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Biomedical subjects

R Lusskin

Publications and source records attributed to R Lusskin.

At least 19 recordsLinked to original sources
PubMed1997

Acute disruption of the posterior tibial tendon associated with open-fracture dislocation of the ankle.

A 27-year-old man with a high-energy, open-fracture dislocation of the ankle underwent debridement and open reduction of his injuries. During surgery a disruption-laceration of the posterior tibial tendon at the level of the fracture of the medial malleolus was found. Repair required location of the proximal muscle and tendon and controlled traction of the musculotendinous unit from its retracted position. Common aspects in the nine previously reported instances of this lesion include relatively high energy of the injury and the fracture type, a transverse fracture in the medial malleolus. Unique to this case was the open injury.

Acute Disease↗
PubMed1996

Malignant granular cell tumor mimicking herniated nucleus pulposus.

Peripheral nerve tumors may arise in any nerve, large or small. Their presence is readily apparent when they are superficial, but when they are located in a deep nerve, symptoms can mimic+ the nerve root pain of herniated nucleus pulposus. This case of malignant granular cell tumor, probably of Schwann cell origin, involved the sciatic and tibial nerves in the popliteal fossa. Originally the pain was assumed to be produced by a herniated nucleus pulposus. The discovery of the mass thus +was delayed. The mass gave a heterogeneous signal on magnetic resonance imaging studies. A peripheral origin of nerve pain should be considered whenever pain radiates to a limb. A complete physical examination that includes palpation of the nerve to which pain is referred gives the best clue as to the true cause of pain when a peripheral nerve tumor is present.

Diagnosis, Differential↗
PubMed1993

Malignant epithelioid hemangioendothelioma arising in an intramuscular lipoma.

BACKGROUND: A malignant epithelioid hemangioendothelioma (EH) developed within a peripheral intramuscular lipoma. It was seen as a painful calf mass. At the time of biopsy and en bloc resection, lung metastases were observed. METHODS: Radiologic, histologic, immunohistochemical, and ultrastructural features of the neoplasm are described, and the literature pertaining to EH is reviewed. RESULTS: The features of this tumor permitted its classification as a malignant EH. CONCLUSIONS: This case illustrates the potential for aggressive behavior in an EH, often considered to be a low-grade malignant neoplasm. Because such tumors can metastasize, they should be removed with wide margins whenever possible. This malignant neoplasm was located within a benign intramuscular lipoma, demonstrating the diagnostic problem that may exist in such a complex lesion.

Epithelium↗
PubMed1992

Ankle reconstruction for malunion by fibular osteotomy and lengthening with direct control of the distal fragment: a report of three cases and review of the literature.

Malunion of ankle fractures will lead to severe osteoarthritis when the architecture and mechanics of the talocrural joint are deranged. When fibular shortening is present, ankle reconstruction can be achieved by fibular lengthening and can provide an alternative to early arthrodesis for deformity and pain. Acceptable clinical and radiographic results can be achieved, provided that accurate reconstruction is achieved and intra-articular osteochondral injury is minimal. Restoration of fibular length, necessary for a good clinical result, can be estimated radiographically by the bimalleolar angle. We report three cases of ankle reconstruction by fibular lengthening with an average follow-up of 33 months.

Adult↗
PubMed1992

The hinged shoulder spica cast for management after shoulder surgery.

A shoulder spica cast is often required after major surgery to the shoulder. This type of cast is usually heavy and awkward. A lightweight fiberglass spica has proven to be useful after repair of the deltoid origin, repair of complete rupture of the rotator cuff, and shoulder arthrodesis. Hinges have been incorporated in the spica at the elbow and shoulder to permit maximum motion appropriate to the surgery. This cast is light and well tolerated. Elbow and shoulder stiffness is reduced by the hinges, which may be fabricated out of stock devices heretofore used in knee orthoses.

Adolescent↗
PubMed1991

Squamous cell carcinoma complicating chronic osteomyelitis in a toe: a case report and review of the literature.

