Biomedical subjects

L Feldberg

Publications and source records attributed to L Feldberg.

10 recordsLinked to original sources

PubMed2004

Assessment of the severity of hand injuries using "hand injury severity score", and its correlation with the functional outcome.

INTRODUCTION: Objective assessment of hand injuries is a complex subject. However, an objective assessment, leading to a score, can help in predicting outcome and can be used as a research tool. Campbell and Kay have devised one such score known as "hand injury severity score" or HISS [J. Hand. Surg. [Br.] 21 (3) (1996) 295]. A study on this score has been carried out in our institute. The idea was to see if the hand injury severity score, correlates with the functional outcome as measured by disability arm shoulder and hand score (DASH), after a period of minimum 2 years. METHOD: All the hand injury patients admitted in the hospital were assessed at the time of admission, and objective information was documented on a hand injury documentation form. The form captured all the data required to calculate "hand injury severity score" . A sample of 70 patients admitted during the first 6 months of 1999 was taken and their scores were calculated. The sample was selected such, that it had a reasonable representation of hand injuries of all severities. After obtaining a due approval from ethics committee, all these 70 patients were sent a DASH questionnaire. A total of 23 patients replied. Spearman's rank correlation test was used to analyse the correlation between the severity of hand injury as assessed using HISS, and functional outcome as measured using DASH. Correlations between the outcome and skeletal component score, outcome and motor component scores, and outcome and Integument component scores, were assessed separately. RESULTS: The study shows a statistically significant association ( r = 0.7182, P = 0.000165) between the severities of injury and the functional outcome. The functional outcome also shows a statistically significant association with the severity of injury to skeletal component (r = 0.5151, P = 0.014083) and motor component (r = 0.6797, P = 0.000507). However, the severity of injury to integument component, as measured by HISS, does not show any association with the outcome (r = 0.3571, P = 0.102736). This study supports the overall structure of the HISS. However an improvement in the integument component scoring is required to improve overall accuracy.

Accidents, Occupational↗

PubMed2003

Mycobacterium malmoense septic arthritis.

We report a case of septic arthritis of an interphalangeal joint and osteomyelitis of the phalanx due toMycobacterium malmoense in a 61-year-old man with a 20 year history of rheumatoid arthritis treated with steroids and azathioprine. This was successfully treated with ethambutol, rifampicin and clarithromycin. To our knowledge this is the only reported case of septic arthritis due to this pathogen which is usually associated with respiratory disease or cervical lymphadenitis.

Antitubercular Agents↗

PubMed2003

Pseudoainhum in chronic psoriasis.

Pseudoainhum is a term used to describe the presence of constricting bands of the extremities due to a variety of underlying causes. Progression of the lesions can cause irreversible damage and autoamputation of the affected digit. This report documents a rare association of pseudoainhum and psoriasis and emphasizes the importance of recognizing this condition.

Adult↗

PubMed2001

Bizarre parosteal osteochondromatous proliferation with cortical invasion.

A 15-year-old male presented with an 18-month history of increasing swelling on the radial aspect of his left forearm. Radiographs and MR images showed a partly calcified mass on the lateral border of the radius with erosion of the underlying cortex. Following a CT-guided needle biopsy, the mass was excised by segmental resection of the radial shaft with replacement by a vascularised fibular graft. Histological examination of the resected specimen showed many features typical of a bizarre parosteal osteochondromatous proliferation (BPOP) but with destruction of the underlying cortical bone by cellular spindle cell tissue. Although there were no cytological signs of malignancy, we believe that this unusual disease should be regarded as a particularly aggressive form of BPOP and treated by wide excision. Clinical follow-up of our patient at 2 years shows no sign of local recurrence or metastasis.

Adolescent↗

PubMed1998

Primary repair of dog bites to the face: 40 cases.

