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Biomedical subjects

W B Geissler

Publications and source records attributed to W B Geissler.

33 records · Page 2Linked to original sources
PubMed1993

Arthroscopic management of wrist triangular fibrocartilage complex injuries in the athlete.

Wrist arthroscopy can facilitate early definitive diagnosis of debilitating soft tissue injuries in athletes. Many such injuries can be treated successfully with minimally invasive arthroscopic techniques, reducing the morbidity associated with surgical exposure and permitting earlier return to competition. The triangular fibrocartilage complex (TFCC) is vulnerable to injury from rotational forces or axial load applied to the hand. Under arthroscopic control, injuries to the central articular disk can be treated by excision of unstable tissue fragments; peripheral separation of the disk from the dorsal or volar ligaments can be repaired with sutures to achieve complete healing. Avulsion fractures from the dorsal ulnar margin of the sigmoid notch of the radius are better treated through a small arthrotomy after initial arthroscopic evaluation.

Arthroscopy↗
PubMed1993

Arthroscopic manifestations of shoulder subluxation and dislocation.

Instruction in the arthroscopy of the normal and pathologic anatomy of various structures of the shoulder associated with instability syndromes is absolutely essential. Arthroscopy is not a substitute for a thorough clinical evaluation and physical examination of the shoulder, however. It provides confirmation of the clinical impression, especially in subtle cases of instability.

Arthroscopy↗
PubMed1992

Isolated rupture of the popliteus with posterior tibial nerve palsy.

We report the case of a 59-year-old man with severe knee pain and inability to flex his toes or invert his plantar flexed foot after an external rotation injury to his knee. MRI showed rupture of the popliteus with a haematoma compressing the neurovascular bundle in the proximal calf, and electromyography demonstrated signs of an axonotmesis of the posterior tibial nerve. There was progressive nerve recovery over 24 weeks. Isolated rupture of the popliteus should be considered in any patient with an acute haemarthrosis, lateral tenderness and a stable knee, especially after an external rotation injury.

Hematoma↗
PubMed1991

Treatment of displaced articular fractures of the radius.

Forty patients with articular fractures of the distal radius in which anatomic reduction of the joint surface could not be obtained by closed manipulation or by ligamentotaxis with external fixators had a combination of percutaneous and/or open reduction techniques to restore articular congruity. X-ray films taken after treatment with an average follow-up of 4 years showed satisfactory extraarticular alignment in 85% of the cases, and 37 (92.5%) patients demonstrated an articular step-off of 1 mm or less at late follow-up examination. Radiographic evidence of radiocarpal arthritis was present in 5% of the cases at follow-up examination.

Adolescent↗
PubMed1991

Percutaneous and limited open reduction of the articular surface of the distal radius.

Between 1979 and 1986, 40 patients with intraarticular fractures of the distal radius, in which anatomic reduction could not be obtained by closed manipulation or external fixation, underwent a combination of percutaneous and/or limited open reduction techniques to restore articular congruity. All 40 patients' radiographs that were retrospectively reviewed with an average follow-up of 4 years showed satisfactory extraarticular alignment in 85% of cases, and 37 patients (92.5%) demonstrated an articular step-off of less than or equal to 1 mm. Thirty-one patients retrieved for follow-up had a good functional result. The treatment goals of intraarticular fractures of the distal radius are anatomic restoration of the joint surface and optimal fixation to maintain reduction in an effort to prevent posttraumatic arthrosis of the wrist.

Adolescent↗
PubMed1991

Imaging rounds #110. Osteopetrosis.

The following case is presented to illustrate the roentgenographic and clinical findings of a condition of interest to the orthopaedic surgeon. Initial history, physical findings, and roentgenographic examinations are found on this page. The next page presents the final clinical and roentgenographic differential diagnosis.

Aged↗
PubMed1990

Anterior interosseous nerve palsy complicating a forearm fracture in a child.

An anterior interosseous nerve palsy occurring as a complication of a closed both bone forearm fracture in a child is presented. Surgical exploration showed that a bone spike from the proximal fragment was perforating the median nerve. The fractured radius was reduced and inspection of the nerve under the microscope showed no fasicular disruption. Complete motor recovery occurred in 4 months and sensibility had fully returned at 10 months after the operation.

