SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The decision to amputate should be made with due consideration of the eventual rehabilitation of the patient. With this in mind, general principles of amputation surgery are outlined and specific levels of amputation are described. Early post-amputation management has advanced over the last two decades to make rehabilitation goals the more readily reached. These advances are discussed.
Metastatic malignancies of the hand are infrequent and seldom initially diagnosed and often taken for infections. They usually occur at the late stage of metastatic generalization and indicate an ominous prognosis and justify surgical amputation. A case of metastasis to the distal phalanx of the left ring finger of a woman who had undergone radical mastectomy for breast cystosarcoma phylloides is reported. The evolution of this lesion, initially taken for a whitlow, lasted 45 days and eventually was treated by amputation. A review of literature confirms the rarity of the lesion, and reveals the pathological, clinical and radiographic characteristics.
During the last 20 years, particularly in Europe, high dosage radiation therapy was primarily advocated and secondarily surgical amputation. Today, the earliest possible surgical elimination is considered to be the most sensible. This need not necessarily take the form of a mutilating procedure since, on the basis of American statistics, the results of resection procedures can be considered to be equally good. In each case, the diagnosis must be histologically clarified by biopsy before drastic surgery. In the context of a plan of therapy which is individually discussed among surgeons, radiation therapists and internists, additional tasks such as metastasectomy and stabilizing procedures in tumor-induced fractures fall to the surgeon. While it is still too early for a survey, we nevertheless hope that the positive aspects of combined therapy in our individual cases will increasingly benefit the total number of patients with malignant bone tumors - even if only in the form of a prolongation of life with less symptoms.
The treatment, diagnosis, and outcome of frostbite victims is by no means an exact science. As this presentation shows, most authors agree that the key to control and treatment of cold injury comes from a reversal of the damage to the microvasculature (19). The methods of diagnosis of the extent of damage are all based on determination of vascular status whether it be tissue or bony structures. Treatment varies widely but rapid rewarming of the affected tissues is by far the most successful treatment to minimize tissue loss. As in the case study presented here, when surgical amputation is necessary, one must take mechanical function into account as well as the line of demarcation in order to give a functional limb for rehabilitation and to prevent the possibility of subjecting the patient to unnecessary repetitive surgical procedures.
Explore the source record for details and available documents.
The surgical technique for hindquarter amputation is described in a step-by-step manner. Since 1955 we have performed 19 such operations for eradication of malignant bone and soft tissue tumors in the pelvic, hip and upper thigh regions. Three hindquarter amputations were performed for local recurrence following initial wide excision. The overall 5-year survival rate for our 19 patients was 42.1 per cent. Malignant soft tissue tumors appear to have a much better 5-year survival rate than malignant bone tumors (60 per cent vs. 22.2 percent). We feel that surgery is still the treatment of choice. However, in the presence of proper indications, chemotherapy and radiotherapy should be added to surgery in order to prolong survival time and save lives.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A new system for measuring the cross-sectional area profiles of amputation stumps and whole limbs has been designed at the Amputee Research Centre. The instrument consists of a cylindrical tank supported on an elevator. The tank is raised to the height of the amputation stump and filled with water. A graph of the cross-sectional area profile of the amputation stump is generated by a mini-computer as the elevator descends. The cross-sectional area (A) is calculated from the expression: formula: (see text) where Hw = height of water in the tank He = height of the elevator Ac = a constant, related to the size of the measuring tank. This paper describes the instrument, which may find application in many other areas where there is a need to study shape.
Explore the source record for details and available documents.
This report describes a new hand injury seen in passengers in dune buggies having rollover accidents. Since these vehicles are usually driven off the road and far from treatment centers the treatment of these injuries is often delayed. As the rollover takes place, the reflex action--usually of the passenger--is to grasp the roll bar. A crush-avulsion injury occurs at the level of the metacarpals, with the thumb frequently spared. Wound contamination, delay in treatment, and the frequency of other serious injuries add to the seriousness of this injury. Redesign of the roll bar, provision of better passenger protection, and an internal grasp support are suggested to reduce its incidence.
Difficulties are experienced by the artificial limb maker and fitter when fitting prostheses to some lower extremity amputation stumps. These difficulties, due partly to operative techniques, are outlined, and suggestions are made for their correction.
Our patient's initial biopsy of the right fibula was diagnosed as Ewing's sarcoma and surgical amputation was suggested as the treatment of choice. After he refused, he was treated with chemotherapy and radiotherapy. The patient refused to continue this type of therapy after a 6 weeks' regimen. The supraorbital swelling occurred 3 years later and the biopsy of it also revealed Ewing's sarcoma, as did the mandibular specimen. The patient, again, refused any further treatment.
The growth of the stump has been studied in eighteen children with below-knee amputations. Measurements were available shortly after operation and later at skeletal maturity. It was found that all patients achieved less than expected growth and that the reduction was greater in those patients who had had amputation for congenital deformity.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.