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Biomedical subjects

J Taleisnik

Publications and source records attributed to J Taleisnik.

At least 19 recordsLinked to original sources
PubMed1997

Radiolunate fusion. The forgotten partial arthrodesis.

Radiolunate fusion has been used successfully in the treatment of rheumatoid ulnar translation of the carpus and degenerative radiolunate arthritis. Fusing the lunate to the radius places the keystone of the carpus in an aligned and stable position. The use of radiolunate fusion has been introduced here for other treatment challenges including traumatic ulnar translation of the carpus, dynamic midcarpal instability, volar and static intercalated segment instability. Pain relief was excellent and preoperative range of motion was maintained with radiolunate fusion.

Arthrodesis↗
PubMed1996

Soft-tissue injuries of the wrist.

The wide spectrum of athletic activities places demands of different magnitudes, orientations, and degrees of repetition on the wrists of athletes. These demands can result in injuries to the soft tissues of the wrist, which may make optimal athletic performance difficult if not impossible. With the advent of increased awareness of injuries particular to a sport and advances in diagnostic acumen, both technologic and clinical, these once enigmatic pathologic entities can be approached with a treatment plan that often can return the athlete to competition quickly. A number of these injuries and their pathomechanics, diagnosis, and treatment options have been described in this article. Although adequate treatment of the subject of athletic soft-tissue injuries to the wrist requires a more lengthy discussion than is appropriate here, the material presented on dorsal pain disorders, carpal instability, and the triangular fibrocartilage complex should serve as a starting point for increasing cognizance and understanding of the injured wrist in the athlete.

Athletic Injuries↗
PubMed1992

Treatment of scapholunate dissociation by ligamentous repair and capsulodesis.

We believe that direct scapholunate ligamentous repair, supported by a dorsal radioscaphoid capsulodesis, should be considered for the treatment of most scapholunate dissociations when there is no osteoarthritis, regardless of the time that has elapsed since injury. We treated 24 patients by this technique between 1972 and 1988. The records of 21 were available for study. Average time from injury to surgical treatment was 17 months (range, 1 to 84 months). Results were evaluated clinically and by means of patient questionnaire and x-ray films. The significant change in range of motion was a loss of palmar flexion, which averaged 11.5 degrees. Grip strength, pain, and x-ray appearance improved in all cases. Only one patient had to change occupations after surgery because of wrist symptoms. Three had minimal x-ray degenerative changes, which did not result in increased pain or in loss of motion and grip strength. There were no complications.

Adolescent↗
PubMed1992

Treatment of scaphoid nonunion with casting and pulsed electromagnetic fields: a study continuation.

This article presents a continuation of a study of the treatment of scaphoid nonunion with pulsed electromagnetic fields (PEMF) and cast immobilization. Fifty-four patients were reviewed. The overall success rate for healing has decreased since the previous review from 80% to 69%. Proximal pole fractures healed in 50%. Success in nonunions with associated radiographic evidence of avascular necrosis decreased from 89% to 73%. Although we believe that the indications for use of PEMF have not changed significantly, this study suggests that a successful outcome with PEMF and casting is less likely than previously reported. We believe that until additional clinical studies have further defined the indications, treatment protocol, and efficacy of this method PEMF treatment should be a secondary alternative to bone-grafting procedures.

Adolescent↗
PubMed1992

The Sauvé-Kapandji procedure.

In 1936, Sauvé and Kapandji described a procedure that included an arthrodesis across the distal radioulnar joint and created a pseudarthrosis of the ulna, proximal to the fusion, to restore pronation and supination. The author has used this technique because preservation of the head of the ulna minimizes the potential for some of the complications that can follow its excision. Retention of the head of the ulna would secure a more normal transmission of loads across the wrist, maintain full support to the carpal condyle and to the extensor carpi ulnaris tendon, and preserve the normal contour and appearance of the wrist. This paper presents the author's experience using this procedure in 37 wrists with rheumatoid arthritis, osteoarthrosis and posttraumatic changes of the distal radioulnar joint, and chondromalacia of the head of the ulna. This is a satisfactory operation, although not infallible. It is probably contraindicated when treating the unstable or frankly subluxed or dislocated distal radioulnar joint, ulna dorsal, a therapeutic problem for which there is no reliable solution. Indications for the Sauvé-Kapandji technique are discussed in relation to other operations frequently used for the distal radioulnar joint.

Adult↗
PubMed1991

Pathologic fractures: a complication of microparticulate synovitis.

We report seven cases of pathologic fracture in adult patients that were seen an average of 5 years (range from 33 to 114 months) after silicone wrist (three) and trapezial (four) arthroplasty. All patients had initially done well after their operation. At return, all had radiographic evidence of generalized implant and intramedullary bone destruction, the latter always including endosteal scalloping and widening from cortical resorption. These radiographic changes may be less striking than the discrete osteolytic lesions seen after degeneration of carpal implants. Our patients represent examples of pathologic fracture as the end stage of untreated microparticulate synovitis, a consequence of prosthetic wear. Our experience suggests that careful and continuous follow-up justified after insertion of stemmed silicone implants, and that patients should be informed of the potential late complications of this procedure, including pathologic fracture.