Child↗
PubMed1990

Management of low velocity gunshot-induced fractures.

Bullets fired from civilian weapons are usually of low velocity, resulting in minimal tissue cavitation as compared to high-velocity weapons. A prospective protocol was initiated for patients sustaining a low-velocity gunshot to the extremity resulting in a stable, nonoperative fracture configuration. Treatment consisted of local irrigation and débridement, tetanus prophylaxis as required, a long acting cephalosporin intramuscularly, and splinting or casting of the fractured extremity. Twenty-five patients were managed by this protocol. This patient population was compared to a random retrospective sample of 25 patients with similar ballistic induced fractures and wounds managed by local débridement and 48 h of intravenous antibiotics. One infection occurred in each group, requiring further therapy. We conclude that the patient with a low-velocity gunshot induced fracture can be managed without the use of short-term intravenous antibiotics with no increased risk of infection.

Adolescent↗
PubMed1989

Open reduction and internal fixation of three-part fractures of the proximal humerus.

Eleven patients with 12 three-part fractures of the proximal humerus were treated by open reduction and internal fixation using AO/ASIF buttress plating. All of the fractures healed. There were no failures of fixation. Nine of these patients returned for a follow up of more than 2 years and had a satisfactory rating using Neer's shoulder rating system. Five patients who had an acromioplasty at the time of their initial surgery had slightly better function and range of motion than the remaining patients. Successful operative treatment requires accurate definition of the fracture pattern, careful attention to the details of internal fixation, and supervised postoperative rehabilitation.

Adult↗
PubMed1989

[Corrective interventions in malunited fractures of the distal radius].

The current indications and technique of wrist osteotomies for ununited fractures of the distal radius are presented. A three-dimensional correction at the metaphyseal level is technically feasible. This not only restores the normal orientation of the articular surface thus reestablishing normal load distribution but also the radial length up to 10 mm which is a prerequisite to prevent ulno-carpal impingement. Painful limitation of forearm rotation due to degenerative changes in the distal radioulnar joint may be treated with Bowers hemiresection arthroplasty. If the radioulnar index should be greater than 10-12 mm an additional shortening osteotomy of the ulna may become necessary. Every additional operation on the ulna should be based on the radiological comparison of the distal radioulnar joint of the opposite hand.

Bone Nails↗
PubMed1988

Operative management of ipsilateral fractures of the hip and femur.

Thirteen patients with ipsilateral hip and femoral shaft fractures are discussed. In nine patients, the femoral shaft fracture was managed by a combination of dynamic compression plating with a medial cancellous bone graft and either multiple cancellous screws or a dynamic hip screw for the proximal fracture (Group I). Four patients had Ender pin fixation (Group II). In Group I, both fractures were united within 16 weeks in all patients, and at least 90% of normal hip and knee motion was regained. Nonunions developed in two of the four Group II patients. Immediate separate fixation of ipsilateral hip and femoral shaft fractures allows definitive management of the proximal fracture and immediate mobilization without external support and provides satisfactory results with a low complication rate.

Adult↗
PubMedDate not supplied

Intraarticular abnormalities in association with posterior cruciate ligament injuries.

The effect of an isolated injury of the posterior cruciate ligament on the articular cartilage and menisci has not been extensively studied. Intraarticular abnormalities in 88 arthroscopically proven posterior cruciate ligament tears in symptomatic patients with straight unidirectional posterior instability were reviewed. There were 33 patients with acute injuries (range, 3 to 21 days; mean, 14) and 55 patients with chronic tears (range, 28 to 3650 days; mean, 786). Of the acute injuries, chondral defects occurred in 4 patients (12%) and meniscal tears in 9 patients (27%; 6 lateral and 3 medial). Chondral defects of both the lateral femoral condyles and patella were present in all 4 patients. Of the chronic injuries, chondral defects occurred in 27 (49%) and meniscal tears in 20 patients (36%) (7 lateral and 17 medial). Chondral defects of the medial femoral condyle were most common. The mechanism of injury resulting in an isolated injury of the posterior cruciate ligament is most likely to affect the lateral compartment or the articular cartilage of the patella. The incidence of articular defects and the incidence of meniscal tears increased in patients with chronic posterior cruciate ligament injuries; both lesions increased most in the medial compartment.

Adolescent↗