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Biomedical subjects

P M Weeks

Publications and source records attributed to P M Weeks.

At least 55 records · Page 3Linked to original sources
PubMed1984

A comparison of three techniques of palatorrhaphy: early speech results.

Sixty-two patients with cleft lip and palate or cleft palate were randomly assigned an operative technique for primary palatorrhaphy: V-Y pushback, Langenbeck, or Langenbeck with pharyngeal flap. Early speech results were evaluated in 52 patients. There were no differences among the treatment groups in late complications, hearing, middle ear disease, velopharyngeal competence, or need for speech therapy, speech bulbs, or secondary pharyngeal flaps. As previously reported, the in-hospital morbidity in these patients was greater with V-Y pushback (more blood transfusions) and Langenbeck plus pharyngeal flap (more upper airway obstruction) palatorrhaphies than with the Langenbeck procedure. The addition of a pharyngeal flap to primary palatorrhaphy seems unnecessary in at least 75% of patients. Therefore, we currently recommend the Langenbeck palatorrhaphy for primary cleft palate repair, although further longitudinal studies of these patients are needed to assess later speech results and maxillary growth.

Cleft Lip↗
PubMed1984

Flexible-implant arthroplasty and finger replantation.

We performed flexible-implant arthroplasty in three metacarpophalangeal joints in two patients at the time of finger replantation. We believe flexible-implant arthroplasty is preferable to permanent arthrodesis for most patients.

Adolescent↗
PubMed1983

Wrist arthrography. The value of fluoroscopic spot viewing.

Wrist arthrography is a valuable procedure for the identification of scapholunate or lunotriquetral ligament tears. The addition of sequential filming during the injection of contrast material permits the arthrographer to determine accurately the specific ligament which is ruptured.

Contrast Media↗
PubMed1983

Post-traumatic palmar carpal subluxation. Report of two cases.

Traumatic carpal instability can be difficult to detect and may present complicated management problems. Post-traumatic palmar carpal subluxation has been previously described only as a theoretical ligament instability. Such a condition implies disruption of the normal ligament attachments either within or around the carpus, or both, which very often results in altered intercarpal relationships and in disturbed kinematics. Post-traumatic palmar carpal subluxation is a form of carpal ligament instability that we could not find in any previous reports. We are reporting the cases of two patients who were followed for three years after such an injury. After closed reduction and non-operative management, both patients had a satisfactory functional result.

Adult↗
PubMed1982

The groin flap in severe hand injuries.

We reviewed 27 patients who required 28 groin flaps for repair of hand injuries. Flap necrosis due to ischemia developed in 18% of the patients. Flap ischemia did not develop after elevation of the flap or partial division of the pedicle. All flap necroses occurred after final (total) division of the pedicle (p less than 0.05). Flap necrosis was more common following immediate insetting of the flap than after delaying the inset, but this difference was not statistically significant. Flap necrosis did not develop if the pedicle was divided in two stages, with the first stage consisting of either preliminary ligation of the superficial circumflex iliac vessels or full-thickness division of a portion of the width of the flap. Our complication rate was much lower than that previously reported for groin flaps.

Adolescent↗
PubMed1981

Effect of continuous load on the mechanical properties of tendon adhesions.

The restoration of tendon gliding after tendon repair or grafting is dependent upon alteration of the scar about the tendon. Application of a load (active range of motion exercises) is used clinically to effect this alteration. Using the chicken as a model, we are attempting to define the optimal timing, quantity and duration of the load. In these initial experiments, the effects of application of a continuous load for forty eight hours were evaluated in eighty nine chickens. A continuous load applied for forty eight hours had no significant effect on motion of repaired tendons or the scar "stiffness".

Animals↗
PubMed1980

Treatment of partial tendon lacerations.

We treated twenty six patients with thirty four partial tendon lacerations by not suturing the tendons and by early mobilization of the digit. These partial tendon lacerations varied from 25 to 95 per cent of the cross sectional area. The mean and median cross-sectional area lacerated was 60 per cent. Twenty three of these patients obtained excellent function, one patient obtained good to excellent function and one patient obtained fair function. One patient was lost to follow-up. No tendon ruptured but one patient did develop trigger finger which spontaneously resolved. Partial flexor tendon lacerations should not be repaired and early active motion should be used if bevelling of the laceration is not present. Bevelled partial tendon lacerations of less than twenty five per cent of the cross sectional area can be either excised or repaired with a simple interrupted suture. If greater than twenty five per cent of the cross-sectional area is lacerated and bevelled, the laceration should be repaired with a few simple sutures. Regardless of the treatment of the tendon early active motion is necessary.

Adolescent↗
PubMed1980

Experimental comparison of technics of tendon repair.

We compared tendon gliding and tensile strengths after 70 modified Bunnell, Kessler, Kleinert, or Tsuge flexor tendon repairs in chickens. We evaluated gliding by three different measurements: angular motion, longitudinal tendon movement with the toe intact, and with the repair isolated. The tendon dimensions and the rupture strengths were measured. We found equal rupture rates and tensile strengths after all repairs and equal gliding after the modified Bunnell, Kessler and Kleinert repairs. Angular motion was better after the Tsuge repair than after the modified Bunnell repair, but longitudinal tendon movement with the toe intact or with the repair isolated was the same. From our observations we believe that a hand surgeon could use either the Bunnell, Kessler, Kleinert, or Tsuge technic of flexor tendon repair and expect equal results.

Animals↗
PubMed1980

Operative mobilization of stiff metacarpophalangeal joints: dorsal versus volar approach.

The effectiveness and merits of the dorsal and volar approaches for release of structures contributing to metacarpophalangeal joint stiffness were studied in 61 joints in 23 patients. Seventy-six percent of the joints in the volar group gained greater than 50 degrees passive motion compared to 29% in the dorsal group. Forty-four percent of the joints in the volar group gained greater than 50 degrees active motion compared to 16% in the dorsal group. Discussion of surgical technique and postoperative management reveals that the advantages of the volar approach are most evident during postoperative management, while the main advantage of the dorsal approach is better operative exposure.

Finger Joint↗
PubMed1980

The results of nerve grafting in the wrist and hand.

To evaluate the usefulness of nerve grafting we studied 38 patients having 11 median, 7 ulnar, and 33 digital nerve grafts. Group funicular (interfascicular) grafting using magnification was performed in all patients. We followed 12 patients with 8 median and 5 ulnar nerve grafts for at least one year and 18 patients with 27 digital nerve grafts for at least six months. Medical Research Council criteria were used for evaluation of nerve function. Results in our patients and in previously reported patients having nerve grafting or repair were compared. Sensory function following ulnar nerve grafting was significantly better than that following nerve repair. Sensory function following median and digital nerve grafting was as good as that following nerve repair. Motor function following ulnar nerve grafting was as good as that following nerve repair. Previously reported patients having median nerve repairs or grafts had significantly better motor function than our patients.

Adolescent↗