Squamous cell carcinoma arising from chronic osteomyelitis is uncommon. Although the majority of cases occur in the lower extremity, incidence in the foot is relatively rare, and in the toe, exceptional. This report illustrates a particularly unusual incidence of squamous cell carcinoma complicating chronic osteomyelitis of the hallux. Guidelines for early diagnosis, recommendations for treatment, and prognostic data are included.

Bone Neoplasms↗
PubMed1988

Combined anterior and posterior approach to the hip joint in reconstructive and complex arthroplasty.

The combined anterior and posterior approach permits access to the front and back of the hip joint for reconstruction and complex arthroplasty, usually without osteotomy of the greater trochanter, with minimal muscle release. There is ease of access to the anterior and posterior capsule, which can be resected under direct vision, thus permitting accurate hemostasis. The entire acetabular rim is exposed for bone grafting as required. The authors review the useful standard approaches and illustrate the combination of the anterior and posterior approaches through a straight lateral incision. Concomitant exploration of the sciatic nerve is demonstrated, as is the osteotomy of the trochanter performed when the ilium superior to the acetabulum must be reconstructed. The utility and limitations of the operation is illustrated by representative cases. This extensive procedure usually can prevent neurologic and vascular compromise and allows excellent observation of the skeletal structures for accurate component alignment.

Aged↗
PubMed1987

The technique of dynamic adhesive strapping for congenital clubfoot.

The use of dynamic adhesive strapping to correct congenital clubfoot in the immediate neonatal period is an effective method of treatment. The technique is described in detail, the steps are illustrated, and precautions and limitations are given. This type of treatment should shorten the amount of time required to correct congenital clubfoot. If the holding phase is sufficiently prolonged, a reduction in the number and complexity of operative procedures needed for recurrent and recalcitrant cases can be expected.

Bandages↗
PubMed1986

The anatomy and physiology of the peripheral nerve.

The anatomy and physiology of nerve tissue and the peripheral nerve are reviewed. The importance of the anatomical and physiological understanding of nerve tissue in the surgical repair of nerve injuries is discussed. This includes an outline of the light and electron microscopic histology of nerve and a short review of axoplasmic flow. In addition, the nerve coverings, endoneurium, perineurium, and epineurium, are described. The relationship of these coverings to the surgical therapy of nerve injuries is outlined. By maintaining, where possible, nerve fascicle continuity and by restoring, where practical, the normal physiology of distorted but not disrupted fascicles, with the use of careful internal neurolysis, optimal clinical return of function should be achieved.

Animals↗
PubMed1986

Evaluation and therapy after injury to peripheral nerves.

Peripheral nerve injuries from whatever cause should be classified according to the degree of axon, fascicle, and main nerve trunk damage. This approach is useful in assessing the chances for spontaneous recovery and planning for surgery directed at improving neural recovery. Evaluation over time may be required to better classify the degree of injury. Once recovery slows or ceases, the surgical approaches available include neurolysis, nerve repair, nerve transposition, autograft reconstruction, and various procedures directed at painful neuromata. With proper mobilization and protection of neural and vascular structures, even extensive orthopaedic reconstructive procedures may be performed. Ischemic neuritis and myopathies may be improved by such combined approaches.

Humans↗
PubMed1986

Surgical management of late post-traumatic and ischemic neuropathies involving the lower extremities: classification and results of therapy.

Traumatic/ischemic events such as fractures, dislocations, lacerations, compression, vascular injuries, and embolus can result in several degrees of nerve injury with resultant sequelae of paralysis, sensory loss, and irritative phenomena (pain, hyperesthesia, and dysesthesia). Neuroma pain may prevent rehabilitation following amputation or nerve lacerations. Thirty-four patients with the late sequelae of traumatic/ischemic neuropathies underwent 36 neural operations using magnification techniques to define and repair neural lesions. Major bone and joint reconstruction could be performed at the same operation with protection of arterial and venous supply. A recovery score using defined criteria for motor, sensory, and irritative (pain) recovery has been developed to quantify the end results in compression/ischemia, contusion/stretch, laceration, idiopathic/irritative disorder, and painful neuroma. Excellent and good results were found in 39 of the 87 specific deficits analyzed (45%). Thus, there is the possibility of improved results in these late neuropathies with therapy before irrevocable muscle fibrosis occurs and intractable pain develops.

Adolescent↗