion of C2-C7 (Type II cervical psoriatic ankylosing disease) who fell at home, sustaining an unrecognized fracture of the odontoid process leading to subluxation of C1-C2 and the transitory tetraplegia. The patient presented with torticollis, and the fracture was unrecognized for a long period of time. METHODS: Case presentation. RESULTS: This patient became independent in all activities of daily living after surgery and rehabilitation despite persistence of torticollis. CONCLUSIONS: A patient who presents clinically with traumatic torticollis after minor trauma and who also has psoriasis and ankylosis of the cervical spine should be suspected of having a fracture-subluxation until definitely proven otherwise. In the present case, the late diagnosis delayed surgical stabilization.

Adult↗

PubMed1995

The instrumented walker: usage patterns and forces.

Studies documenting the forces that are transmitted through a walker's frame are still scant. The purpose of this study was to evaluate the pattern and magnitude of forces that are transmitted through the frame of a walker during ambulation. A standard aluminum walker was instrumented. Gauges, which were mounted on all four legs, recorded axial, frontal, and sagittally oriented forces. A custom made computerized system registered the forces during 30 seconds of data acquisition. Twelve patients with ambulation dysfunction were tested with this system. Two different usage patterns emerged from the study. One usage pattern was observed in patients who were using the walker as a mean to reduce the amount of weight transmitted through the lower extremity. The second pattern was observed in patients with severe balance problems. These patients used the walker to enhance their balance and stability. The system described allows walker usage pattern analysis. Better understanding of force distribution and usage patterns may lead to improved or new walker design.

Adult↗

PubMed1995

Heterotopic ossification: treatment of established bone with radiation therapy.

Ectopic bone formation or heterotopic ossification (HO) is frequently seen on rehabilitation units after total hip arthroplasties, burns, and neurological injuries. Currently the major role for treatment is in prophylaxis and the major methods include anti-inflammatory medications, irradiation, and diphosphanate administration. These prophylactic measures are generally considered to be ineffective for the treatment of ectopic bone once it has already formed. We describe two cases of HO for which a radiation therapy protocol was used to treat established, ectopic bone after it had become problematic. Both patients were found to have increased range of motion and decreased complaints of pain after treatment, though no gross plain film x-ray changes were noted. We conclude that radiation therapy may be useful not only for prophylaxis of heterotopic ossification but for ectopic bone after it has been formed, especially when pain and progressively decreased range of motion are problematic.

Adult↗

PubMed1994

Total knee arthroplasty in Parkinson's disease.

Total knee arthroplasty in Parkinson's disease (PD) has been reported only twice in the literature. Parkinson's disease is considered a contra-indication for total knee replacement by some authors. We report on a 77-year-old man with PD who underwent total knee arthroplasty for severe degenerative joint disease. The patient had a somewhat prolonged but successful rehabilitation as an inpatient and continued to make gains following discharge. Currently he is an independent functional ambulator. Based on our experience with this patient, we recommend that patients with PD who maintain ambulatory function prior to surgery and are cognitively able to integrate new knowledge and follow commands should be considered candidates for total knee replacement if it is indicated. Our patient demonstrates, however, that even in patients suffering from mild PD the rehabilitation process may be significantly prolonged and more difficult than in patients without PD. Objective studies evaluating the role of pre-surgical rehabilitation are needed.

Aged↗

PubMed1993

Needle electromyography of the diaphragm: a new technique.

Electrodiagnostic evaluation of diaphragmatic function has consisted of phrenic nerve stimulation and surface or esophageal recordings of the electrical activity of the diaphragm. Needle electromyography of the diaphragm has rarely been reported because of the perceived danger of this procedure. We describe a new technique for needle electromyography of the diaphragm. An EMG electrode is placed in the costal insertion of the diaphragm under the 8th, 9th, or 10th rib cartilage, distant from the major vessels, pleura, lungs, and abdominal viscera. Diaphragmatic denervation was found in 42 of 81 patients using this method. There were no complications related to the procedure. Needle electromyography of the diaphragm provides important information in the diagnosis and management of respiratory dysfunction.

Adult↗

PubMed1993

Progressive supranuclear palsy: clinical presentation and rehabilitation of two patients.

Progressive supranuclear palsy (PSP), is an infrequent movement disorder characterized by supranuclear ophthalmoplegia, pseudobulbar palsy, and axial dystonia with frequent and unpredictable falls, usually backward. Median survival from time of diagnosis is two years. When diagnosis is reached, the patients are usually disabled and unable to ambulate independently. No specific rehabilitation protocol has been described for PSP. This article examines our rehabilitation experience with two PSP patients and our management of their frequent and unpredictable falls. The rehabilitation program consisted of a thorough physical evaluation; cognitive and speech evaluation and training; exercises to improve strength and coordination; and static and dynamic balance training. In order to improve safety during ambulation, we provided the patients with a heavy shopping cart or wheelchair that they could grab when in danger of losing their balance. The patients were able to achieve independence in ambulation.

Aged↗