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Biomedical subjects

D C Ferlic

Publications and source records attributed to D C Ferlic.

At least 37 records · Page 2Linked to original sources
PubMed1986

Volz total wrist arthroplasty in rheumatoid arthritis: a long-term review.

The results of 30 Volz total wrist arthroplasties in 23 patients with stage III or stage IV rheumatoid arthritis were reviewed 36 to 106 months after the operation (average 69 months). Sixty percent were rated good or excellent, 27% were rated fair, and 13% were rated poor. Good or excellent results were achieved in 77% with single-prong metacarpal components, but in only 47% of the double-prong group. Wrist imbalance was the primary cause of poorer results with the double-prong metacarpal component. Pain relief and patient satisfaction were achieved in 86% of the cases. Typical radiologic patterns of deterioration were resorption of bone under the collar of the radial component (79%, average 3.7 mm) and metacarpal component loosening (24%). Most patients with component loosening had little or no discomfort. Complications occurred in 12 cases but affected the final outcome in only three patients.

Adult↗
PubMed1985

Bilateral traumatic dislocations of Volz total wrist arthroplasties: a case report.

Bilateral traumatic dislocations of Volz total wrist arthroplasties in a patient with rheumatoid arthritis occurred 7 years after the initial surgical procedures. Treatment consisted of closed manipulation and reduction of both wrists followed by temporary splinting. Good function was restored in both wrists without operative intervention. No fractures or loosening at the bone cement interface was encountered.

Arthritis, Rheumatoid↗
PubMed1985

Synovectomy of the hand and wrist.

Synovectomy of tendons gives excellent results with rare recurrence. This is because the local environment is altered from a closed space into a decompressed area of healthy fat. The synovium can invade and destroy tendon, cartilage or bone when in a closed space and under pressure. Unfortunately, the environment can not be so altered in a joint. Joint synovectomy, however, is the only procedure available to prolong function of the patient's own joint (and relieve pain) for an "X" amount of time, which depends upon the course of the generalized disease. After two to three years, the result of a synovectomy is dependent upon the course of the general disease activity and not the surgery. It is absolutely necessary that general medical treatment be carried on before, during, and after surgery, as the surgery is only one incident, often dramatic, in total care of the patient. Chemical synovectomy of the hand has been shown to have variable results with only short-term gains being noted. Surgical synovectomy is indicated when synovitis persists in spite of adequate medical management and there is pain and early correctible deformities. Besides removing the synovium, it is necessary to reconstruct the capsular support and correct alignment. Flexor tenosynovitis in the fingers should be treated with decompression of the digital sheath, not incising the pulley system due to the possibility of accentuating the forces causing ulnar drift. Dorsal tenosynovitis in the wrist is treated by tenosynovectomy, synovectomy, resection of the distal ulna, reconstruction of the ulnar side of the wrist and transposition of the dorsal carpal ligament beneath the extensor tendons.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthritis, Rheumatoid↗
PubMed1983

Extensor tendon rupture over the metacarpal heads.

Rupture of the extensor tendons is common in longstanding rheumatoid arthritis of the hand. The tendons commonly involved are those of the ring and little fingers and the common site of rupture is over the dorsal ulna and distal edge of the extensor retinaculum. We are reporting two cases of extensor tendon rupture over the metacarpal head of the middle finger due to prominent osteophytes.

Adult↗
PubMed1983

Compression arthrodesis of the thumb.

A retrospective study of all patients who had undergone thumb arthrodeses at the Denver Orthopedic Clinic since 1972 was undertaken to determine the incidence of satisfactory results with the Micks External Compression Fixator. Sixty-six patients underwent 82 metacarpophalangeal or interphalangeal arthrodeses that resulted in bony fusion in 81 cases. Indications for surgery included pain, instability, and collapse-type thumb deformity. Complications in the 81 successful cases included three that required a second procedure, one for nonunion and two for loss of position. There were eight cases of pin track drainage that cleared with removal of the device and did not adversely influence the outcome. Joints arthrodesed with external compression formed bony union in approximately half the time required for bony unions with Kirschner wire fixation. The fused position of either metacarpophalangeal or interphalangeal joints did not influence patient satisfaction, and all patients were satisfied with their surgery and demonstrated satisfactory use of the thumb.

Adolescent↗
PubMed1983

Dorsal wrist synovectomy in rheumatoid arthritis--a long-term study.

Dorsal wrist synovectomy, tenosynovectomy of the extensor tendons, excision of the distal ulna, ulnar-side stabilization of the wrist, and placement of the extensor retinaculum underneath the extensor tendons is an effective procedure in wrists with rheumatoid arthritis. Twenty-seven patients who had surgery on 38 wrists were followed for 5 to 14 years, with an average of 7.4 years. There were 25 female and two male patients with an average age of 54 years. Over 95% had excellent pain relief. There was significant reduction of wrist motion, but the arc of motion was within a functional range. Subsequent tendon rupture was minimal and even tendons found to be thinned out at the time of surgery remained intact. There was no recurrence of synovitis. Carpal measurements were done by using the pisiform bone as a reference point. The carpal height was maintained in 70% of the wrists. Carpal translocation occurred in 44% of the wrists. Three patients required wrist arthrodesis, and five, arthroplasty. Carpal collapse and translocation could not be predicted by preoperative x-rays. Progressive carpal collapse was associated with increasing ulnar deviation of fingers. Progression of carpal collapse and ulnar translocation occurred in a linear fashion with the years of follow-up.