Aged↗
PubMed1989

Rheumatoid arthritis of the wrist.

Rheumatoid deformity alone is not an indication for surgery; pain and loss of function are. For the wrist, the selection of the procedure depends on thorough clinical and radiographic evaluations for tendon and joint synovitis, tendon ruptures, nerve compressions, and deformity. Operative treatment varies with the patient's age, handedness, occupation, needs, and expectations. One or more of the following modalities may need to be used: joint and tendon synovectomy, tendon transfer, repair and relocation, ligament repair, ligamentodesis and capsulodesis, limited and total arthrodesis, arthroplasty with and without arthrodesis, and with and without endoprosthesis, and different techniques for the management of the painful distal radioulnar joint.

Arthritis, Rheumatoid↗
PubMed1987

Combined radiocarpal arthrodesis and midcarpal (lunocapitate) arthroplasty for treatment of rheumatoid arthritis of the wrist.

Arthroplasties for the wrist with rheumatoid arthritis are usually revised for the articulation between radius and carpus. The midcarpal joint is disregarded although it remains structurally better preserved and is therefore better suited for the preservation of stable motion. When the midcarpal surfaces are satisfactory, a radio-scapho-lunate fusion, accompanied by a midcarpal synovectomy, is an excellent procedure. When the midcarpal surfaces, particularly the head of the capitate, are also destroyed, the tendency has been to either perform a pan-arthrodesis, or to insert a wrist endo-prosthesis. For these severely unstable and destroyed wrists, a stabilization of the radiocarpal joint by arthrodesis, combined with preservation of motion at the midcarpal level by resection of the damaged head of the capitate and its replacement with a small implant has been done. This procedure has allowed all patients to retain a functional range of motion and to experience satisfactory relief of pain.

Adult↗
PubMed1987

Pain on the ulnar side of the wrist.

Pain on the ulnar side of the wrist is frequently encountered in clinical practice. Its causes may be difficult to diagnose and are best evaluated using a systematic sequence of clinical, radiographic, and special procedures. Soft tissue, articular, and osseous causes of ulnar wrist pain are reviewed.

Arthritis↗
PubMed1986

Treatment of nonunited scaphoid fractures by pulsed electromagnetic field and cast.

Thirty-five of 44 nonunited scaphoid fractures that were at least 6 months old healed in a mean time of 4.3 months during pulsed electromagnetic field (PEMF) treatment using external coils and a thumb spica cast. The mean time from the onset of the fracture to treatment was 40 months. No concurrent operation was performed. Follow-up time averaged 8.4 months. Eight of nine fractures with avascular necrosis healed. Five of eight fractures in the proximal third healed. Twelve (75%) of 16 patients treated in short-arm thumb spica casts and PEMF healed versus 22 (92%) of 24 patients treated initially in long-arm thumb spica casts and PEMF. We have found PEMF to be a reliable alternative method of treating nonunited scaphoid fractures. Because of the low risk, simplicity of use, and reliability, we recommend its consideration in the treatment of undisplaced, nonunited fractures without carpal instability less than 5 years after the injury. Treatment should initially begin with a long-arm cast.

Adolescent↗
PubMed1984

The extensor retinaculum of the wrist.

The dorsal retinaculum of the wrist consists of two layers: the supratendinous and the infratendinous. The infratendinous layer is limited to an area deep to the ulnar three compartments. There are six compartments for the tendons dorsal to the wrist separated by six longitudinal vertical septa. Each septum originates from the supratendinous retinaculum and inserts onto the radius. The sixth compartment for the extensor carpi ulnaris is complex. The tendon of the extensor carpi ulnaris is enclosed in an independent fibrous tunnel formed by the supratendinous retinaculum superiorly, the infratendinous retinaculum inferiorly, the sixth septum laterally, and the ulnar insertion of the retinaculum reinforced by longitudinal fibers called the "linea jugata" medially. Our findings support the concept of an adaptable dynamic collateral ligament system rather than the traditional radial and ulnar collateral ligaments.

Fascia↗
PubMed1984

Midcarpal instability caused by malunited fractures of the distal radius.

Thirteen patients with malunited fractures of the distal radius developed symptoms of pain and instability of the midcarpal joint. In six cases, a recurrent voluntary midcarpal subluxation was also present during ulnar deviation. These symptoms were first noticed several weeks, and at times several months, after all immobilization for the treatment of the original fracture had been discontinued. We believe that the loss of the normal palmar tilt of the distal articular surface of the radius prepositions the carpus in a dorsal collapse alignment, which enables this instability to develop. Although the instability is localized to the midcarpus , it is treated best, in our opinion, by a corrective osteotomy of the distal radius. In nine patients, osteotomies resulted in relief of preoperative symptoms and correction of midcarpal instability. In one patient, osteotomy of the radius was deemed unnecessary because the loss of palmar tilt of the radius was minimal. Instead the midcarpal ( triquetrohamate ) joint was stabilized by ligament reconstruction. Only transient correction was obtained, with later recurrence of the voluntary midcarpal subluxation.

Adolescent↗