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Biomedical subjects

D Keret

Publications and source records attributed to D Keret.

At least 55 records · Page 3Linked to original sources
PubMed1984

Synovial cyst and ulnar nerve entrapment. A case report.

A 77-year-old man affected by rheumatoid arthritis demonstrated clinical evidence of progressive ulnar nerve compression that proved to be caused by an extra-articular synovial cyst of the elbow. Conservative measures failed to reduce the size of the cyst or to check progress of the ulnar nerve lesion. Surgical treatment by elbow synovectomy and partial cystectomy was effective. The ulnar nerve lesion healed, and the cyst disappeared. Ulnar nerve compression by soft tissue in continuity with a rheumatoid elbow joint is very uncommon. Only one similar case was found in the English-language literature.

Aged↗
PubMed1983

The sagging rope sign: a critical appraisal.

Certain features of the sagging rope sign recently analysed by Apley and Weintroub (1981) are examined in detail. Evidence is presented to show that the line is a radiological shadow cast by the lateral edge of a severely deformed femoral head rather than a condensation of the spongiosa within the neck. An explanation is offered to explain the common association of the presence of this radiological sign with premature epiphysial fusion.

Adolescent↗
PubMed1982

The gastrocnemius muscle flap in the correction of severe flexion contracture of the knee.

Extreme flexion contracture of the knees due to extra-articular contracture of the knee joints is a frequent deformity in catastrophic neurological lesions such as multiple sclerosis, meningomyelocoele, paraplegia, quadriplegia, and cerebral spastic paralysis. Such gross knee contractures together with the coexisting hip flexion contractures create a severe nursing problem. Adequate perineal hygiene and positioning are very difficult to achieve and thus pressure sores frequently develop in these bed-ridden patients in spite of devoted nursing care. The orthopaedic surgeon can help alleviate the plight of these unfortunate victims: first the hip joint contractures are released by the classical methods and then, at the same session, the knee contractures: a simple one stage procedure is described. Primary cover of the large popliteal skin defect is achieved by a gastrocnemius versatile muscle flap, which is itself covered by a free split skin graft. An illustrative case is described.

Contracture↗
PubMed1981

Spinal intradural metastases of extraneural origin.

Three cases of intradural extramedullary (spinal subdural) metastases, originating from outside the central nervous system, are presented. Two were located at the cervico-dorsal junction, and one was mid-dorsal. A breast ductus carcinoma, a cervical neuroblastoma, and an apoduma of unknown origin, were the primary neoplasms. All presented clinically with a short history typical of cancerous spinal cord compression. Plain X-rays of the spine did not show areas of destruction. Myelography in two cases clearly suggested that intradural location of the tumour. The relative frequency of these tumours and their pathogenesis are briefly reviewed. It is stressed that primary tumours are mainly in the breast or lung. Their metastases are mainly found in the cervico-dorsal region. It is assumed that they really are metastases of the dura mater itself, growing inward. The importance of the lymphatic and venous pathways in their spread into the dura mater is emphasized.

Adult↗
PubMed1981

Fracture of the medial sesamoid bone of the hallux.

Fracture of the sesamoid bones of the hallux is rare. A case of fracture of the medial sesamoid bone is presented. The X-ray finding of an irregular line dividing the medial sesamoid bone together with typical local symptoms and signs established the diagnosis in a 17-year-old female athlete. Nonunion of the fractured sesamoid was successfully treated by extraction of the sesamoid fragments. Complete relief of pain was followed by the patients' return to full athletic activity. The diagnostic criteria and indications for operation are discussed briefly.

Adolescent↗
PubMedDate not supplied

A simple and efficient surgical technique for subungual exostosis.

Subungual exostosis is a benign osteochondral tumor usually involving the distal phalanx of the great toe. The lesion most frequently occurs in the second and third decades of life and is rare before the age of 10 years. There are few reports of its occurrence in children, and most of them advocate partial or complete nail excision to treat this lesion successfully. We report our experience with six children and adolescents using a simple surgical technique that involves approaching the exostosis under the nail to preserve nail coverage. Rapid recovery and excellent cosmetic appearance were achieved immediately after the operation.

Adolescent↗
PubMedDate not supplied

Voluntary habitual dislocation of the hip joint in a child.

A review of the literature revealed that voluntary habitual dislocation of the hip in children is a rare entity. We encountered the case of a 6-year-old girl with habitual posterior subluxation of the hip. Parental counseling is all that was needed while spontaneous resolution of the condition was awaited.

Child↗
PubMedDate not supplied

Massive osteolysis of the femur (Gorham's disease): a case report and review of the literature.

A case of Gorham's disease involving the proximal femur of a 12-year-old girl is presented. Although Gorham's disease is rare and has benign histologic characteristics, in this patient it took an aggressive clinical course that resulted in severe morbidity. Diagnosis is difficult to establish; almost all investigative approaches provide only indirect evidence of the pathology. A high index of suspicion and open biopsy performed soon after presentation will establish diagnosis. Treatment modalities may be more effective if applied earlier in the disease process, especially as the osteolytic process appears to escalate after pathologic fractures, which occur frequently in this disorder.

Child↗
PubMedDate not supplied

Avascular necrosis of the capital femoral epiphysis in metachondromatosis.

A 6-year-old boy with metachondromatosis, an inherited disorder characterized by multiple enchondromas and exostoses, developed avascular necrosis of the capital femoral epiphysis mimicking Perthes disease. Despite containment, significant coxa magna occurred with flattening and lateral extrusion, requiring intertrochanteric osteotomy and shelf augmentation.

Bone Neoplasms↗
PubMedDate not supplied

Dysplasia epiphysealis hemimelica: diagnosis and treatment.

Clinical features and radiographic findings of eight patients with dysplasia epiphysealis hemimelica are described. In all patients, a single lower extremity was involved. The most common sites of involvement were the distal tibia and the distal femur. Magnetic resonance imaging was beneficial in determining a plane of separation between the accessory ossification center and the normal epiphysis. If the lesion is extraarticular, simple excision of the mass yields favorable results. If the lesion is intraarticular, an osteotomy may be needed to correct an angular deformity. Recurrence of the deformity is common.

Adolescent↗
PubMedDate not supplied

Anterior impingement of the femoral head: a late phenomenon of Legg-Calvé-Perthes' disease.

A previously unrecognized late phenomenon of anterior impingement of the femoral head in Legg-Calvé-Perthes' disease is reported in four patients. After an asymptomatic period following reossification of the femoral head, the patients had pain triggered by internal rotation of their hips. Standard roentgenograms did not indicate any cause of the pain. Computed tomography (CT), arthrography, and arthroscopy demonstrated impingement of the anterior aspect of the femoral head against the anterior rim of the acetabulum on internal rotation of the leg. Three hips had femoral head articular surface damage with osteochondral projections at the area of anterior impingement. Arthroscopic debridement and proximal femoral osteotomy was successful in relieving the symptoms.

Arthrography↗
PubMedDate not supplied

Intraspinal epidermoid tumors in children: problems in recognition and imaging techniques for diagnosis.

Iatrogenic intraspinal epidermoid tumors are very rare. The similarity of the clinical manifestations of the tumor with other childhood problems can pose a problem in diagnosis. In addition, because of the lag in time between the lumbar puncture and the development of a symptomatic tumor, this relationship is overlooked and can cause a delay in diagnosis, as in the present report of four children. Magnetic resonance imaging was found to be superior to myelography in defining the tumor and its relationship to other structures inside the dural sac. All patients underwent surgical excision, with subsequent resolution of symptoms.

Child↗