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Biomedical subjects

D S Louis

Publications and source records attributed to D S Louis.

At least 91 records · Page 5Linked to original sources
PubMed1985

Complications of carpal tunnel surgery.

During a 12-year period, the authors treated 25 patients with 26 complications of previous carpal tunnel surgery. Twenty-four of these patients were referred following initial surgery elsewhere. The most frequent complication identified was neuroma of the palmar cutaneous branch of the median nerve in 14 of the cases. Other complications were hypertrophic scars, dysesthesias after multiple procedures to release the carpal tunnel, joint stiffness, failure to relieve symptoms, and neuromas of the dorsal sensory branch of the radial nerve. All of these complications are potentially preventable. With a properly placed incision, exposure carried out under magnification, and surgery under direct vision the majority of these complications may be prevented. It is further noted that the technique of transverse incision at the wrist for release of the carpal tunnel is potentially dangerous and should be abandoned.

Adult↗
PubMed1985

Extravasation of chemotherapeutic agents.

Extravasation of vesicant agents into the soft tissues can lead to painful and indolent ulcerations. Precautions for avoiding extravasation include the use of fresh intravenous lines. The line should be placed in the forearm whenever possible. Hand veins, joint surfaces and extremities with impaired circulation should be avoided as infusion sites. If evidence of extravasation appears, the infusion must be stopped immediately and appropriate measures initiated.

Antineoplastic Agents↗
PubMed1984

Evaluation of normal values for stationary and moving two-point discrimination in the hand.

Stationary and moving two-point discrimination were tested in a normal population stratified by age and sex. The 467 subjects tested consisted of 202 females and 265 males whose ages ranged from 4 years to 92 years. Statistical analysis of the data revealed the following: (1) Moving two-point values were of lesser magnitude than stationary two-point values in all areas tested; (2) test values for median innervated areas were lower by both methods than values for ulnar innervated areas; (3) there was a gradual increase in the magnitude of the test values for both methods with advancing age; (4) female subjects consistently tended to discriminate at shorter distances when compared with male subjects at corresponding sites; and (5) the absolute values obtained were dependent upon the individual examiner, but the statistical significance applied to the data of all of the examiners.

Adolescent↗
PubMed1984

Capitate-radius arthrodesis: an alternative method of radiocarpal arthrodesis.

Arthrodesis of the wrist may be indicated for a variety of conditions and can be achieved by many techniques. We have had experience with radiocarpal arthrodesis by fusion of the capitate to the radius after a modified proximal row carpectomy . The common feature in our 10 patients was a flexion deformity of the wrist. In five of the patients it was the result of spastic posturing. Five of the patients had a variety of other conditions. Primary arthrodesis occurred in all patients and the cosmetic improvement was appreciated by all patients. Functional improvement seemed to be most related to the preoperative condition. The follow-up evaluation averaged 5.4 years with a range from 6 months to 11 years.

Adolescent↗
PubMed1984

Surgical management of doxorubicin (Adriamycin) extravasation.

The advent of potent chemotherapeutic agents has been helpful in the medical management of a variety of malignancies. Unfortunately, the side effects and complications have been significant. Our recent experience with a patient who had the avoidable complication of extravasation with doxorubicin (Adriamycin) into the upper extremity is described. Frequently, the medical management of this problem has been observation alone followed by late surgical referral. This tissue fixation of the chemotherapeutic agent is such that it stays bound locally and causes an ever enlarging ulceration of tissue. This slough can occur not only in a circumferential fashion, but also in the superficial to deep manner, resulting in full-thickness lesions. Early surgical intervention is important to shorten the morbidity and to return the patients to their home environment.

Adolescent↗
PubMed1984

Capitate-lunate instability: recognition by manipulation under fluoroscopy.

Videotape fluoroscopy was used to diagnose a previously undescribed carpal dissociation, the capitate lunate instability pattern. In eight patients with midcarpal pain and clicking, the examiner simultaneously applied pressure to the scaphoid tuberosity while applying longitudinal traction and flexion to the wrist under fluoroscopic control. This maneuver revealed dorsal subluxation of the proximal carpal row and capitate lunate subluxation in each of the eight patients. Plain radiography and arthrography were not helpful in the diagnosis. All eight cases were managed conservatively. Videotape fluoroscopy is the best radiologic method of diagnosing capitate-lunate instability.

