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Biomedical subjects

R J Bruno

Publications and source records attributed to R J Bruno.

8 recordsLinked to original sources
PubMed2001

Nerve entrapment in athletes.

Nerve entrapment syndromes can occur in athletes. The repetitive and vigorous use or overuse of the upper extremity makes the athlete particularly vulnerable to disorders of peripheral nerves. Understanding the clinical signs and symptoms is essential to treatment. The pertinent anatomy, clinical presentation, treatment, and rehabilitation necessary for return to sports for various nerve entrapments have been described. This should enable the physician caring for the athlete to help prevent injury and to guide appropriate treatment, if intervention becomes necessary.

Arm↗
PubMed2001

Bone graft harvesting from the distal radius, olecranon, and iliac crest: a quantitative analysis.

The purpose of this study was to quantify the volume and density of cancellous bone available from 3 commonly used bone graft sites in upper extremity surgery: the distal radius, olecranon process, and anterior iliac crest. Sixteen cadavers (age range, 59-98 years) with no prior history of bone harvest or metabolic conditions affecting bone were used. Cancellous graft was obtained using standardized techniques designed to simulate the clinical setting. Packed cancellous bone volume was determined as the volume occupied by the harvested bone after compression packing with a uniform load. Defect volume was determined by measuring the volume of the site from which bone was harvested. The distal radius and olecranon provided similar volumes of packed cancellous bone (2.7 and 2.8 cc, respectively). The anterior iliac crest provided approximately twice this amount (5.3 cc). The packed cancellous bone volume/defect volume ratio was not different between the 3 sites studied. Male gender was associated with a significantly greater amount of packed cancellous bone volume for all sites. We believe the olecranon to be an alternative to the distal radius as a source of bone graft for upper extremity procedures. We suggest using the anterior iliac crest when a large volume of cancellous bone is required.

Aged↗
PubMed2001

The collateral ligaments of the elbow: anatomy and clinical correlation.

Stability of the elbow is provided by the congruous nature of the bony articulations and the medial and lateral collateral ligament complexes. The medial ligament provides additional support to valgus stress. The lateral ligament prevents rotational instability between the distal humerus and the proximal radius and ulna. Collateral ligament insufficiency typically is posttraumatic and can occur on either side of the joint. An understanding of the normal anatomy is required to make the correct diagnosis and complete a successful surgical reconstruction.

Athletic Injuries↗
PubMed2000

Examination of the anatomic relationship of the proximal germinal nail matrix to the extensor tendon insertion.

The purpose of this study was to delineate the relationship of the terminal extensor tendon insertion to the proximal limit of the germinal nail matrix. Sixteen fresh-frozen human cadaver fingers without any evidence of trauma (average age, 55 years; 3 males and 1 female) were used for this study. Under x25 magnification the proximal limit of the germinal nail matrix and the terminal bony insertion of the extensor tendon were identified. The distance from the terminal tendon insertion to the germinal nail matrix was ascertained using precision calipers. The average distance from the terminal extensor tendon insertion to the proximal edge of the germinal nail matrix was found to be 1.2 mm. We conclude that the proximal limit of the germinal matrix is extremely close to the terminal extensor tendon bony insertion. When the extensor tendon insertion is visualized during operative exposures of the dorsum of the distal phalanx, care should be taken to avoid damaging the germinal matrix. Conversely, when the nail bed is being completely excised, visualization of the insertion of the extensor tendon will indicate that further proximal dissection is not required.

Adolescent↗
PubMed2000

Management of acute and chronic biceps tendon rupture.

In conclusion, the authors believe that younger high-demand patients should be offered the option of surgical repair; can be performed through the preferred single anterior incision with two suture anchors. Chronic tears, even with retraction, may be successfully reconstructed using a free tendon graft, often the flexor carpi radialis. Complications, including radial nerve palsy and proximal radioulnar synostosis, can be avoided with the single-incision technique. Older, low-demand patients can be rehabilitated and have excellent function without acute repair. Partial tendon injuries, for the most part, may be treated with rest and rehabilitation and explored only for chronic, unremitting pain. The authors believe that the single anterior approach should be used over the previously popularized two-incision technique.

Age Factors↗
PubMed1999

The pattern of bone mineral density in the proximal femur and radiographic signs of early joint degeneration.

OBJECTIVE: To determine if the presence of early radiographic signs of degenerative changes in the hip is associated with the pattern of bone mineral density (BMD) in the proximal femur. METHODS: Twenty-eight patients scheduled for unilateral hip replacement were placed into one of 2 groups based on the preoperative radiographic findings in the asymptomatic hip: Group 1 (no changes) or Group 2 (doubtful or minimal changes). Both femora and the lumbar spine were scanned by dual energy x-ray absorptiometry. RESULTS: The BMD z scores of the asymptomatic hip were significantly higher at the neck and Ward's triangle sites in Group 2 compared to Group 1 (p < 0.05). There were no differences between the groups in the symptomatic hip except at Ward's triangle, where Group 2 had higher z scores than Group 1 (p < 0.05). The lumbar BMD z scores were elevated in both groups (p < 0.05). CONCLUSION: Proximal femur BMD in the asymptomatic hip of patients scheduled for unilateral hip replacement is elevated when there are early radiographic signs of hip osteoarthritis (OA), consistent with the idea that early OA involves bone as well as cartilage.

Absorptiometry, Photon↗
PubMedDate not supplied

The evolution to market-driven quality.

Quality experts and Baldrige Award recipients agree that whether or not a company wins the coveted award, it gains countless benefits from going through the application process. In 1989, one unit at GTE applied for the Baldrige. This article details the results of that process, as well as the company's ongoing pursuit of market-driven quality.

Awards and Prizes↗