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Biomedical subjects

W D Engber

Publications and source records attributed to W D Engber.

At least 19 recordsLinked to original sources
PubMed1992

Chronic Lyme disease arthritis: review of the literature and report of a case of wrist arthritis.

A case of Lyme arthritis with advanced degenerative changes localized to the midcarpal joint was treated with a limited wrist arthrodesis with relief of pain and improved function. Chronic Lyme arthritis occurs as the third stage of Lyme disease. Serologic testing and a history of a characteristic rash may be helpful in the diagnosis. Radiographic and histopathologic findings are nonspecific, with both degenerative and inflammatory characteristics. Intravenous antibiotics provide an effective treatment of chronic Lyme arthritis.

Adult↗
PubMed1990

Biomechanical and histological evaluation of the Herbert screw.

The Herbert screw has been demonstrated to have widespread clinical applicability. A biomechanical and histological evaluation of the Herbert screw was conducted to better define its applications. When subjected to pull-out, toggle, and compression testing, in a cancellous bone calf model, it was demonstrated to be biomechanically inferior to the 4.0 mm ASIF cancellous screw. The use of two Herbert screws minimized but did not eliminate this difference. Articular cartilage healing in a rabbit model was consistently demonstrated if the Herbert screw was buried deep to the osteochondral junction. However, toluidine blue histochemical staining showed that the hyaline-like repair cartilage differed qualitatively from normal cartilage. Utilization of the Herbert screw should include an understanding of the limitations of its fixation potential and a recognition of the repair response after intraarticular applications.

Animals↗
PubMed1989

Retrograde Herbert screw fixation for treatment of proximal pole scaphoid nonunions.

Most nonunions of the carpal scaphoid bone can be treated with a high rate of success by use of conventional bone grafting techniques. However, fractures with a small proximal pole fragment may be difficult to treat by use of these techniques. Nine patients with nonunion and three patients with unstable proximal pole fractures were treated with retrograde dorsal Herbert screw fixation and adjunctive bone grafting. Follow-up averaged 25 months. Of the 12 patients, the fracture healed in 11 and one fracture remained ununited. This technique has been successful in our practice and should be considered in the treatment of small proximal pole nonunions and displaced proximal pole fractures.

Adolescent↗
PubMed1987

Ganglions of the wrist and digits: results of treatment by aspiration and cyst wall puncture.

In a prospective study, 87 carpal and digital ganglions were aspirated, multiply punctured, and digitally ruptured. Fifty percent of wrists and digits were immobilized for 3 weeks and 50% were mobilized early. Mean follow-up was 22 months. Thirty-six percent (31/87) of all ganglions treated showed a successful outcome. Twenty-seven percent (16/60) of dorsal carpal, 43% (6/14) of palmar carpal, and 69% (9/13) of palmar digital ganglions did not recur. Immobilization significantly improved the results of treatment of dorsal carpal ganglions. Forty percent (12/30) of those in the immobilization group and 13% (4/30) of those in the early mobilization group had a successful outcome (p less than 0.05).

Fingers↗
PubMed1986

Expanding applications for the Herbert scaphoid screw.

A distinctive new bone screw developed for the management of scaphoid fractures and nonunions promises to have expanding applicability. Its utilization for osteochondral fractures, small joint arthrodeses, osteochondritic lesions, and fractures involving small bones is described. Its unique design affords significant advantages over more conventional management techniques of these problems.

Arthrodesis↗
PubMed1986

Metastatic breast cancer in the femur. A search for the lesion at risk of fracture.

