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Biomedical subjects

L Erhard

Publications and source records attributed to L Erhard.

13 recordsLinked to original sources
PubMed2004

[Primary Swanson metacarpophalangeal joint arthroplasty in major hand traumas. A report of two cases at 14 years follow-up].

In major hand injuries, destroyed joints may be treated by joint transfer, arthroplasty or fusion with or without temporary external fixation. Four immediate digital metacarpophalangeal joint Swanson implants in two patients with amputation or devascularizated near-amputation were reviewed with a 14 years follow-up. No infection was noted. Prostheses were stable with a 31 degrees active range of motion and grip strength was 42% of the opposite side. Functional results were "useful" with patients satisfaction. In one patient, heavy manual worker, implants were replaced fourteen years after trauma because of recent pain on one joint and implants fragmentation. The other patient was painless. Immediate Swanson arthroplasty in major hand injuries may be an alternative in metacarpophalangeal joints destruction.

Adult↗
PubMed2002

[Secondary treatment of digital mutilations: reconstruction or amputation].

Decision for stump improvement, shortening or reconstruction after finger mutilation is based on multiple factors. Some of them belong to the patient, age, psychological background, job and leisure activities and cosmetic expectation. Others belong to the injury, its mechanism and the anatomical lesions. Abstention, prostheses and rehabilitation are among the options. Conventional techniques are not to be forgotten as age remains an ultimate frontier in microsurgical reconstruction to obtain a good sensory result. Function and appearance are closely linked for a useful and a used hand.

Adolescent↗
PubMed2001

Tensile properties of suture methods for repair of partially lacerated human flexor tendon in vitro.

The decision to treat zone II partially lacerated flexor tendons is challenging, because there can be justification for either repair or no repair, depending on the surgeon's assessment of the strength of the residual intact portion of the tendon. In this study tensile properties of various repair techniques were compared. Cadaveric human flexor tendons (n = 118) were lacerated to 75% of their cross-section and repaired with either a core suture method (Kessler, modified Kessler, Savage, Lee, augmented Becker, or Tsuge all finished with a circumferential running suture), an epitendinous suture alone (circumferential or partial), or the tendons were left unrepaired. Among the core suture methods there was no significant difference (p >.05) in maximum failure force (overall mean, 211.2 N; SD, 53.2) or force to produce a 1.5-mm gap (74.1 N; SD, 49.7). Likewise there was no significant difference (p >.05) in tendon stiffness (41.0 N/mm; SD, 14.0) or resistance to gap formation (52.3 N/mm; SD, 23.1). In comparison, repairs without the core suture, including unrepaired tendons, were significantly weaker (144.7 N, p <.001) and had a marginally lower stiffness (p =.04) but had a similar resistance to gap formation (43.5 N/mm).

Hand Injuries↗
PubMed1999

Carpal tunnel release by the Agee endoscopic technique. Results at 4 year follow-up.

Ninety-five hands (86 patients) were treated by endoscopic carpal tunnel release using the technique of Agee. They were the first ones operated on by the senior author (GF) using this technique. The patients were interviewed at a mean follow-up of 4.5 years: 72% of hands were free of symptoms and 94% were described by the patients as functionally normal. Seventeen hands (out of 27) with residual or recurrent symptoms were examined. Nine hands (nine patients) were only partially improved (mean 6.7 on a 10 point scale) and in eight hands (seven patients), some symptoms had recurred after a mean delay of 3.8 years. It was possible to find a second pathology in most of these cases. It is necessary to inform the patient before operation that incomplete relief or recurrence of symptoms can occur after endoscopic carpal tunnel release, as with conventional release.

Adult↗
PubMed1999

[Anatomical study of the interosseous membrane of the forearm].

The authors have dissected 20 forearms of human cadavers to study anatomy and some functions of the IOM. The fibers bundles of the IOM were arranged in one plane descending obliquely and distally from the radius to insertion to the ulna. Central band of the IOM was easily found and was thick. It's a resistant ligament for longitudinal stability of the radius. Now, it's important to know anatomical alignment of the IOM because ultrasound imaging can be used for diagnosis of its rupture or elbow injuries and in a early future, surgical methods of repair or reconstruction of IOM will be developed.

Forearm↗
PubMed1998

[Joint denervation, a simple response to complex problems in hand surgery].

STUDY AIM: In patients with preserved mobility and stability a painful joint remains a difficult problem, especially in elderly patients. All operations, including intracarpal arthrodesis, reduce an already limited mobility, require prolonged immobilization and have a high rate of complications. Denervation could be proposed in such cases. MATERIALS AND METHODS: In our study denervation was performed on 132 wrists, 36 first carpo-metacarpal joints and 32 proximal inter-phalangeal joints. RESULTS: We have been disappointed in the past by partial wrist denervations. Fifty cases of complete and isolated wrist denervation were reviewed with a mean 5-year followup. Strength and mobility were only marginally improved but pain was decreased by a mean 75% (on a visual analog scale) in 74% of patients. At the proximal inter-phalangeal joint level, the mean pain improvement was 88% in 85% of patients. At the first carpo-metacarpal joint level, results of denervation were less predictable and the mean pain improvement was 67% in 81% of patients, with a mean 17-month follow-up. CONCLUSION: Joint denervation is a simple but precise operation performed under local anesthesia and on an outpatient basis. It provides good results in elderly patients, with few complications.

Adult↗
PubMed1998

[Skin problems in severe retraction stiffness of the hand and fingers. Role of the so called "castle" flap].

Skin retraction is a commonly observed complication of severe joint stiffness in the hand. After freeing the joint, this raises the problem of closing the skin without tension to avoid necrosis, disunion or pain during early rehabilitation and splinting. We have used a simple rotation flap for PIP extension (and hyperextension) stiffness and a "castle" flap for PIP flexion retraction and for both extension and flexion stiffness of the MPJ. It consists in withdrawing the skin (dorsal or palmar) of the phalanx distal to the freed joint. We have used this flap in 13 clinical cases of severe stiffness and it allowed wide access to all structures involved and facilitated early post-operative mobilization.

Contracture↗
PubMed1998

[What's new concerning carpal tunnel syndrome?].

Despite its frequency, carpal tunnel syndrome is still a subject of debate in the literature. Is a clinical diagnosis sufficient to justify the indication for surgery? Electromyography appears to play a very important role and, apart from its diagnostic and medicolegal value, may reveal associated lesions able to account for persistence of certain symptoms in the medium- or long-term; about which the patients must be informed. More general social questions are raised by the recognition of occupational carpal tunnel syndrome and its economic implications. Medical treatment by nocturnal resting splint still has a real place and endoscopy constitutes an alternative to classical open surgery. Surgical techniques must comply with rigorous rules, the only way of ensuring security and prevention of recurrences, which are difficult to treat.

Adrenal Cortex Hormones↗
PubMed1986

Biochemical polymorphism in Egyptian Baladi cattle and their relationship with other breeds.

Gene frequencies were estimated in a sample of Baladi cattle for milk proteins, blood proteins and blood groups. Gene frequency estimates of Bos taurus, Bos indicus and Sanga breeds were assembled from the literature. The gene frequencies were utilized for estimating the genetic distance between the breeds and breed groups. The Egyptian Baladi cattle appeared to be closer to Bos taurus breeds than to the Sanga. They are far removed from Zebus.

Alleles↗