Biomedical subjects
Publications and source records attributed to A Blankstein.
Too often a relatively minor surgical procedure can prevent complications at a later stage. The diagnosis in children is often missed because of normal physiologic states that closely resemble the pathology. The early detection and correction of congenital short Achilles tendons can prevent further developmental abnormalities.
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Although ankle sprains are probably the most common injury in adolescent sports people, epiphyseal injuries are missed on the presumption of a ligamentous tear. The risk of damaged ligaments has been overemphasized while the potentially dangerous epiphyseolysis has been understressed. An oblique X-ray of the ankle joint is indicated prior to "stress" pictures.
Septic arthritis of the sternoclavicular joint (SCJ) is a rare disorder, and is usually associated with predisposing factors such as contiguous foci of infection, heroin addiction, rheumatoid arthritis and diabetes mellitus. Three cases in previously healthy adults are reported here. The aetiology, clinical manifestations and treatment are briefly reviewed. The considerable difficulty in diagnosing this disorder in adults is emphasized. In summary, diagnosis of septic arthritis of the SCJ in adults requires a high index of suspicion, and must be considered not only in patients with predisposing factors, but also in previously healthy adults.
The treatment of high-velocity missile injury to the limbs is often associated with segmental bone loss, as well as damage to neurovascular and soft tissue. In such "limb threatening" cases, massive bone allograft can fill the bone defect and offer stability to the soft tissue reconstruction. The return of function in the affected limb is relatively rapid when using this method as a primary procedure. The indications for use of this technique and illustrative case reports are presented and discussed.
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Muscle contractures are infrequent in Israel. This report discusses one case of a congenital contracture associated with a skin dimple treated in Israel. A 3-year-old boy presented with difficulty in running, riding a bicycle, and squatting. Flexion of the right hip in adduction was impossible. The hip could be fully flexed in abduction. Congenital contracture of the right gluteus maximus muscle was successfully treated by surgical release.
Aneurysmal bone cyst (ABC) is a benign lesion and generally occurs in the long bones and vertebral column. ABC of the rib is an uncommon entity. Two cases of ABC involving the rib are reported. Its occurrence in the eight decade of life as manifested in one of our patients is extremely rare. The aetiology, clinical manifestations, pathology and treatment are briefly discussed. En bloc resection of the lesion is curative, and offers a good cosmetic and functional result.
An unusual case of hemangioma involving three adjacent dorsal vertebrae with a clinical picture of progressive paraparesis is presented. Radiological verification of the lesion can be expected if possible, using plain X-Rays, tomography, CT scan and myelography. The roentgenographic appearances of vertebral hemangioma were characteristic, but only CT revealed the true extent of the disease. Reports of such a case have appeared infrequently in the literature. [Karshner 1936, Bailey 1955, Reeves 1964, Robbins 1958].
Self-inflicted injuries are probably more common than is generally appreciated. Three patients with self-inflicted hand injuries are described. A delay in making the correct diagnosis resulted in severe hand disability in 2 of the patients. Early diagnosis of this entity, combined with prompt psychotherapy, prevented disability in the third. The pertinent literature is reviewed and the importance of early diagnosis and psychotherapy is stressed.
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Osteoblastoma has become a well defined bone tumor since its first description by Jaffe and Mayer in 1932. This tumor was considered to occur in almost any bone of the skeleton. Only one previous case of sternal osteoblastoma was described in the literature. Herein we report, as far as we know, the second reported case of osteoblastoma in the sternum, as an isolated tumor.
A fast, simple, and accurate method is described for intralesional injections using a laboratory repetitive pipette that was modified for this specific purpose.
The problem of subluxation of the hip joint during femoral elongation is reviewed and pathogenesis and prevention of this rare complication are discussed.
A case of factitious lymphedema of the hand is presented. Attention is drawn to this entity and its differential diagnosis. Delayed detection in our case resulted in prolonged and costly hospitalization with some loss of hand function. Treatment should be left to those skilled in psychotherapy.
Percutaneous lateral discectomy (PLD) in a 32-year-old man was followed by postoperative disc space infection and adjacent vertebral osteomyelitis caused by Staphylococcus aureus. The simplicity and decreased morbidity associated with PLD may be offset by severe infections. The small incision made in the annulus during PLD may not allow adequate drainage in the case of infection and may subsequently direct the infective process to the adjacent vertebral endplates. Meticulous aseptic technique, and possibly the use of prophylactic antibiotic therapy, is important in PLD.