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Biomedical subjects

A Ganel

Publications and source records attributed to A Ganel.

At least 91 records · Page 5Linked to original sources

Sequential use of technetium 99m MDP and gallium 67 citrate imaging in the evaluation of painful total hip replacement.

Fourteen patients with 20 total hip joint replacements were studied for 14 painful prosthetic hips. Clinical examination, plain film radiographs and 99Tcm-MDP bone scans failed to differentiate between infection and mechanical loosening of a prosthesis. Sequential use of 99Tcm-MDP and 67Ga-citrate bone scans were performed in an attempt to discover underlying infectious process. Increased focal uptake of both radiopharmaceuticals over the same hip indicated an infectious process responsible for prosthetic loosening. There were no false positive gallium examinations. Sequential use of 99Tcm-phosphate compounds and 67Ga-citrate is recommended for differentiation between mechanical loosening of a prosthesis and loosening of a prosthesis secondary to an infectious process.

Adult↗

Anterior transposition of the ulnar nerve.

Twenty-four patients with 26 ulnar neuropathies in the elbow region were treated by anterior transposition of the ulnar nerve. The dominant arm was involved in 14 of these patients. Improvement of paresthesia was found in 17 out of 21 (75 per cent) in this series of patients; 10 out of 18 (55 per cent) had improvement of sensation; 7 out of 14 (50 per cent) had less pain; 10 out of 14 (71 per cent) showed an increase in motor power, but only 2 out of 12 patients (16 per cent) with long-standing muscle atrophy showed any improvement in their condition. Electromyographic studies (EMG) were carried out before and after operation. The postoperative studies revealed increased motor conduction velocity within the elbow segment of the ulnar nerve in 15 patients. Slowing in ulnar nerve conduction velocity was found in 3 patients, and in 8 the EMG remained unchanged. Our EMG series indicated that patients with a conduction velocity of less than 40 m/s will certainly benefit more from anterior transposition of the ulnar nerve than will patients whose measurements are within the normal range.

Adult↗

Distal transfer of the greater trochanter in cox vara.

Seven patients (nine hips) who suffered from coxa vara were treated by distal transfer of the greater trochanter. The operation eliminated or markedly diminished the preoperative Trendelenburg sign, thus improving gait. In three patients (four hips) operated upon at the aged of 9 and 12 years, the initial coxa vara was converted into an almost normal valgus kemoral neck. There was one poor result due to technical failure.

Adolescent↗

Nerve entrapments associated with postmastectomy lymphedema.

Ninety females underwent mastectomy for breast cancer and were thereafter investigated to determine whether nerve entrapments were responsible for some of the disabling symptoms in their arms. The majority of these patients suffered from fullness (edema), numbness, paraesthesia, weakness and pain of the arm on the mastecotmized side. Lymphedema of varying degrees found in 50% of these patients was associated with brachial plexus entrapment and carpal tunnel syndrome (CTS). 28% of the patients has CTS, and 28% suffered from brachial plexus entrapment of the arm on the mastecotmized side, as compared with 8% and 5%, respectively, on the nonoperated side. 12% of the patients suffered from both types of entrapment. Thus we consider that brachial plexus entrapment and carpal tunnel syndrome should be added to the list of complications following mastectomy, with lymphedema playing an active part in their development.

Adult↗

Arthrography as a method of diagnosing tear of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb ("gamekeeper's thumb").

Arthrography of the metacarpo-phalangeal (MP) joint of the thumb was performed on 47 thumbs. The normal arthrographic appearance shows a closed joint space, whereas leakage of contrast material indicates tear of the joint capsule with or without an associated tear of a stabilizing ligament. Arthrographic demonstration of the heads of the adductor pollicis muscle was found to be specific for tear of the ulnar collateral ligament (UCL) of the MP joint, a tear which is commonly responsible for its instability. Arthrography is suggested as a safe and accurate diagnostic examination for the early detection of tears of the UCL of the MP joint.

Adolescent↗

Arthrography as a method of diagnosing soft-tissue injuries of the wrist.

Wrist arthrography was performed in 30 patients suffering from post-traumatic wrist sprain, or whom 15 sustained fractures. A longstanding soft-tissue injury was demonstrated in 70% of the whole group and in 60% of wrist sprains not associated with fracture. Findings include radiocarpal-radionulnar communications (26.6%), radiocarpal-midcarpal communications (36.6%), midcarpal-carpometacarpal communications (30%), radiocarpal-pisotriquetral communications (60%), tendon communications (20%), and lymphatic filling (43.3%).

Adolescent↗

Leg lengthening in achondroplastic children.

Bilateral simultaneous elongation of the lower limbs was performed in 3 achondroplastic children. A total of 10 bones were elongated with Wagner's distraction apparatus, mainly by a modified Wagner technique. Maximal elongation of 34 to 44% of the original bone length resulted in relatively minor complications. Elongation of the lower limbs in achondroplastic children improves trunk-to-lower-limb proportions.

Achondroplasia↗

Surgical treatment for pneumatosis cystoides intestinalis complicating jejunoileal by-pass.

A case of chronic pneumatosis cystoides intestinalis, complicating jejunoileal by-pass procedure for morbid obesity, is described. Grave clinical symptoms associated with irreversible segmental mucosal atrophy and mural fibrosis resulting from untreated long-standing pneumatosis intestinalis, required resection of the whole by-passed small intestine. It is suggested that this simple and safe surgical procedure is justified in selected cases. Conservative treatment of asymptomatic patients with pneumatosis intestinalis, however, may prevent further surgical intervention in these patients.

Adult↗