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Biomedical subjects

W E Burkhalter

Publications and source records attributed to W E Burkhalter.

At least 37 records · Page 2Linked to original sources
PubMed1984

A functional treatment method for interphalangeal pyogenic arthritis.

A treatment plan for pyogenic arthritis has been devised in which the accessory collateral ligaments are resected through radial and ulnar midaxial incisions. The surgical wound is debrided and copiously irrigated with an antibiotic solution, and intravenous antibiotics are instituted before operation and continued after operation. Physical therapy is begun within 24 hours of surgery and includes active range of motion (ROM) of all joints, dynamic splinting, and hand therapy to ensure both full flexion and extension. Forty patients were treated with this method within a 6-year period. Of five interphalangeal (IP) joints of the thumb, four regained 0 degree to 60 degrees full ROM and one gained 15 degrees to 65 degrees limited ROM. Of the two distal IP joints, one regained full ROM and the other became fused. Among the 33 proximal IP joints, 13 regained full ROM of 110 degrees and 13 regained limited ROM. Good functional results were obtained with this treatment plan in lieu of amputation, which previously was the most likely treatment.

Adult↗
PubMed1984

Delayed primary bone grafting in the hand and wrist after traumatic bone loss.

Seventeen patients had 21 bone graft operations as part of the overall delayed primary management of hand and wrist wounds. All bone graftings were performed within 10 days of injury. Internal or external fixation was used in all cases, and all wounds healed without infection. Complications included a fibrous union at one bone graft juncture and one malunion. Follow-up was from 3 months to 7 years. Successful delayed primary bone grafting requires a well-decompressed and surgically-clean wound, good blood supply, adequate fixation, and secure soft-tissue cover. If these conditions cannot be met, bone grafting should be deferred and performed in the conventional manner. The advantages of delayed primary bone grafting are: primary bone healing, a shorter rehabilitation period, fewer operations, avoidance of wound contracture, and bone grafting in a well-vascularized scar-free bed.

Adolescent↗
PubMed1984

Closed treatment of fractures of the hand.

Closed treatment of hand fractures avoids the stiffness associated with internal fixation. Early motion within the framework described allows the soft tissues to participate in achieving stability of the fracture and seems to speed union.

Adult↗
PubMed1983

Septic arthritis of the wrist.

Twenty-eight patients (two of them children) with septic arthritis of twenty-nine wrists were treated with early surgical drainage, parenteral antibiotics, and early motion after surgical decompression. The etiology was trauma in seventeen patients, and Staphylococcus aureus was the organism that was most commonly recovered on culture. In twenty-two patients (twenty-three wrists) who were followed for six months to nine years there were no recurrences. The results were evaluated in terms of range of motion, grip strength, and subjective complaints of discomfort and disability. Of the ten wrists with a good or excellent result, all had had the arthrotomy within ten hours after diagnosis, and of the thirteen with a fair or poor result, surgery had been delayed for sixteen hours or longer. The long-term results deteriorated in direct proportion to increasing time until treatment and the number of procedures performed.

Adolescent↗
PubMed1976

The upper-extremity amputee. Early and immediate post-surgical prosthetic fitting.

The results of immediate and early post-surgical prosthetic fitting in eighty-seven upper-extremity amputees as well as the results in nine patients with shoulder dislocation who were fitted with temporary devices were reviewed. No local wound complications occurred and the rate of prosthetic acceptance was high. A practice prosthesis, with a filler insert formed from liquid Silastic foam allowed to set between the walls of the practice prosthesis and the amputation stump, was used extensively in this series. With the Silastic insert and practice prosthesis, prosthetic training could be instituted during healing of the amputation wounds, proximal wounds, or fractures.

Amputation, Surgical↗
PubMed1976

Femoral-neck fractures in young adults.

Twenty-two young adult patients with femoral-neck fractures fitting the following criteria were evaluated. All patients (1) were between twenty and forty years old, (2) had clinical and follow-up roentgenograms at least twelve months after the injury, (3) incurred fracture of the neck of the femur through normal bone, and (4) did not incur a stress fracture. The incidence of non-union was 59 per cent (thirteen of twenty-two patients) and of avascular necrosis, 86 per cent (nineteen of twenty-two patients). Evaluation of patients and results are discussed.

Adult↗
PubMed1975

The tibial shaft fracture.

Two large series of civilian-incurred (212) and combat-incurred (228) tibial shaft fractures are compared. Closed tibial fractures were treated by closed manipulation and weight bearing ambulation in a long leg plaster cast. Open injuries following wound exploration and debridement were treated similarly with wound closure. Combat-incurred tibial shaft fractures responded similarly to civilian-incurred injuries. Allowing an open fracture to heal with exposed bone at the fracture site resulted in an average time to removal of external immobilization only two weeks greater than for the uncomplicated tibial fracture. Whether weight bearing ambulation was instituted immediately (24-48 hr) or early (3-4 wk) did not shorten the time to removal of external immobilization. The infection rate in 289 open tibial fractures (228 combat-incurred and 61 civilian-incurred) was 3.8%, and all infections occurred in the open penetrating injuries.

Amputation, Surgical↗
PubMed1975

The functional treatment of pyogenic arthritis of the adult knee.

A method of treatment of pyogenic arthritis of the adult knee employing wide open arthrotomy and early active motion, as well as synovectomy in some knees, was used in thirty-four patients with pyogenic arthritis of the knee. Of these patients, sixteen had a good result, twelve had a fair result, and six had a poor result. This method of treatment was used as a salvage procedure in most of the patients, but may have more general application in the treatment of pyogenic arthritis of the knee.

Ankylosis↗