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Biomedical subjects

D S Louis

Publications and source records attributed to D S Louis.

At least 55 records · Page 3Linked to original sources
PubMed1989

Magnetic resonance imaging of the collateral ligaments of the thumb.

Injury to the ulnar collateral ligament of the metacarpal phalangeal joint of the thumb can usually be diagnosed on the basis of a combination of history, radiographic examination, and clinical stress testing of the joint when appropriate. Occasionally, when the patient is seen late and the diagnosis is doubtful, stress evaluation may be ill-advised because a nondisplaced ligament may be displaced in the process. We had recent experience with three patients in whom the use of magnetic resonance imaging was helpful in diagnosing a displaced ulnar collateral ligament in two cases, and an intraligamentous injury in the other. These studies were conducted at no charge to the patient as part of institutional investigational research. The current cost of this technology is prohibitive for routine use; however, when it becomes less expensive, it may be helpful as a diagnostic tool.

Adult↗
PubMed1989

Diagnosis and treatment of obscure ulnar-sided wrist pain.

Thirty-seven patients were followed for symptoms of chronic ulnar-sided wrist pain in which specific physical examination and standard radiographs were unrevealing. Initial conservative treatment did not relieve the pain. The patients underwent further diagnostic studies including dynamic cineroentgenographic evaluation and radiocarpal arthrography. Nineteen of the 37 patients were demonstrated to have a triangular fibrocartilage complex (TFCC) tear on arthrography; 18 had a normal examination. The average follow up was 23 months. Seven of the 19 patients with TFCC tears have undergone operative treatment, and 5 (71%) remain symptomatic. Of the remaining 12 patients with TFCC tears treated nonoperatively, eight (67%) have persistent symptoms. Of the 18 patients whose arthrograms were normal, five eventually underwent surgical exploration, four of which remain symptomatic. Of the 13 patients without TFCC tears treated nonoperatively, seven (54%) continue to have symptoms. In our experience, both surgical exploration and nonoperative treatment have been less than satisfying. In addition, treatment results could not be correlated with arthrographic findings.

Adolescent↗
PubMed1989

Rehabilitation of the injured hand.

The gradual development of hand surgery as an area of specialization has led to the development of rehabilitative efforts that have complemented this trend. This had led to further specialization in hand therapy as a primary endeavor. Specific efforts in the areas of rehabilitation for soft tissue, bone, tendon, and nerve injuries have facilitated functional restoration of the injured hand.

Hand Injuries↗
PubMed1988

Rupture of flexor tendons to the little finger due to bony irregularities in the carpal tunnel.

Rupture of a finger flexor tendon occurs most commonly in the patient with rheumatoid arthritis. We have treated two patients who suffered rupture of the flexor tendons to the little finger due to bony irregularities in the carpal tunnel unrelated to rheumatoid disease. Each irregularity was removed and the rough surface covered with a portion of the flexor retinaculum. This resurfacing affords protection against recurrent abrasion and rupture. Tendon function was restored by suturing the ruptured profundus tendon to the adjacent intact profundus tendon of the ring finger. Satisfactory function of the little finger was achieved in both patients. Neither patient has experienced recurrent rupture.

Adult↗
PubMed1988

Poland's syndrome: variable expression and associated anomalies.

Poland's syndrome is a well-known constellation of congenital anomalies that includes varying degrees of hypoplasia involving the thoracic cage in association with anomalies of the hand. Although the latter are most frequently described as syndactyly with short or absent middle phalanges, many forms of expression were seen in a series of 20 patients. Thirty-one other anomalies were seen in this group in addition to those usually considered as part of the syndrome. Of special interest are those involving the spine and genitourinary tract that require special studies for early detection.

Abnormalities, Multiple↗
PubMed1988

Silicone wrist implant: long-term follow-up study.

Nineteen patients with 20 silicone rubber wrist implants of the Swanson design were followed for an average of 6 years. Sixty-five percent of the patients experienced little or no wrist pain after the operation. There was an average of 24 degrees of wrist flexion and 21 degrees of extension. Implant fracture occurred in 65% of the patients. This was not necessarily correlated with clinical symptoms. Subsidence of the implant occurred 100% of the time. Revision procedures were done after six (30%) of the procedures. There was no evidence of radiographic change suggesting silicone synovitis. There is a progressive deterioration in the radiographic appearance and the clinical result after use of this implant. Salvage by means of radiocarpal arthrodesis, or a soft tissue arthroplasty, has been successful in our patients.

Arthritis↗
PubMed1988

Barton's and Smith's fractures.

Smith's and Barton's fractures are discussed in light of their original descriptions and current experience. Included here are excerpts from the original descriptions of Smith and Barton as well as the management of these two kinds of fracture.

Eponyms↗
PubMed1988

Retraction.

Explore the source record for details and available documents.

Retraction Notice↗
PubMed1987

'Kissing lesions' of the thorax and upper extremity.

An upper extremity compressed beneath the body of a comatose individual can contribute to the development of a compartmental syndrome. Crushing injuries such as these can result in skin necrosis at the sites of contact between the chest wall and the compressed limb. These "kissing lesions" must be recognized as indicators of a severe crush injury and impending compartmental syndrome, as fasciotomy is urgently required.

Arm Injuries↗
PubMed1987

Malignant fibrous histiocytoma involving a digit.

A case of malignant fibrous histiocytoma (MFH) involving phalanges of a single digit is reported. MFH of the bones of the hand has not previously been reported. Ten years after wide local excision, the patient remains clinically free of disease.

Adult↗
PubMed1987

Symptomatic relief following carpal tunnel decompression with normal electroneuromyographic studies.

Carpal tunnel syndrome is a frequently encountered clinical entity. A retrospective study of a selected patient population revealed 12% of patients to have normal electrodiagnostic studies. Operative release of the transverse carpal ligament in these patients alleviated median nerve entrapment symptoms. Entrapment neuropathy of the median nerve remains a clinical diagnosis, and absolute reliance on electrodiagnostic studies is unwarranted when making a decision to surgically treat a patient with a suspected carpal tunnel syndrome.

Carpal Tunnel Syndrome↗
PubMed1987

Peripheral nerve tumors in the upper extremity.

Peripheral nerve tumors involving the hand and upper extremity are rare. The types of tumors are few and they can usually be suspected on clinical grounds. The hand surgeon should have a knowledge of the diagnostic possibilities and the treatment options.

Forearm↗
PubMed1986

Oestrogen and progesterone hormone receptors in Dupuytren's disease.

Dupuytren's disease is associated with alcoholism and chronic liver disease, conditions frequently associated with deranged steroid hormone metabolism. The possible influence of endogenous sex steroid hormones on the development of Dupuytren's disease has therefore been investigated. An analysis of diseased palmar fascia for oestrogen and progesterone receptors was undertaken in fifteen patients. Hormone specific receptors were not found in the palmar fascia of our patients with Dupuytren's disease, thus suggesting that other mechanisms or factors contribute to the pathogenesis of this fibrotic process.

Aged↗