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Biomedical subjects

C L Saltzman

Publications and source records attributed to C L Saltzman.

82 records · Page 5Linked to original sources
PubMed1991

Familial cervical dysplasia.

Nine of twelve family members from three generations were affected by an inherited form of cervical vertebral dysplasia. All of the affected people had an abnormality of the first cervical vertebra. Some also had defects of the axis and caudad to it. The mode of transmission of the disorder is autosomal dominant, with apparently complete penetrance and variable expressivity. Two patients had symptoms. One had a passively correctable tilt of the head, with an associated audible clunk and hypoplasia of the left superior facet of the second cervical vertebra. This patient had no local symptoms, neurological involvement, or muscle spasm. In the other patient, suboccipital pain developed. Radiographs revealed an anterior atlanto-occipital dislocation. The symptoms resolved after reduction and arthrodesis. Because of the apparently complete penetrance of this disorder, physicians caring for patients who have this type of congenital malformation of the cervical spine should consider examination of closely related members of the family. Clinical findings such as tilting of the head, torticollis, or limitation of cervical motion suggest that additional evaluation should be done. The examination should include lateral radiographs of the cervical spine in flexion and extension. Three-dimensional computed-tomography reformatting was helpful in demonstrating the complex cervical anatomy in our patients. Patients who have recognized abnormalities should be followed and should be re-examined whenever local or neurological symptoms develop. A magnetic resonance image of the spine in flexion and extension was valuable for identification of the potentially disastrous situation of impending damage to the cord in patients who had instability and evolving symptoms.

Adult↗
PubMed1990

Results of treatment of displaced patellar fractures by partial patellectomy.

The results of partial patellectomy as a treatment for displaced patellar fractures were assessed retrospectively with use of clinical, radiographic, and isokinetic strength-testing criteria. Forty patients who had been followed for an average of 8.4 years were studied. In the extremity that had been operated on, the mean active range of motion was 94 per cent, the circumference of the thigh was 100 per cent, and the strength of the quadriceps was 85 per cent of these measurements in the contralateral extremity. The over-all result was rated as excellent in twenty patients, good in eleven, fair in six, and poor in three. There was a significant statistical correlation between the type of fracture and the outcome. The results of this study indicate that partial patellectomy can be an effective treatment for selected patellar fractures.

Adult↗
PubMed1989

Hand problems in pregnancy.

The most frequently encountered hand disorders in pregnancy are carpal tunnel syndrome and de Quervain's tenosynovitis. Conservative therapy should be initiated to minimize patient discomfort. Appropriate splinting is the cornerstone of treatment in pregnant women. Surgery is usually not indicated in this patient population.

Carpal Tunnel Syndrome↗
PubMed1987

Leapfrog leg.

Explore the source record for details and available documents.

Athletic Injuries↗
PubMedDate not supplied

Longitudinal tibial stress fractures: a report of eight cases and review of the literature.

PURPOSE: We present the imaging features of longitudinal stress fractures in eight patients and evaluate the literature to determine which tests are most useful for making this diagnosis. METHOD: Three musculoskeletal radiologists retrospectively reviewed eight cases of longitudinal tibial stress fractures presenting between 1988 and 1994. Reports on 36 cases, cited in the literature between 1960 and 1996, also were reviewed. Imaging modalities used and characteristic imaging features were noted. RESULTS: Plain radiographs had a characteristic appearance in approximately 28% of patients. Initially, plain films were negative, and in most cases, they eventually showed characteristic radiographic features. However, 25% of cases failed to demonstrate a plain film abnormality, with the diagnosis made by other modalities. CT or MRI is often diagnostic, and longitudinal stress fractures have characteristic imaging features with each modality. While sensitive, bone scan has lower specificity than either CT or MRI. CONCLUSION: Longitudinal stress fractures have characteristic imaging features, and familiarity with these features is necessary for timely and efficient diagnosis, avoiding morbidity due to delay or use of unnecessary tests.

Adult↗
PubMedDate not supplied

Surgical treatment for mild deformities of the rheumatoid forefoot by partial phalangectomy and syndactylization.

Thirteen patients (14 feet) were treated for mild rheumatoid forefoot deformities with lesser toe partial proximal phalangectomies and partial syndactylizations. Eleven patients (85%) were reviewed at an average of 8 years postoperatively. The results were completely satisfactory in four patients, satisfactory with minor reservations in three patients, satisfactory with major reservations in one patient, and unsatisfactory in three patients. The major cause of reservations and lack of satisfaction was metatarsalgia. Seven patients (64%) reported that their activities were limited by intermittent metatarsalgia. Four patients (36%) considered the cosmetic appearance of the forefoot to be unsatisfactory. All but one patient required some form of shoewear modification. Based on this study, we believe the indications for this procedure are limited. These include rheumatoid patients with mild forefoot deformities without significant metatarsalgia or ongoing disease who have failed nonoperative treatment. Relative contraindications to this operation appear to include the recent onset of rheumatoid arthritis, active disease, significant metatarsalgia, and strong cosmetic concerns regarding outcome. In borderline clinical decisions that involve whether or not to leave or excise the lesser metatarsal heads, they probably should be excised to decrease late metatarsalgia.

Adult↗
PubMedDate not supplied

Cuboid stress fractures: a report of two cases.

Stress fractures of the tarsal cuboid are rare. The literature contains three reported cases. This report presents two additional cases. These two occurred in collegiate athletes, and mimicked peroneal tendonitis on presentation. History, physical examination, plain radiographs, and bone scan were used for diagnosis. Treatment consisted of immobilization and activity modification, with complete resolution of symptoms in both cases.

Adult↗
PubMedDate not supplied

Achilles tendon injuries.

As the number of persons who participate in athletic activity into their later years has increased, so has the incidence of overuse injuries to the Achilles tendon. The etiology of these problems is multifactorial and includes biomechanical factors and training errors. Use of a histopathologic scheme for classification of these injuries facilitates a logical approach to treatment. Conservative care is a mainstay of treatment for inflammatory conditions. Satisfactory outcomes may be obtained with either nonoperative or operative treatment of acute ruptures, although surgically treated patients appear to recover better functional capacity. Treatment of neglected injuries to the Achilles tendon continues to be a challenging problem.

Achilles Tendon↗
PubMedDate not supplied

Thick lips, bumpy tongue, and slipped capital femoral epiphysis--a deadly combination.

Multiple endocrine neoplasia type 2b (MEN 2b) is a rare genetic disorder. Affected individuals have malignant thyroid tumors, pheochromocytoma, and ganglioneuromatosis. The musculoskeletal manifestations of MEN 2b include a Marfanoid habitus, pes cavus, scoliosis, slipped capital femoral epiphysis, joint laxity, poor muscle development, and delayed maturation. The initial clinical presentation of MEN 2b frequently involves the musculoskeletal system. The characteristics ganglioneuromatosis of the lips and tongue, however, should alert the orthopedic surgeon to the underlying disorder. Effective treatment of the malignant neoplasms hinges on early diagnosis. The risk of perioperative hypertensive crisis is significant; it may be prevented by appropriate treatment of the pheochromocytoma.

Adolescent↗