Biomedical subjects

Kevin M Kaplan

Publications and source records attributed to Kevin M Kaplan.

3 recordsLinked to original sources

PubMed2007

Glove tears during arthroscopic shoulder surgery using solid-core suture.

PURPOSE: Surgeons have noticed an increased incidence of finger lacerations associated with arthroscopic knot tying with solid-core suture material. This study examines glove perforations and finger lacerations during arthroscopic shoulder surgery. METHODS: We collected 400 surgical gloves from 50 consecutive arthroscopic shoulder repair procedures using No. 2 solid-core sutures. Two surgeons using double gloves were involved in every case, with one being responsible for tying all knots. Powder-free latex gloves were worn in all cases. Knots consisted of a sliding stitch of the surgeon's preference followed by 3 half-hitches via a knot-pusher instrument. All gloves were inspected grossly and then tested for tears with an electroconductivity meter. RESULTS: The knot-tying surgeon had significantly more glove tears than the control (P < .01). Tears were localized to the radial side of the index finger of the glove at the distal interphalangeal joint in all cases. Of the tying surgeon's gloves, 68 (34%) were found to have tears. These included 17 inner gloves (17%) and 51 outer gloves (51%). If an inner glove was torn, the corresponding outer glove was torn in all cases. A mean of 3.96 knots were tied in each case. There was a significantly higher incidence of inner glove tears when more than 3 knots were tied (P < .03). There was no significant difference in glove tears between suture types. Finger lacerations did occur in the absence of glove tears. However, in the presence of an inner glove tear, there was a statistically significant association with a finger laceration at the corresponding level (P < .03). CONCLUSIONS: Intraoperative glove tears and subsequent finger lacerations occur with a high frequency when arthroscopic knots are tied with solid-core suture material. Risk can potentially be minimized by frequent glove changes or use of more durable, less penetrable gloves. CLINICAL RELEVANCE: This study addresses surgeon and patient safety during arthroscopic shoulder surgery.

Arthroscopy↗

PubMed2006

Total hip arthroplasty in a patient with contralateral hemipelvectomy.

Total hip arthroplasty has evolved in regard to surgical technique, implant design, and long-term survivorship over the last several decades with excellent clinical results. Owing to these improvements, indications for surgery have expanded to include a greater variety of patients. We present the case of a 62-year-old man who underwent total hip arthroplasty 39 years after contralateral hemipelvectomy. The importance of an appropriate preoperative plan in regard to patient positioning and postoperative protocol is addressed. Our patient was informed that data concerning his case would be submitted for publication.

Arthroplasty, Replacement, Hip↗

PubMedDate not supplied

Embryology of the spine and associated congenital abnormalities.

BACKGROUND CONTEXT: The spine is a complex and vital structure. Its function includes not only structural support of the body as a whole, but it also serves as a conduit for safe passage of the neural elements while allowing proper interaction with the brain. Anatomically, a variety of tissue types are represented in the spine. Embryologically, a detailed cascade of events must occur to result in the proper formation of both the musculoskeletal and neural elements of the spine. Alterations in these embryologic steps can result in one or more congenital abnormalities of the spine. Other body systems forming at the same time embryologically can be affected as well, resulting in associated defects in the cardiopulmonary system and the gastrointestinal and genitourinary tracts. PURPOSE: This article is to serve as a review of the basic embryonic development of the spine. We will discuss the common congenital anomalies of the spine, including their clinical presentation, as examples of errors of this basic embryologic process. STUDY DESIGN/SETTING: Review of the current literature on the embryology of the spine and associated congenital abnormalities. METHODS: A literature search was performed on the embryology of the spine and associated congenital abnormalities. RESULTS: Development of the spine is a complex event involving genes, signaling pathways and numerous metabolic processes. Various abnormalities are associated with errors in this process. CONCLUSION: Physicians treating patients with congenital spinal deformities should have an understanding of normal embryologic development as well as common associated abnormalities.

Humans↗