Biomedical subjects

N Paksima

Publications and source records attributed to N Paksima.

4 recordsLinked to original sources

PubMed1998

Management of recurrent, complex instability of the elbow with a hinged external fixator.

We have treated 16 patients with recurrent complex elbow instability using a hinged external fixator. All patients had instability, dislocation or subluxation of the ulnohumeral joint. The injuries were open in eight patients and were associated with 20 other fractures and five peripheral nerve injuries. Two patients had received initial treatment from us; 14 had previously had a mean of 2.1 unsuccessful surgical procedures (1 to 6). The fixator was applied at a mean of 4.8 weeks (0 to 9) after the injury and remained on the elbow for a mean of 8.5 weeks (6 to 11). After treatment we found the mean range of flexion-extension to be 105 degrees (65 to 140). At a final follow-up of 23 months (14 to 40), the mean Morrey score was 84 (49 to 96): this translated into one poor, three fair, ten good and two excellent results. Complications included one fractured humeral pin, one temporary palsy of the radial nerve, one recurrent instability, one wound infection, one severe pin-track infection and one patient with reflex sympathetic dystrophy. Although technically demanding, the use of the fixator is an important advance in the management of recurrent complex elbow instability after failure of conventional treatment.

Adult↗

PubMedDate not supplied

A new technique for arthroscopic resection of a bucket handle tear.

The authors present a previously undescribed technique for excision of a bucket handle tear. The technique uses a Caspari suture punch to pass a suture through the meniscus and use the suture as a tool to maneuver the meniscus so that its posterior horn attachment can be cut. The technique is noteworthy in that it eliminates the need for establishing an additional portal.

Arthroscopy↗

PubMedDate not supplied

Post-traumatic thumb reconstruction.

Many options exist for the management of post-traumatic thumb reconstruction. While the single most important factor for determining the most appropriate procedure is the level of the amputation, many other factors must be considered including patient considerations regarding function and cosmesis as well as the nature of the injury and the expertise of the surgeon. Patients must be included in the decision-making process and their needs and expectations must be clearly defined and addressed. The patient who is most concerned with cosmesis rather than function is more likely to be satisfied with a prosthesis than with even the most cutting-edge surgical procedure.

Finger Injuries↗

PubMedDate not supplied

Peripheral nerve injuries and repair in the upper extremity.

Peripheral nerve injuries are commonly seen as a result of domestic, industrial, or military trauma. Sharp objects usually cause these nerve injuries. When assessing these injuries, it is important to evaluate each nerves' motor and sensory function. One must be cognizant of associated injuries such as fractures, vascular damage, and musculotendinous lacerations. The time since the injury, level of injury, and age of the patient are important prognosticators impacting the return of function. Intraoperatively, one must assess the vascularity of the soft tissue bed and the nerve itself, the nerve gap, conduction, and the topography of the fascicles to insure proper orientation. Application of the principles of nerve repair (magnification, minimal tension, meticulous soft tissue handling, experienced surgeon and staff) can enhance the chances for a successful result. Additionally, to maximize functional recovery following peripheral nerve repair, a carefully planned program of postoperative occupational therapy and rehabilitation must be instituted.

Arm Injuries↗