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K J Favero

Publications and source records attributed to K J Favero.

9 recordsLinked to original sources
PubMed1998

Gadolinium-enhanced dynamic MRI of the fractured carpal scaphoid: preliminary results.

The aim of the present report was to evaluate the vascularity of fracture fragments of the fractured carpal scaphoid in the acute (< 4 weeks) and chronic (> 3 months) phases using a gadolinium-enhanced dynamic MRI sequence. Eight patients with acute scaphoid fractures, six patients with chronic scaphoid fractures, and three control patients without fractures were evaluated using a T1-weighted fast spoiled gradient recalled acquisition (fSPGR) sequence with gadolinium-DTPA enhancement (0.1 mmol/kg bodyweight). Signal intensity over time plots were obtained using region of interest measurements from both fracture fragments. Enhancement factors (EF) were then calculated from the plots. No enhancement of the scaphoid was seen in control subjects (EF: distal scaphoid pole 1.04 +/- 0.01, proximal pole 1.07 +/- 0.08). In acute fracture patients, enhancement of the distal pole was greater than that of the proximal in all cases but one in which the two poles enhanced in a similar fashion (EF: distal 1.99 +/- 0.77, proximal 1.43 +/- 0.99). In chronic fracture patients the enhancement pattern was reversed, as the proximal pole enhanced to a greater degree than the distal with the exception of one case where both poles enhanced equally (EF: distal 1.74 +/- 0.52, proximal 2.64 +/- 0.50). Using a two-tailed non-parametric Mann-Whitney U-test, the difference in enhancement of the proximal poles between the acute and chronic groups was found to be highly significant (P < 0.003). Dynamic contrast-enhanced (fSPGR) MRI demonstrates significant differences in the enhancement patterns of the scaphoid when chronic and acute fractures are compared.

Adult↗
PubMed1996

Extrinsic radiocarpal ligaments: magnetic resonance imaging of normal wrists and scapholunate dissociation.

OBJECTIVE: To determine whether magnetic resonance imaging [MRI] in planes of imaging parallel to the known course of the extrinsic radiocarpal ligaments of the wrist aids in the visualization of these structures. SUBJECTS AND METHODS: MRI was performed on 32 wrists: a single normal cadaveric wrist, 23 normal wrists in volunteers and 8 wrists in patients with known scapholunate dissociation and rotatory scaphoid subluxation. Proton-density and T2-weighted images were obtained in the sagittal plane and gradient recalled echo images in an oblique sagittal plane, selected to parallel the extrinsic radiocarpal ligaments. The images were interpreted by two musculoskeletal radiologists. Each of the six main extrinsic ligaments was assessed for visualization or nonvisualization, and the morphologic features of those visualized were documented. RESULTS: With the exception of the dorsal radioscaphoid ligament, the volar and dorsal extrinsic radiocarpal ligaments were all consistently visualized in the normal wrists. For the eight cases of scapholunate dissociation, MRI demonstrated underlying rupture or thickening of the volar radioscaphocapitate ligament in all wrists and of the dorsal radiolunate ligament in five. CONCLUSION: MRI in the true and oblique sagittal planes can consistently demonstrate the extrinsic radiocarpal ligaments of the wrist. With this technique, extrinsic ligamentous abnormality can be demonstrated in patients with scapholunate dissociation and rotatory scaphoid subluxation.

Adult↗
PubMed1994

Arthrography of the contralateral, asymptomatic wrist in patients with unilateral wrist pain.

To determine the significance of arthrographic abnormalities in patients with unilateral wrist pain, the authors compared the prevalence and site of intra-articular ligament perforation in asymptomatic and symptomatic wrists of the same group of patients and correlated asymptomatic perforation with age, hand dominance and hand overuse. Thirty-seven patients (29 men and 8 women ranging in age from 19 to 61 years) who had unilateral wrist pain and positive arthrographic findings for the symptomatic wrist underwent radiocarpal arthrography of the asymptomatic wrist. Three radiologists blinded as to the clinical findings examined the images for perforation in the triangular fibrocartilage complex, the lunotriquetral ligament and the scapholunate ligament. Intra-articular ligament perforations were found in 33 (89%) of the 37 asymptomatic wrists. Seventeen (46%) of the 37 patients had symmetric sites of perforation in the two wrists. Perforation of the triangular fibrocartilage complex occurred in 22 (59%) and 19 (51%) of the symptomatic and asymptomatic wrists respectively, of the lunotriquetral ligament in 13 (35%) and 7 (19%) respectively and of the scapholunate ligament in 13 (35%) and 11 (30%) respectively. No significant correlation between asymptomatic perforation and age or hand overuse was found (chi 2 test, Fisher's exact test). The authors conclude that asymptomatic perforation is common, even in young patients, so ligament perforation is not necessarily the cause of wrist pain in patients with such pain. However, for patients with the appropriate clinical findings, arthrography can be used to confirm or exclude ligament perforation.