Dog bites to the face can be life-threatening if major infection occurs, and traditional management consists of wound toilet and debridement, with repair only when the possibility of infection has been eliminated. Surgical opinion is now swinging towards earlier repair. We have analysed retrospectively the outcome of 40 cases that, irrespective of time delay between injury and presentation, underwent primary repair or reconstruction after wound toilet, debridement and administration of prophylactic antibiotics. The victims were 17 males and 23 females with ages ranging from 2 to 76 years (mean 25). Median delay between the injury and presentation in the emergency department was 60 minutes (range 7 minutes to 5 days). All patients received surgical treatment within 24 hours of admission, 18 being operated on within 6 hours. 31 had primary repairs and 9 patients had reconstructive procedures with local skin flaps or skin grafts. Primary healing was achieved in all but 2 patients, of whom one developed minor wound infection and one had necrosis of a composite graft. These results support the view that, for dog bites to the face, primary repair is the method of choice.

Adolescent↗

PubMed1997

Textured or smooth implants for breast augmentation? Three year follow-up of a prospective randomised controlled trial.

Silicone breast implant surface texturing has been shown to reduce the short-term incidence of adverse (Baker III/IV) capsular contracture in augmentation mammaplasty in double-blind randomised controlled trials. It is, however, undetermined whether the textured surface merely delays the onset of severe contracture or its effect on capsular contraction is persistent. The current study reviewed, after three years, 49 of the 53 patients who had undergone subglandular breast augmentation mammaplasty in a randomised double-blind study with textured or smooth silicone gel-filled implants in 1989. The incidence of adverse capsular contracture was 59% for smooth implants and 11% for textured ones (P = 0.001; chi 2 = 10.60). Eight patients (31%) with smooth prostheses underwent breast implant exchange for severe capsular contracture between the one and three year assessments, compared with a revisional surgery rate of only 7.4% (2/27 patients) for the textured group (P < 0.04). These adverse capsular contracture and revisional breast implant surgery rates clearly demonstrate that the effect of textured implants in reducing capsular contracture in augmentation mammaplasty found at one year is maintained at three years, and suggest that it may be long lasting.

Breast Implants↗

PubMed1996

Dupuytren's disease in children.

Although Dupuytren's disease of the hand has been reported in teenagers, it is generally considered to be a disease of adults. A series of nine children who developed Dupuytren's disease of the hand before the age of 13 years is presented. Eight had surgical removal of the diseased tissue and histological confirmation of the diagnosis before the age of 13 years and one at 14 years of age. The presence of the condition in young children and teenagers is discussed and the literature summarized.

Adolescent↗

PubMed1992

Cement burns and their treatment.

Twenty patients with cement burns presenting to Stoke Mandeville Hospital Burns Unit between 1981 and 1989 are described. They represent 1.8 per cent of the total adult patients treated at this unit. Fifteen (75 per cent) had surgery for full thickness skin burns. A questionnaire sent to all the accident and emergency officers employed within the catchment area of the Burns Unit at Stoke Mandeville Hospital showed important gaps in their knowledge of the subject. It is suggested that further publicity be given to this uncommon but potentially serious injury.

Accidents, Occupational↗

PubMed1991

Hand injuries from leading horses.

An estimated 3.5 million people ride horses in the United Kingdom (Cannon, 1989). Injuries consequent to falls are common (Edixhoven et al., 1981), but those sustained while leading horses are less well recognized. In eight cases inappropriate grip of the reins or halter rope while leading a horse or pony resulted in an avulsion injury to a finger or thumb. It is suggested that people at risk be informed of such injuries.

Adolescent↗

PubMed1991

Accessory palmaris longus muscle causing ulnar nerve compression at the wrist.

An accessory palmaris muscle that arose from the base of the fifth metacarpal passed proximally and inserted into the palmaris longus tendon. In its course it compressed the ulnar nerve and vessels. It was detached proximally and folded on itself to provide hypothenar bulk. The entrapment symptoms were relieved.

Humans↗