PubMed Health⌕ Search

Biomedical subjects

M A Mital

Publications and source records attributed to M A Mital.

At least 19 recordsLinked to original sources
PubMed1995

Classification and surgical treatment of the thumb-in-palm deformity in cerebral palsy and spastic paralysis.

Over a 20-year period, 59 children with spasticity mainly due to cerebral palsy underwent surgery for correction of a thumb-in-palm deformity. A classification of the deformity based on the functional anatomy of the thumb divided the problem into four different types. A retrospective analysis of the results has shown the classification to be helpful in selecting a surgical option for treatment. In addition, the classification helps to keep accurate records, predict patient progress, and coordinate postoperative treatment.

Cerebral Palsy↗
PubMed1981

Treatment of pronation contractures of the forearm in cerebral palsy by changing the insertion of the pronator radii teres.

In twenty-two patients with cerebral palsy and a pronation contracture of the forearm, transfer of the pronator radii teres posteriorly to the anterolateral border of the radius converted it from a pronator to a supinator. Of the twenty-two patients so treated and followed for two to six years, 82 per cent were judged to have a good to excellent result since they had gained an average of 46 degrees of active supination compared with their preoperative status. There was no loss of motion with the passage of time and, determined by palpation, active contract of the transferred pronator teres was evident during voluntary supination. The procedure allowed the patients to improve function significantly by giving them the ability to supinate the forearm during activities requiring axial rotation of the forearm.

Adolescent↗
PubMed1980

The so-called unresolved Osgood-Schlatter lesion: a concept based on fifteen surgically treated lesions.

Of 118 patients with 151 knees treated for Osgood-Schlatter disease, fourteen patients (fifteen knees) had a distinct and separate ossicle at the proximal aspect of the tibial tubercle. This ossicle appeared after the child was first seen in all but three of the fifteen knees. When the ossicle failed to unite with the tubercle, the non-union was associated with local discomfort during activity and when direct pressure was applied on the tubercle. The symptoms did not respond to conservative treatment for an average of 3.8 years. Resection of the ossicle along with the adjacent bursa was followed by prompt relief of symptoms. Histological studies showed no evidence of avascularity. All ossicles were attached to the distal part of the undersurface of the ligamentum patellae and were separated from the tubercle by a bursa or scar tissue. The findings strongly support the concept that avulsion of the proximal cartilaginous part of the tibial tubercle is the cause of Osgood-Schlatter disease and they also suggest that once a separate ossicle is formed and becomes symptomatic, surgical excision is necessary to relieve the symptoms.

Adolescent↗
PubMed1979

Lengthening of the elbow flexors in cerebral palsy.

A procedure has been devised for treatment of the inability to extend the elbow due to either a fixed contracture of the flexor muscles or increased involuntary flexor-muscle tone and spasticity. The operation consists of lengthening all of the primary elbow-flexor muscles. It has been used successfully in thirty-two elbows of twenty-six children with cerebral palsy who were followed for an average of four years (range, two through six years). The average gain in extension was 40 degrees, and there was no loss of the patient's ability to flex the elbow or supinate the forearm. No vascular or neural complications were encountered. Independence in feeding was achieved in four patients. Seven patient acquired the ability to engage in sports and six, who previously had been unable to walk independently due to inability to handle crutches, could do so following this procedure.

Adolescent↗
PubMed1979

Congenital radio-ulnar synostosis: surgical treatment.

The results of an operative approach to the problem of radio-ulnar synostosis were assessed in thirteen patients, ten to twenty-five and one-half years after the procedure was performed. We concluded that in a patient with bilateral synostosis one hand, the one not used in writing, should be shifted to a position of 20 to 35 degrees of supination. With one hand in this position, the other may be left in considerable pronation. Often after such a shift it is not necessary to rotate the second arm. However, if the pronation is marked in the second forearm, and if function is impaired unduly by this position, surgical correction is indicated. The arm should be placed in a position of 30 to 45 degrees of pronation. In unilateral radio-unlar synostosis, the ordinarily ideal position of the radius is between 10 and 20 degrees of supination. In an adult, the patient's occupation should be considered in deciding on the rotatory positions of the forearms. We usually prefer a method of transverse osteotomy through the conjoined mass of the radius and ulna. Careful observation of the effect on the vascular status of the limb during and immediately after surgery is important.

Adolescent↗
PubMed1979

Pain in the knee in children: the medial plica shelf syndrome.

The medial plica shelf syndrome as a clinical entity should be added to the list of differential diagnoses as a possible cause of symptoms of internal derangement of the knee in children. It most frequently mimics chondromalacia of the patella and indeed may lead to it. It can be clinically suspected in the presence of the signs described in this report. The condition can be diagnosed early and accurately by arthroscopy and thereafter treated satisfactorily, with minimal morbidity. The results of such treatment not only have been gratifying over the period of follow-up (five to 32 months), but in all probability have prevented further serious damage to the knee.

Adolescent↗
PubMed1976

An approach to head, neck and trunk stabilization and control in cerebral palsy by use of the Milwaukee brace.

This paper reports the successful use of the Milwaukee brace in nine children with cerebral palsy and lack of head, neck and body control. After an initial period of apprehension, the brace has been approved by the patients themselves, their families, teachers and therapists and has added greatly to the quality of life within the limits of the patients' abilities. Follow-up has ranged from three months to five years (mean 3 1/2 years) and no deleterious effects have been noted.

Adolescent↗