Clinical records and radiographs of 203 female patients with 516 metastatic breast lesions located in the proximal femur were examined retrospectively to determine: the dimensions of those lesions that were at risk of fracture; and the relationship of other variables (bone pain, body habitus, age, and radiation treatment) with the occurrence of a pathologic fracture. Twenty-three patients sustained 26 pathologic fractures. Their average age, height, and weight were not significantly different from the 180 patients without fractures. Similarly, moderate to severe bone pain was experienced by a great majority of the total patient population, yet only 11% sustained fractures. Fifty-six patients received radiation treatment of a femoral metastasis. Ten of these patients subsequently sustained fractures. Radiation treatment relieved bone pain but did not have any consistent curative effect on the lesion itself. Finally, the authors were unable to identify either a specific percent involvement of the bone or a critical diameter for metastases that fractured because: 296 (57%) of the 516 metastases were permeative lesions and unmeasurable; 14 (54%) of the 26 pathologic fractures observed occurred through unmeasurable lesions; and the 12 measurable lesions that fractured had the same range of percent involvement as the 208 measurable lesions that did not fracture. Breast metastases at risk of fracture cannot be identified by measurements obtained from standard radiographs alone.

Adult↗
PubMed1985

Nonoperative treatment of traumatic dislocations of the extensor digitorum tendons in patients without rheumatoid disorders.

Traumatic subluxation and dislocation of the extensor digitorum tendons are uncommon in patients without rheumatoid disorders. Management of the acute injury is not well defined in the orthopedic literature. Two cases of traumatic dislocations of the extensor digitorum tendon were seen acutely in young persons without rheumatoid disease. These patients were successfully managed by early closed reduction and immobilization. This treatment had yielded good hand function to date, without recurrence of the dislocation. One of these cases was particularly unusual in that the direction of the tendon dislocation was radial. This particular injury has not been previously described.

Adult↗
PubMed1985

Trigger wrist: a case report.

Previously published reports on trigger wrist have described triggering of the fingers at the wrist. We observed a case of true triggering of the wrist that was due to a nodule in the extensor carpi radialis longus tendon as it entered the second dorsal compartment. Reduction tenoplasty of the traumatic nodule and release of the second dorsal compartment relieved all symptoms. This is the first reported case that is accurately identified as trigger wrist.

Adult↗
PubMed1979

Syndactyly with Larsen's syndrome.

The association of syndactyly with Larsen's syndrome is reported. A revised listing of syndromes which may be associated with syndactyly is presented.

Abnormalities, Multiple↗
PubMed1977

Camptodactyly: an analysis of sixty-six patients and twenty-four operations.

Camptodactyly is a nontraumatic flexion deformity of the proximal interphalangeal joint. The literature pertaining to its etiology and treatment is reviewed. An analysis of 66 patients with 110 affected hands is discussed with particular reference to the natural history of this deformity and the results of 24 operative procedures. Improvement was noted in less than 20% of 32 patients treated nonoperatively and followed for an average of 30 months. Corrective types of operative procedures in 20 hands resulted in improvement in only 35%. A treatment plan dependent on the age of the patient, the presence or absence of osteocartilagenous changes at the proximal interphalangeal joint, and associated anatomic abnormalities is presented.

Contracture↗
PubMed1977

Stress fractures of the medial tibial plateau.

In a review of thirty-six patients with fifty-seven stress fractures of the medial tibial plateau, I found that limitation of activity was universally successful in treatment. Neither displacement of the fracture nor recurrence of symptoms after healing were seen. The main danger in this entity is misdiagnosis and inappropriate treatment.

Adolescent↗
PubMedDate not supplied

Hand-reduction malformations: genetic and syndromic analysis.

Sixty-one sequential patients initially referred because of hand-reduction abnormalities were retrospectively reviewed. Twenty distinct diagnoses were recognized. Particularly noteworthy was the number of instances in which standard classification schemes failed to explain fully the structural or syndromic characteristics in this group of patients. One-fourth (15 of 61) of the diagnoses were of disorders resulting from abnormalities of single genes; more than one-third (21 of 61) had multiple malformation syndromes. The importance of dysmorphologic and genetic investigation of individuals with congenital reduction malformations of the hands is evident from these data and from the cases presented.

Abnormalities, Multiple↗