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M H Gonzalez

Publications and source records attributed to M H Gonzalez.

39 records · Page 3Linked to original sources
PubMed1986

Scaphoid implant resection arthroplasty. Long-term results.

A silicone scaphoid implant was developed in 1967 to help improve the results of simple resection arthroplasty in the treatment of arthritic changes associated with advanced scaphoid disease. Patients who had scaphoid implant surgery since 1967 were studied. Preoperative and postoperative roentgenograms, charts, surgical pathology, and clinical evaluations were reviewed. A total of 55 cases of scaphoid implant arthroplasty were evaluated. A classification system was developed based on progressive severity, and treatment recommendations were developed for each stage of disease progression. Cystic and degenerative changes in contiguous carpal bones were evaluated. No evidence of cystic change could be found in 37 wrists, minimal changes were found in 9, moderate changes in 5, and severe changes in 4. There were no implant infections or fractures. Implant rotation occurred in two cases. Functional use of the hand with decreased pain was observed. It is important to detect and treat carpal instability, which may be associated with scaphoid disease. Cystic formation can be minimized by avoiding oversized implants, treating the associated carpal instability, bone-grafting preexisting cysts, and avoiding Kirschner wire fixation. By following treatment protocols as established in the classification system, the scaphoid implant can be successfully used in the management of scaphoid pathology.

Adult↗
PubMed1985

The effect of adjunctive methylmethacrylate on failures of fixation and function in patients with intertrochanteric fractures and osteoporosis.

In a retrospective review of eighty-two intertrochanteric fractures (twenty-nine stable and fifty-three unstable) in seventy-nine elderly, debilitated patients with associated advanced osteoporosis (Grade III or less by the system of Singh et al.), fifty-six were available for follow-up: twenty-eight that had been treated at the University of Illinois with an approximately anatomical reduction and compression-screw fixation and twenty-eight (in twenty-seven patients) that had been treated at the University of Chicago with an approximately anatomical reduction, compression-screw fixation, and adjunctive methylmethacrylate bone cement in the head-neck fragment. Follow-up analysis after an average of thirty-four months for the group that had augmentation with cement and an average of twenty-six months for the uncemented group showed that for the eighteen stable fractures that could be followed the rates of complications of fixation were the same in the two groups, while for the thirty-eight unstable comminuted fractures that were followed the rate of complications of fixation was lower when adjunctive methylmethacrylate cement was used. Among the unstable fractures, one failure (in twenty-one fractures) in the cement-augmented group and ten failures (in seventeen fractures) in the uncemented group were due to failure of fixation (p less than 0.01). For reasons that are not clear, when the thirty-two patients with a healed fracture who could be evaluated for function were rated using the Iowa hip score, the nineteen who were treated with adjunctive cement had significantly lower scores than did the thirteen who were treated without cement (76 +/- 16.5 compared with 92 +/- 12.1, p less than 0.01).

Aged↗