Biomedical subjects

Tsu-Min Tsai

Publications and source records attributed to Tsu-Min Tsai.

6 recordsLinked to original sources

PubMed2005

Fiberglass cast application.

Plaster of Paris has been largely superceded for casting in orthopedic departments by synthetic cast materials. Despite its weight, its relative brittleness, its unpopularity with patients, and its messiness in application, plaster of Paris remains the mainstay of casting in the emergency department. This is due to a combination of economic reasons, the belief that synthetic casts leave less room for swelling and its relative ease of application compared to synthetic materials. We present a technique for synthetic cast application that avoids the problems of the rapidly setting cast and therefore allows the time for less experienced hands to produce a well-fitting cast or splint. We believe that this option, which allows the patient to have a lighter synthetic cast, rather than the traditional plaster of Paris cast, will be welcomed by both the patient and physician.

Casts, Surgical↗

PubMed2005

A biomechanical comparison of four extensor tendon repair techniques in zone IV.

BACKGROUND: This study was designed to evaluate the biomechanical parameters of four different suture techniques specifically designed for zone IV extensor tendon injuries: the double figure of eight, the double modified Kessler, the six-strand double-loop, and the modified Becker suturing techniques. Ease of repair, tendon shortening, strength to 1-mm gap, strength to 2-mm gap, ultimate strength, and mode of repair failure were evaluated. METHODS: Twelve fresh-frozen cadaver hand-forearm units (48 fingers) were randomly assigned to the four suture repair treatments. The speed of tendon repair as performed by two matched-hand surgeons was recorded. Prerepair and postrepair tendon lengths were measured to document tendon shortening. The repair was stressed by linear distraction at 2.0 mm/minute using a servohydraulic frame. Video recordings of each distraction were independently reviewed for biomechanical parameters by three physician-observers in a double-blind setup. A one-way analysis of variance and t test analysis was performed. RESULTS: Results show that the double figure-of-eight technique and the double modified Kessler were significantly (p < 0.05) easier to perform at 7 minutes 31 seconds and 7 minutes 58 seconds, respectively, than the other two techniques. Tendon shortening ranged from 1.9 to 2.4 mm. There was no statistically significant difference in tendon shortening among the four techniques. Strength to 1-mm gap was significantly higher with the modified Becker technique, with a mean 28.8 +/- 8.0 N. This was followed by the six-strand double-loop technique, with 21.0 +/- 6.6 N, the double modified Kessler at 17.7 +/- 4.5 N, and the figure-of-eight technique at 17.5 +/- 2.4 N. Strength to 2-mm gap was significantly (p < 0.05) greater for the modified Becker technique and the modified Kessler technique at 56.0 +/- 9.2 N and 48.6 +/- 12.6 N, respectively, as compared with the other two suture methods. The modified Becker technique showed the highest ultimate strength at maximal loading at 63.3 +/- 7.8 N, followed by the double modified Kessler technique with strength of 56.8 +/- 14.8 N. Both were significantly stronger than the other two techniques. CONCLUSIONS: This study shows that the modified Becker suture technique, although not easily performed, proved to be the strongest repair, with a significantly greater resistance to 1-mm and 2-mm gap and the greatest ultimate strength on maximal loading.

Biomechanical Phenomena↗

PubMed2005

Ideas and innovations: radial approach to carpal tunnel release in conjunction with thumb carpometacarpal arthroplasty.

Several authors have written about the co-existence of thumb carpometacarpal arthritis and carpal tunnel syndrome, and 4% to 43% of patients undergoing thumb carpometacarpal arthroplasty also have a carpal tunnel release. Some authors advocate that carpal tunnel release and thumb carpometacarpal arthroplasty should be performed at the same time. We perform a combined thumb carpometacarpal arthroplasty and radial approach carpal tunnel release through a single incision. The purposes of this study are to (1) determine the safety of this approach and (2) evaluate the effectiveness of this approach in decreasing the pain and numbness observed prior to surgery. Eight patients had combined thumb carpometacarpal arthroplasty and radial approach carpal tunnel release. With an average follow up of 14 weeks, all patients reported an improvement in pain and numbness. No nerve injuries occurred, and no difficulty in wrist flexion was observed. One patient had pillar pain persisting at 19 weeks follow-up. One patient had basilar thumb pain at 19 weeks, though this was improved over pre-operative levels.

Adult↗

PubMed2005

Osteoblastoma of the scaphoid: a case report.

Osteoblastoma is an uncommon primary bone tumor that rarely is found in the hand or wrist. Recurrent osteoblastomas often have a more aggressive appearance than the original tumor, and differential diagnosis from osteosarcoma is difficult. The pain that can accompany this tumor is debilitating. Therefore, successful treatment requires complete removal of the tumor. The purpose of this report is to present an unusual case of osteoblastoma of the carpal scaphoid. This tumor was treated successfully by curettage and bone grafting. At 1 year postoperatively, the patient presented with a stable, painless wrist with full range of motion.

Adult↗

PubMed2003

Causes of ulnar tunnel syndrome: a retrospective study of 31 subjects.

PURPOSE: The purposes of this study were to determine the distribution of causes and sites of nerve compression in the ulnar tunnel (Guyon's canal), and investigate the relationship between ulnar tunnel syndrome (UTS) and other conditions associated with it. METHODS: We performed a retrospective review of 31 patients diagnosed with and treated for UTS to determine the most common cause of compression and the sites of compression, systemic illnesses associated with UTS, and postoperative results. RESULTS: The cause of ulnar nerve compression was idiopathic in 14, trauma in 8, a thrombosis in 2, proliferation of synovium in 2, a prominent hook of the hamate in 1, a schwannoma in 1, postoperative swelling in 1, an aberrant fibrous band in 1, and a ganglion in 1. The sites of compression were classified into 3 zones. Twenty-eight cases had compression in zone 1, 6 in zone 2, and 19 in zone 3. Seventeen cases (55%) had compression in more than 1 zone. Twenty-two cases (71%) were associated with carpal tunnel syndrome (CTS). Twelve (86%) of the 14 idiopathic UTS cases were associated with CTS. The relationship between idiopathic UTS and CTS was not statistically significant. Six cases were associated with diabetes mellitus. CONCLUSIONS: The most common cause of UTS in our series was idiopathic. Most idiopathic UTS cases were associated with CTS. The clinical symptoms of UTS improved after surgery in all cases. Therefore because of the presence of multiple compression sites of the ulnar nerve in the hand, for UTS patients we believe that the release of Guyon's canal and/or the pisohamate tunnel is an effective way not only to relieve symptoms but also to determine the real cause of compression.

Adolescent↗

PubMed2003

Ruptures of the distal biceps brachii tendon: results of three surgical techniques.

The results of three different surgical techniques used for the treatment of 46 ruptures of the distal biceps brachii tendon in 45 patients were evaluated and compared. Mean follow-up time was 14 months. The 46 ruptures were categorised according to the surgical technique used for treatment. In Group I, 17 arms were treated using two incisions and transosseous suture fixation; in Group II, 19 patients were treated using bone-anchor fixation; and in Group III, ten patients were treated using a tie-on-button technique. After treatment, 41 patients (89.1%) had full active range of motion (ROM) and 38 patients (82.6%) had excellent or good strength. The results after treatment in all three groups were satisfactory. Though the outcomes of these techniques were similar, operative time, time to return to regular activity, and time to return to work was shorter in the bone-anchor and tie-on-button groups than that in the two-incision transosseous fixation group.

Adult↗