Biomedical subjects

W H Kirkpatrick

Publications and source records attributed to W H Kirkpatrick.

5 recordsLinked to original sources

PubMed1996

Early motion after arthroplasty.

Early controlled motion after arthroplasty in the MP and PIP joints allows for collagen remodeling during the encapsulation process that creates a stable joint. Motion generally is begun within the first few days after surgery and must be supervised carefully. Dynamic splinting is an important component in achieving early motion in the MP joints and often is a useful adjunct in the PIP joints. Early motion after total wrist arthroplasty depends on surgical fit of the prosthesis. Only a tight fit allows early motion. The potential for complications resulting from early motion in the wrist is greater than in the MP or PIP joints and may involve increased wear, fracture, or component loosening. The benefits of early motion after arthroplasty, therefore, must be weighed against potential risks. Although generally necessary in the MP and PIP joints to achieve satisfactory results, early motion after total wrist arthroplasty has limited applications and significant risks.

Arthritis↗

PubMed1993

Scaphoid excision and capitolunate arthrodesis for radioscaphoid arthritis.

Eighteen patients with symptomatic radioscaphoid arthritis had scaphoid excision and capitolunate arthrodesis. Eight patients also had a silicone scaphoid replacement. The follow-up period averaged 3 years. Fusion was solid in 12 cases at an average of 8 weeks, and pain was significantly less at follow-up evaluation. Six patients had a pseudarthrosis and five had persistent pain. Immobilization in the pseudarthrosis group averaged 6 weeks, which was significantly less than the group that fused. Two patients underwent successful repeat fusions. Wrist extension averaged 26 degrees, flexion 34 degrees, radial deviation 11 degrees, and ulnar deviation 24 degrees. Grip strength averaged 25 kg. Presence of an implant had no significant effect on motion or strength. Pin track infection and pseudarthrosis were the main complications. Pain relief, functional motion, good strength, and patient satisfaction can be expected after scaphoid excision and solid capitolunate arthrodesis. Kirschner wires should be buried subcutaneously to avoid infection. The addition of a scaphoid implant offered no advantage over simple scaphoid excision.

Arthritis↗

PubMed1992

Metastatic renal carcinoma in the hand: treatment with preoperative irradiation and ray resection.

Isolated metastatic renal-cell carcinoma of the hand is a rare disorder that requires aggressive management for pain relief, improvement of hand function, and prevention of further spread of disease. An unusual presentation of isolated, advanced metastatic renal-cell carcinoma in the left third metacarpal of the nondominant hand is presented. Localized preoperative radiation therapy was used prior to ray resection to decrease tumor bulk and vascularity. The patient is alive and disease free at 1 year postoperatively with a functional but impaired hand.

Aged↗

PubMed1991

Dacron collateral ligament reconstruction with proximal interphalangeal joint arthroplasty.

A porous Dacron (Phoenix Bioengineering, Bridgeport, PA) tendon is described for collateral ligament reconstruction and augumentation with proximal interphalangeal joint implant arthroplasty. Eight cases with a minimum follow-up of 15 months are reviewed. Diagnoses include posttraumatic arthritis and osteoarthritis, as well as rheumatoid arthritis. The porous Dacron tendon is constructed as a collagen-like weave. It has been useful in patients who have insufficient local tissue to achieve lateral proximal interphalangeal joint stability. In selected cases, it can obviate the need for a tendon graft and provide an alternative to arthrodesis.

Adult↗

PubMed1991

Dacron stabilization of the distal ulna.

The pronator lock procedure offers an alternative to the treatment of chronic, symptomatic dorsal translation of the distal ulna in pronation. The porous Dacron tendon has been a useful adjunct and has obviated the need for free tendon grafts, intact tendon slips, or fascia lata in the construction of the radioulnar tether. Careful clinical and biomechanical evaluation of the technique and material is required and is currently under investigation.

Chronic Disease↗