Adult↗
PubMed1993

Transfer of innervated latissimus dorsi free musculocutaneous flap for the restoration of finger flexion.

Transfer of functioning free muscle for the restoration of finger flexion is an uncommon procedure. We present our experience with five patients with severe forearm injuries in whom a latissimus dorsi musculocutaneous free tissue transfer was performed in an attempt to provide soft tissue coverage and active digital flexion. Four patients had active finger flexion with volitional control of the transferred muscle between the tenth and the fifteenth weeks. On average, active flexion lags were 2.0 cm in the index finger, 2.1 cm in the long finger, 2.3 cm in the ring finger, and 1.4 cm in the small finger. Although preoperative grip strength was doubled, postoperative strength was still only about 31% of that on the opposite side. All patients required at least one tenomyolysis or revision tenorrhaphy before the best clinical outcome was achieved.

Adolescent↗
PubMed1989

The quadrangular fragment fracture. Roentgenographic features and treatment protocol.

The quadrangular fragment fracture is a clinically discrete type of cervical lesion that poses a difficult management problem. Physically, it resembles the triangular fragment fracture or teardrop fracture, but it responds very poorly to posterior fusion, the conventional treatment for these fractures. It is characterized by a quadrangular-shaped fragment from the anterior one-third of the vertebral body, a significant degree of posterior subluxation, an angular kyphosis, and an increased interspinous space with facet subluxation due to disruption of the soft tissues. Recognition of the quadrangular fragment may help determine the treatment protocol. A group of 23 patients with quadrangular fragment fracture was treated with the standard protocol and had poor results, including difficulty in maintaining reduction, neck pain, and significant residual kyphosis. A second group of 15 patients received kyphosis. A second group of 15 patients received the second treatment protocol, which consisted of one to two weeks of skull traction over an extension bolster, followed by an anterior interbody strut graft to stabilize the fracture and further traction over an extension bolster until four weeks postinjury. Treatment minimized the angular kyphosis apparent at bony healing, and all patients achieved satisfactory union with good alignment and no significant neck pain.

Adolescent↗
PubMed1987

Ulnar nerve laceration--a complication of carpal tunnel decompression: case report and review of the literature.

Complications of peripheral nerve injury arising from the surgical treatment of carpal tunnel syndrome are not uncommon. No documented report of the association of ulnar nerve injury with carpal tunnel decompression has been found. This case-study describes partial laceration of the ulnar nerve as a complication of carpal tunnel surgery and reviews the literature on this subject.

Adult↗
PubMed1987

Neuralgic amyotrophy.

Thirty-nine patients with neuralgic amyotrophy were reviewed. In addition to the clinical findings reported in the neurological literature, we commonly found pain throughout the upper limb, and diffuse involvement of the brachial plexus. Five patients had spinal accessory nerve lesions and five had glenohumeral instability. Sixty-four per cent of the patients had had an orthopaedic consultation during their acute illness. It is therefore important that orthopaedic surgeons are aware of this clinical syndrome and its management. The prognosis is excellent with non-invasive treatment.

Adult↗
PubMed1985

Femoral neck fractures in skeletally mature patients, fifty years old or less.

We studied the cases of thirty-two skeletally mature patients, fifty years old or less, who had a fracture of the femoral neck. In all patients with a stage-1 or 2 fracture, the fracture healed without osteonecrosis. Among the stage-3 and 4 fractures, the rate of non-union was 5.5 per cent and that of osteonecrosis, 33 per cent (3 and 18.8 per cent, respectively, for the whole group). Three patients with osteonecrosis required revision to arthroplasty at six, sixty-eight, and ninety-nine months. Three others had good function of the hip at forty-eight, ninety-six, and 129 months despite the development of osteonecrosis. Treatment of these fractures yielded very good results over-all, and even the occurrence of osteonecrosis did not necessarily cause an unsatisfactory result.

Adolescent↗