Experience in monitoring the circulation in free-flap transfers.
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Animals↗
Biomedical subjects
D H Harrison
Publications and source records attributed to D H Harrison.
Use of the polypropylene peg for immediate stabilization in digital replantation.
A common site for digital amputation is through the middle phalanx, with comminution of the distal or proximal interphalangeal joints. To circumvent delayed union and a stiff painful joint, a not infrequent sequele of standard fixation methods, 12 cases are presented in which a polypropylene peg has been employed for immediate stabilization, as the first stage of replantation. It provides rapid osteosynthesis, a painless stabilization of the finger in a functional position, permits early return of movement in adjacent joints, and prevents excessive shortening of the finger. No case has been complicated by infection or extrusion.
Adult↗
Nasal injuries: their pathogenesis and treatment.
The treatment of a fractured nose by manipulation is criticised. A "perfect" result was achieved in only one-third of 40 cases, a finding mirrored in the literature. The anatomy of nasal fractures produced experimentally in 15 cadavers is described. A recurring pattern of septal fracture and displacement is identified as the cause of the poor results of manipulation. Release of locked septal displacement by a defined local submucous resection, as part of the primary treatment, has given greatly improved results.
Adult↗
Re-alignment procedure for ulnar drift of the metacarpophalangeal joint in rheumatoid arthritis.
An operation for correcting ulnar deviation in rheumatoid arthritis, by employing local tendon transfers at an early stage in the developing deformity, is described. The pathology, clinical staging and results in 103 joints are presented.
Arthritis, Rheumatoid↗
Primary treatment of craniofacial injuries.
This presentation offers analysis of findings and treatment of 15 patients who suffered cranio-facial injury. 4 of them sustained isolated fractures of the glabella and supra-orbital margin; the remainder suffered disruption of the facial and cranial skeleton. In all cases, the possibility of dural tear with C. S. F. leak, should be considered. The advantages of primary treatment of cranio-facial injuries by a joint neuro- and maxillo-facial team are as follows:--The risk of meningitis is greatly reduced.--The precise diagnosis of injury and maximum conservation of tissue is possible.--Most of the dissection necessary for repair is carried out by the force of impact and no fibrous tissue is present to hinder reconstruction.--Finally, primary surgery gives the best possible cosmetic results. Secondary skeletal surgery, even on the scale proposed by Tessier, often falls short of the results possible with adequate primary treatment.
Adolescent↗
pO2 and pH micro-electrode studies in surgical patients [proceedings].
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Adult↗
The stiff proximal interphalangeal joint.
The anatomical factors causing stiffness at the proximal interphalangeal joint are considered, a rational approach to the surgical treatment is proposed, and the results in thirty joints are presented.
Finger Joint↗
Open palm technique for Dupuytren's contracture.
A study of the pre-operative condition of seventy-five hands afflicted with Dupuytren's contracture is followed by an analysis of the results of limited fasciectomy approached by midlateral digital and transverse palmar excisions. The palmar wounds were left open and healing occurred with minimal complications. The correction of contractures compares favourably with that achieved using other techniques of access and wound closure.
Adult↗
Septic arthritis in association with primary lymphoedema.
The association between b-haemolytic streptococcal arthritis of the knee and primary lymphoedema is reported. This condition appears to resolve slowly using conventional methods of treatment, in the form of immobilisation and antibiotic therapy. However, the penetration of penicillin into the joint in these two patients was adequate, suggesting that there is no place for the intra-articular injection of antibiotic in the treatment of this condition.
Aged↗
Morbidity after gold weight insertion into the upper eyelid in facial palsy.
Morbidity and outcome after gold weight insertion into the upper eyelid in patients with lagophthalmos were assessed retrospectively by patient questionnaire and case-note review. Results indicated that although satisfaction with the lid and overall facial appearance was high, complications and symptoms attributable to the gold weights were not uncommon.
Adolescent↗
HMOs don't have to fail.
One of the bright spots in the sometimes black picture that is painted of our national health care system is HMOs. Health maintenance organizations provide health services to an enrolled group of patients for a fixed, prepaid fee. This arrangement induces HMOs to try to keep patients healthy for a competitive rate. Because of its special nature, however, an HMO cannot be managed like a fee-for-service hospital or group practice. And because few managers fully understand them, more and more HMOs are failing. The authors of this article say, however, that some failures can be avoided. Good management techniques can help HMO managers-whether they are community-spirited citizens or seasoned executives-overcome many of the problems that plague HMO plans: out-of-control utilization rates, growth that can occur overnight, conflict between the values of HMOs and of the physicians that staff them, and competitors in the health field.
Administrative Personnel↗