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Biomedical subjects

N Gould

Publications and source records attributed to N Gould.

At least 37 records · Page 2Linked to original sources
PubMed1982

Transcutaneous muscle stimulation as a method to retard disuse atrophy.

Thirty healthy, young adults (18 to 25 years of age), were volunteers in a three-group study to determine the efficacy of transcutaneous electrostimulation as a means of preventing atrophy of normal musculature on wearing a long-leg cast. Each group of ten subjects (five males and five females) were chosen by lot: Group I, nonisometric, Group II, isometric, Group III, TMS electrostimulated thigh and calf muscles. There was little difference in the findings in Groups I and II, and each lost an appreciable amount of muscle mass and power after just two weeks of immobilization. However, in the electrostimulated group muscle atrophy was one-half that of the other groups in the thigh area and one-fifth that of the others in the calf area. In addition, the calf musculature retained its bulk and power with actual increase in a few of the less athletic individuals. Trancutaneous muscle stimulation offers great promise for surgically treated or impaired extremities, enabling early return to activity with optimal function.

Adolescent↗
PubMed1981

Hallux rigidus: cheilotomy or implant?

Fifty-one feet in 42 patients with varying degrees of symptomatic hallux rigidus and with 2 years of follow-up have been operated with excellent results. Cheilotomy was performed in all cases with only cheilotomy employed in the young patients and implant surgery (single-stem silicone) reserved for the older and more advanced arthritis cases. Pain generally disappeared within 3 months. Range of toe motion in dorsiflexion increased. All patients returned to their activity of choice. All patients were able to utilize off-the-shelf footwear postoperatively. There have been no fractures or inflammatory reactions of the implants as yet, including those inserted 4 or more years ago.

Adolescent↗
PubMed1981

Surgical treatment of stenosing tenosynovitis at the ankle.

Twelve cases of stenosing tenosynovitis about the ankle (eight posterior tibial and four peroneal), with at least 2 to 4 years of follow-up, have been successfully relieved of their symptoms and returned to increased activity by utilizing a simplified comprehensive surgical technique. Surgery consists of: 1) appropriate treatment to the tendon itself whether intact, partially ruptured, or completely ruptured; 2) deepening of the constricted groove; 3) fashioning of new pulleys from available sheath and retinaculum; and 4) construction of a new sheath from regional deep fascia. Postoperative management includes non-weightbearing, soft bandages, and home exercise therapy for 1 month, followed thereafter by intensive home therapy buildup of the involved muscle and orthoses. Pathology findings included thickening of the tendon sheath, varying degrees of fibrosis of the tendon itself, with or without rupture, and reactive hypertrophy of the bone at the involved groove.

Adolescent↗
PubMed1981

Stenosing tenosynovitis of the flexor hallucis longus tendon at the great toe.

The purpose of this paper is to call attention to the previously overlooked entity, stenosing tenosynovitis of the flexor hallucis longus tendon in the sesamoid area of the great toe. Nine patients have been tabulated and successfully treated during the past 4 years, with an average 2 1/2-year follow-up. Trauma seems to be the causative factor. Five cases had accompanying pathology. Three cases responded to inflation of the tendon sheath with 1% lidocaine anesthesia, but the remainder required tenolysis of the sheath plus surgery to the accompanying pathology for relief. Early recognition of this problem and prompt inflation with lidocaine may be the only required treatment if this is the only entity. Chronic cases will respond to tenolysis. A plantar full visualization surgical approach is recommended.

Adolescent↗
PubMed1980

Epidemiological survey of foot problems in the continental United States: 1978-1979.

Questionnaire cards were sent to 45,000 family shoe store customers; 15,000 cards were completed and returned, thereby permitting a broad statistical base in respect to the incidence and types of foot problems encountered in the United States. The incidence of corns, calluses, warts, ingrown toenails, bunions, hallux rigidus, hammer toes, cavus, and pes planus were correlated with age, sex, race, and demographic background, along with the incidence of surgery, conservative treatment, or no treatment. The extrapolated data indicated that 40% of the population have foot problems, of which 12% had surgery and 7% have been untreated.

Adolescent↗
PubMed1980

Early and late repair of lateral ligament of the ankle.

