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R F Vandell

Publications and source records attributed to R F Vandell.

2 recordsLinked to original sources

Complex dislocations of the metacarpophalangeal joint.

A dorsal longitudinal incision provides excellent exposure for reducing complex dislocations of the metacarpophalangeal joints of the thumb and index finger. Within the past four years, we have successfully treated five patients with irreducible dislocations of the metacarpophalangeal joint of the thumb and four with dislocations of the index finger by open reduction through a dorsal incision. This approach exposes the joint and the major structure blocking reduction, the volar plate. The digital nerves, which are tented volarly over the metacarpal head, are not prone to injury and osteochondral fracture fragments can be easily removed from the joint. All of the dislocations were stable following reduction.

Adult↗

Multiple extremity amputations in hypotensive patients treated with dopamine.

Dopamine hydrochloride has been established as effective in the treatment of hypotension and shock in patients with adquate blood volume. The physiological response is dose related. Administration of more than 10 microgram/kg/min results in alpha-receptor stimulation and vasoconstriction, and peripheral extremity ischemia has been reported. Four patients treated with dopamine subsequently had the development of peripheral ischemia and gangrene, resulting in the need for multiple extremity amputations. These reactions represent a major complication of treatment.

Aged↗