Adolescent↗
PubMed1980

Painful neuromas in long below-elbow amputees.

During a five-year period, seven patients were seen who failed to wear their protheses because of neuromas in their amputation stumps. Proximal ligation of the median, radial, and ulnar nerves allowed prosthetic wear and use in every instance. The advantage of this technique used at the time of the original amputation or at an early elective time will aid in the rapid rehabilitation of the patient.

Adult↗
PubMed1980

Case report 112.

Explore the source record for details and available documents.

Adult↗
PubMed1980

Case report 116.

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Adolescent↗
PubMed1980

Calcifying tendinitis in the hand.

Two cases of acute calcification in the hand are presented with a review of the clinical presentation, pathological findings, differential diagnosis, and treatment. The value of radiographic study is emphasized. A variety of conservative, non-operative treatments have been successfully utilized in the past and are reviewed. The importance of differentiating this infrequent problem from an acute infectious process is emphasized, inasmuch as hospitalization and surgical drainage may be indicated for an acute infection but not for cases of calcifying tendinitis.

Acute Disease↗
PubMed1979

Herpetic whitlow: herpetic infections of the digits.

Ten cases of herpes simplex infections of a digit were observed during a 3 year period. The diagnosis was confirmed in seven cases by culture or tests of serum antibodies. In three cases the clinical characteristics were sufficient to suggest the diagnosis. Medical and dental personnel are particularly prone to develop this affliction; their occupations are a frequent clue to the diagnosis. Nonsurgical treatment of this self-limited entity is recommended.

Adult↗
PubMed1979

Multiple carpometacarpal dislocations. A review of four cases.

The cases of four patients with carpometacarpal fracture-dislocations of the ulnar four joints are reported, in all of whom there was extensive additional trauma. Open reduction was necessary in three patients, and only one was treated successfully by a closed reduction. He then had persistent but painless subluxation of the metacarpal bases. On end-result evaluation, two of the other three patients had occasional discomfort and diminished grip strength. One patient had a diminished range of motion of the wrist joint at one-year follow-up, and one patient had narrowing and sclerosis of the carpometacarpal joints.

Adolescent↗
PubMed1978

Assessing ulnar instability of the metacarpophalangeal joint of the thumb.

Seven hundred and fifty normal thumbs were examined to determine the normal range of radioulnar mobility of the metacarpophalangeal joint with the joint in full extension, 15 degrees of flexion, and full flexion. Full flexion was the position of greatest stability. Twenty-five adult unembalmed cadaver thumbs were examined to determine the optimal position for testing the metacarpophalangeal joint for ulnar collateral ligament stability. When radial stress was applied to the metacarpophalangeal joint of 20 specimens after cutting the adductor aponeurosis and capsule, minimal ulnar instability was found. However, further sectioning of the ulnar collateral ligament revealed marked ulnar instability most significantly when the thumbs were examined in full metacarpophalangeal flexion. Finally, division of the adductor aponeurosis, dorsal capsule, ulnar collateral ligament, accessory collateral ligament, and volar plate resulted in complete instability of the metacarpophalangeal joint in all positions tested.

Biomechanical Phenomena↗
PubMed1978

Doppler hemodynamic assessment of obscure symptomatology in the upper extremity.

Thirty-eight patients were studied because of symptoms thought to be vascular in origin. In 18 patients in whom angiography was performed, the presence or absence of hemodynamically significant vascular occlusive lesions was predicted correctly by Doppler ultrasound techniques. Normal Doppler studies in the remaining 20 patients expedited nonvascular diagnostic evaluation and treatment and helped to avoid unnecessary angiography. Studies required 15 to 20 minutes and no complications occurred. Noninvasive Doppler evaluation is inexpensive, free of risk, and provides an accurate means of determining alterations in upper extremety hemodynamics.

Adolescent↗