Utilizing an apparatus for separately testing the status of the anterior talofibular and the calaneofibular ligaments of the ankle in 25 healthy, 15- to 30-year-old adults, it became apparent that the stability of the ankle depends primarily upon the integrity of the anterior talofibular ligament. When the "fore n' aft" stress measurement exceeds 4 mm, a positive anterior drawer test is elicited, and the ankle ligament needs surgical repair. Tibial talar tilt normals ranged up to 18 degrees. Repair (early and late) is accomplished by suturing what one finds (there is always some ligament present) and reinforcing the anterior talofibular ligament repair with overlap of the nearby lateral talocalcaneal ligament plus the marginal ankle retinaculum. Four weeks in a plaster of paris walking cast are followed by use of Ace bandages of 2 weeks. Light activity is begun 6 weeks after repair, and activity of choice is begun 8 weeks after repair. Repeat stress testing is performed at 3 months postsurgery, and a questionnaire is completed at the same time. On a point system (1 to 10) reviewing pain, stability, and swelling, the results in 50 cases rate from 8 to 10, with a lower rating improving with more time. Surgical time is approximately 30 minutes. There seems to be no need for more radical surgery utilizing other muscles. The senior author has employed this surgery for the past 19 years with approximately 165 cases. Only 50 patients with proper 3-month postoperative stress testing and questionnaire follow-up, who were operated upon 1 or more years ago, area recorded here.

Adolescent↗
PubMed1980

Stenosing tenosynovitis of the pseudosheath of the tendo Achilles.

This entity consists of a chronic inflammatory process of peritenon of the tendo Achilles (usually bilateral) at variable points of the tendon itself but usually near the insertion in the Achilles. Its occurrence, but not only in runners but in relatively sedentary individuals of both sexes, seems to be the result of microtrauma of stress with insidious onset of local pain in increasing degree with physical activity. Clinically, in the advanced cases, fibrillation, nodulation, and "yellowing" of the edematous tendon occur and probably are a precursor to later ruptures. Pathological changes consist of one or more of the following: a myxomatous degeneration of collagenous tissue; fibrosis; round cell inflammatory infiltrate; and proliferation of fibrovascular connective tissue. The use of steroid injections seems to be of no help and probably is contraindicated. Surgery consists of excision of the entire pseudosheath, allowing the tendon to assume a new, nonconstricting alignment. All but one of the nine patients with a follow-up of at least 1 year went on to clinical, painless recovery, with unrestricted future activity, in just a few months.

Achilles Tendon↗
PubMed1971

A proper chair.

Explore the source record for details and available documents.

Aged↗
PubMedDate not supplied

Surgery of the forepart of the foot in rheumatoid arthritis.

The purpose of this paper is to introduce a surgical approach to treatment of severe forefoot deformities of rheumatoid arthritis. Briefly, the surgery consists of base of the first metatarsal osteotomy to correct metatarsus primus varus, and metatarsal head resection beginning with the fifth metatarsal and carried around in crescentic fashion through the necks of the other metatarsals, so that as an end result the great toe is the longest, the second next to the longest, etc. The short extensor tendons are dissected to their insertions and, since they have drifted laterally into the "valleys" pulling the toes into lateral drift with them, they are usually sacrificed. The long extensor tendons are appropriately lengthened to proper tension. All the toes are straightened by plantar capsulotomies, dermotomies, and long flexor tenotomies, and the toes held straight with C-.045 wire in shishkabob fashion. Then, under direct vision, each wire is drilled up into the metatarsal shaft, aligning the toes into parallel cosmetic fashion. In the early cases, a single stem silastic implant was utilized but for the past 5 years now the double stem silastic implant is employed for the first MTP joint and is inserted "upside down" in order to give its greater power towards the floor. A cast is not used, but the patient ambulates on a well-padded bandaged foot by the second or third day. Twenty patients (40 feet) were operated upon (17 females and 3 males, ages 28 to 72 years, average 47 years), with a follow-up of 3 to 5 years. Pain relief has been remarkable. Good great toe function has been obtained in all cases with excellent power to the floor and a satisfactory range of dorsiflexion ability. About 67% have developed some mild recurrence of hallux valgus, but none so severe that it has been disabling. All patients have been pleased with their final results.

Adult↗