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Biomedical subjects

T S Axelrod

Publications and source records attributed to T S Axelrod.

13 recordsLinked to original sources
PubMed1998

Scaphoid nonunion with avascular necrosis of the proximal pole. Treatment with a vascularized bone graft from the dorsum of the distal radius.

Scaphoid nonunion with avascular necrosis of the proximal pole remains a difficult problem. We have endeavoured to heal the fracture, restore scaphoid height and revascularize the proximal pole of the scaphoid by means of a vascularized dorsal interposition graft from the distal radius. The procedure has resulted in union of six of ten fractures. Fractures that healed had not been treated by a previous bone grafting procedure. Dissatisfaction was due to loss of motion in patients who had healed fractures, and pain in those patients with persistent non-unions.

Adolescent↗
PubMed1997

Atrophic nonunion of the clavicle: treatment by compression plate, lag-screw fixation and bone graft.

We describe a new surgical treatment of atrophic nonunion of the clavicle. The nonunion is excised by cuts at 45 degrees to the long axis and repair uses 3.5 mm pelvic reconstruction or dynamic compression plates, with a lag screw to provide interfragmentary compression. The site is grafted with cancellous bone. We have been successful in all seven patients, with early return to normal function. The consequent narrowing of the shoulder girdle is fully acceptable for appearance and function.

Adolescent↗
PubMed1997

Management of complex dislocations of the distal radioulnar joint.

The authors reviewed their experience in the treatment of complex dislocations of the distal radioulnar joint. Six cases of complex dislocations were treated between 1990 and 1993. An algorithm for the treatment of these injuries has been developed. In most cases, complex dislocations are associated with an avulsion fracture of the ulnar styloid. The authors prefer to treat these by fixation of the ulnar styloid using a tension band wiring technique. Cases in which the ulnar styloid fragment is small, or in which there is no styloid fracture, are treated with open reduction and repair of the triangular fibrocartilage complex if the distal radioulnar joint is irreducible, or by ulnoradial transfixion pinning if the distal radioulnar joint is reducible but unstable. Good results were obtained in five of six cases using this algorithm.

Adolescent↗
PubMed1996

Synovial osteochondromatosis of the distal radio-ulnar joint.

Synovial osteochondromatosis is an uncommon lesion characterized by cartilagenous and osseous metaplasia of joint synovium. It is typically monarticular, affecting large joints such as the knee and hip, although it has also been described in the ankle, elbow and shoulder. It is exceptionally rare in the hand, but has been reported involving the tenosynovium of the digits and the wrist. We report a rare case of synovial osteochondromatosis involving the distal radio-ulnar joint in a 16-year-old man.

Adolescent↗
PubMed1996

Intraarticular osteotomy of distal radial malunions.

Failure to reduce intraarticular fractures of the distal radius to less than 2 mm of residual articular incongruity often will lead to posttraumatic arthrosis. Intraarticular osteotomy of the distal radius was performed for intraarticular malunions with a step greater than 2 mm in the distal radial articular surface, in the absence of arthrosis. The technique involves careful recreation of the fracture into the joint and rigid internal fixation of the osteotomy site. Four patients were followed up at an average of 23 months postoperatively (range, 12-43 months). All patients treated with this operation were satisfied with their results and their wrists were functioning well at the time of review. All had good or excellent Gartland and Werley functional wrist scores. Further followup is required to document the long term outcome of these patients.

Adult↗
PubMed1995

"Splint-top" fracture of the forearm: a description of an in-line skating injury associated with the use of protective wrist splints.

Upper extremity injuries are commonly seen in the sport of in-line skating. The use of protective equipment, including wrist splints, has been advocated as a means to decrease both the incidence and severity of upper extremity injuries in this sport. We report on four cases of open forearm fractures in the in-line skaters that occurred adjacent to the proximal border of the wrist splints. The unusual nature of these injuries and the location of the fractures in relation to the location of the splints suggest that the two may be mechanistically related. The splint and distal forearm may act as a single unit to convert the impact from the level of the wrist to a torque moment, with the fulcrum located at the proximal border of the splint. The energy from the fall is then dissipated by the fracturing of the forearm bones at this level. These cases suggest that the use of wrist splints may be associated with their own specific set of injury patterns.