Arthritis, Rheumatoid↗
PubMed1983

Pyoderma gangrenosum presenting as an acute suppurative hand infection--a case report.

Pyoderma gangrenosum, an uncommon disorder characterized by necrosis and noninfective skin ulcerations, was found in a patient who presented with an apparent hand infection. Cultures of the purulent material showed no growth. The treatment of choice was large doses of steroids and control of his ulcerative colitis. No similar case could be found in the literature.

Acute Disease↗
PubMed1982

Prosthetic arthroplasties of the shoulder.

Twenty-two Neer shoulder arthroplasties were performed in rheumatoid and osteoarthritic patients and followed for a minimum of two years, with an average of four years, seven months. In addition to the Neer humeral prosthesis, eight had Neer glenoid components and seven had a subacromial spacer inserted. Two years postoperation, 11 patients had no pain and eight had only mild discomfort. Shoulder function improved more than 100% compared with the preoperative ratings while the range of motion increased relatively little. There was one failure. Although the hemiarthroplasty group scored similarly to the total shoulder group, total shoulder arthroplasty is preferred because of possible further glenoid deterioration. A subacromial spacer is used if the rotator cuff cannot be repaired. The Neer shoulder prosthesis is recommended for the relief of rheumatoid or osteoarthritic shoulder pain.

Adult↗
PubMed1980

Volz total wrist arthroplasty in rheumatoid arthritis: a preliminary report.

The results of 20 Volz design total wrist arthroplasties in 19 patients with stages III and IV rheumatoid arthritis are presented. Follow-up averaged 18 months. Using a 100-point evaluation form, there were 75% excellent or good results and 10% poor results. An effective extensor carpi radialis brevis tendon and the presence of volar and ulnar contractures were the most important factors influencing the results. This operation is recommended in patients with painful stage III or IV rheumatoid wrist disease, and in whom the extensor carpi radialis brevis is functioning where preservation of motion is desired.

Adult↗
PubMed1978

The use of the Flatt hinge prosthesis in the rheumatoid thumb.

Nine patients with marked destruction in both the metacarpophalangeal and interphalangeal joints of the thumb, were treated with fusion of the interphalangeal joint and insertion of the Flatt hinged metal prosthesis into the metacarpophalangeal joint. Of the nine thumbs treated in this manner, eight had good to excellent results. One prosthesis was removed after it became infected, leaving both joints fused.

Arthritis, Rheumatoid↗
PubMed1978

Flexor tenosynovectomy in the rheumatoid finger.

The usual operation fo stenosing flexor tenosynovitis is resection of the proximal pulley. In the rheumatoid hand this operation may not be proper because motion still may be limited by the thickened synovium more distally, and also because there is a greater chance for the production of ulnar drift later on if the proximal pulley system is obliterated. The operation we recommend for the finger with rheumatoid tenosynovitis is a tenosynovectomy, but with maintainence of the pulley system and resection of one slip of the superficialis in order to decompress the digital theca. We have performed this operation on 54 fingers with satisfactory results.

Arthritis, Rheumatoid↗
PubMed1977

Degenerative arthritis of the carpometacarpal joint of the thumb: a clinical follow-up of eleven Niebauer prostheses.

Eleven patients with disabling osteoarthritis at the base of the thumb were treated with a Dacron-reinforced trapezium replacement arthroplasty. Examination from 1 to 3 years later (average, 20 months) showed that all patients were satisfied, principally because of relief of pain. The range of motion and stability were satisfactory, although far from normal. Postoperative dislocation did not occur. This problem was eliminated by correcting hyperextension of the metacarpal phalangeal joint and by reinforcing the capsule over the trapezium with a buttress created by transferring half of the distal end of the flexor carpi radialis to the insertion of the extensor carpi radialis longus. None of the prostheses fractured and no bone erosion was seen on postoperative roentgenogram.

Aged↗
PubMed1975

Shoulder arthroplasty in rheumatoid arthritis.

Replacement arthroplasty for the shoulder in rheumatoid arthritis is an operation which is being performed increasingly often. Several types of arthroplasty may be performed. One type is a true total shoulder replacement which involves replacing both the head of the humerus and the glenoid fossa. In a second type of arthroplasty, the articular surface of the humeral head is replaced. A modification of this type is the addition of a polyethylene spacer. Indictations for surgery, the surgical procedure, and the postoperative management are duscussed. The primary goal in the rheumatoid shoulder is a pain-free joint with a functional range of motion.

Arthritis, Rheumatoid↗
PubMed1975

Surgical treatment of the symptomatic unstable cervical spine in rheumatoid arthritis.

In rheumatoid arthritis spontaneous subluxation of cervical vertebrae is not infrequent and can usually be managed by conservative treatment. Surgical treatment, however, is necessary when there is neural involvement. Of twelve patients who had spine fusion for atlanto-axial subluxation only six had solid union. When conservative treatment fails, reduction by halo traction and arthrodesis of the cervical spine is the method recommended, but the best method of post-operative care remains uncertain. In these patients postoperative immobilization was provided by various methods, including a halo cast or brace, but no method appeared to be superior.

Adolescent↗