Should an incompletely severed tendon be sutured?
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Biomedical subjects
Publications and source records attributed to P M Weeks.
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To completely open the web space in burn syndactyly and provide tissue that is pliable and elastic, we describe a flap from the lateral and volar surfaces of an adjacent finger which will completely cover the opened defect. The results of this procedure in 24 web spaces are reported.
Of 253 consecutive hypospadias repairs by various surgeons, using the Byars technique, 57 (22 percent) had postoperative fistulae; 41 required one operation, 9 required two operations, and 7 required more than two operations for closure of these fistulae. Other complications were infrequent. When performed either by attending or resident physicians, the Byars hypospadias repair produced complete correction of the chordee, a urethra of satisfactory length and caliber, normal penile appearance, and a fistula rate comparable to that reported after other procedures.
To determine ideal treatment, 58 patients with cystic hygroma of the neck were studied. Approximately equal distribution of the lesion among sexes and sides of the neck was noted, but frequency was less than expected among blacks. Complete excision, the treatment of choice, gave an 81% cure rate. Partial excision was curative in only 12% of cases, but it decreased the tumor mass enough to eliminate the need for further treatment in 62% of cases. Aspiration of the cysts may be of value in diagnosis and management of acute respiratory problems but not for definitive therapy. Sclerosing agents and radiation therapy was not effective treatment of cystic hygromas. Of the clinical recurrences, 76% occurred within a year after therapy.
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An atypical elderly patient with spontaneous regression of a primary lesion of malignant melanoma is presented. The 12 previously reported cases are also reviewed. The histological diagnosis of spontaneous regression of a melanoma can still be made after the regression appears to be grossly complete. All localized areas of depigmentation, or of scarring, should be biopsied when searching for an "occult" primary.
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This paper focuses on the management of the thumb-index web space contracture, a contracture that can interfere significantly with hand function. The anatomy of the thumb-index web space and the contracture mechanism are reviewed. Contractures frequently result from traumatic hand injuries involving the web space or peripheral nerves. Exercises and splinting techniques for preventing or correcting these contractures are directed at achieving and maintaining maximum range of motion and strength of the thumb. Case reviews are reported that show improvements in range of motion measurements of 31 patients treated with the described techniques.
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Fifty-percent-lacerated unrepaired chicken tendons were studied. Free mobility resulted in tensile strength significantly increased over immobility when the free mobility was begun on the day of wounding or after 28 days of immobility.
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