Adult↗
PubMed1995

Wrist arthrodesis using a dynamic compression plate.

We performed 45 wrist arthrodeses in 43 patients by a modification of the AO technique using the dynamic compression plate. Radiological follow-up was obtained in 41 wrists; all had united at a mean of ten weeks. Clinical follow-up was obtained in 32 wrists. Subjectively, the surgical outcome was satisfactory in 26, marginally satisfactory in two and unsatisfactory in four. This method is safe and reliable. The plate can be contoured to allow a variety of positions of fusion, and gives rigid immobilisation. The rate of union is higher than that for other techniques.

Adult↗
PubMed1991

Severe complex injuries to the upper extremity: revascularization and replantation.

Twenty-nine patients with an incomplete (26) or a complete (3) amputation of the upper extremity proximal to the wrist with revascularization or replantation were reviewed. Limb survival rates were very high (93%) despite the severity of the injuries. All patients regained some useful hand function, with 76% attaining a group I or group II (Chen criteria) functional result. Bone shortening osteotomies are a helpful way to reduce the soft tissue defect size. In contrast to earlier studies, clear correlations between the level of injury, degree of nerve lesion, bone pathology, and the number of major nerves involved, and the functional outcome achieved were not found. There was a weak correlation between the type of wound and the functional recovery ultimately obtained.

Activities of Daily Living↗
PubMed1990

Open reduction and internal fixation of comminuted, intraarticular fractures of the distal radius.

Comminuted intraarticular fractures of the distal radius present a difficult problem in management. It is well established that unreduced significant articular incongruency will result in early degenerative osteoarthritis. The technical demands of, and the results to be expected from, formal open reduction and internal fixation of these comminuted articular fractures have not been addressed in the current literature. From 1981 to 1986, 20 patients were treated by open reduction after failure of closed means. Seventeen patients were personally reviewed at an average follow-up of 3.25 years. The results indicate that the procedures are technically demanding and have high early (15%) and late (35%) complication rates. This gives an overall complication rate of 50%, including the need for further operative procedures. However, patient satisfaction is very high, most patients (89%) returning to previous occupations. Function and radiographic results are excellent. Articular congruency was restored in 88%.

Adult↗
PubMed1989

Radiographic definition of the dorsal and palmar edges of the distal radius.

The dorsal and palmar edges of the distal radius, as well as the concavity of the articular surface were labeled with wire and radiographs taken from neutral to 30 degrees of added dorsal tilt. The dorsal edge was identified as the structure that protrudes distally in neutral. The palmar edge was found to overlap with the sclerotic subchondral bone of the radius in neutral. With increasing dorsal tilt the profile of the palmar edge appeared as it protruded distal to the sclerotic subchondral line of the radius. The profile of the palmar edge could be distinguished from that of the dorsal edge on the anteroposterior view. The wire, which was placed midway between the dorsal and palmar edges and the concavity of the articular surface corresponded to the prominent sclerotic subchondral bone line of the distal radius. This did not change in position with increasing dorsal tilt. This clarification of the radiologic anatomy is helpful in extending the use of the anteroposterior radiograph for the interpretation of fractures and malunions of the distal radius.

Humans↗
PubMed1988

Granulocyte precursors are the principal cells in bone marrow that stimulate allospecific cytolytic T-lymphocyte responses.

Mouse bone marrow cells were fractionated and enriched for functional activity as stimulators of allospecific cytolytic T-lymphocyte (CTL) responses in vitro. The relevant stimulator cells were enriched sequentially in the low-density fraction of bone marrow, its 2-hr adherent and 18-hr non-adherent fractions and in the FcR-negative fraction of 18-hr non-adherent cells. The functionally enriched cell population contained over 90% granulocyte precursors by ultrastructural analysis. The results indicate that granulocyte precursors are the principal cells in bone marrow that stimulate alloreactive T-cell responses.

Animals↗