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Biomedical subjects

E Akelman

Publications and source records attributed to E Akelman.

40 records · Page 3Linked to original sources
PubMed1988

Extensor tendon injuries at the proximal interphalangeal joint.

From the prior discussion, it should be apparent that the multitude of operative procedures reflects the complexity inherent in the extensor mechanism and the often unpredictable outcome of operative intervention. Large studies with detailed analysis of data are few. Despite this, several themes are apparent and need to be respected. The chronic boutonniere deformity reflects long-term derangement with secondary compensation of the extensor mechanism. The surgeons rendering treatment must have a thorough appreciation of normal anatomy as well as an understanding of the evolving pathomechanics. Both physician and patient must be committed to the need for long-term treatment of this disability. The literature leaves no doubt that surgical intervention is best initiated after the attainment of full passive PIP extension. Finally, even in the chronic situation, long-term splinting and exercises may be successful and both obviate surgery and result in a superior outcome.

Acute Disease↗
PubMed1986

Limited triscaphoid intercarpal arthrodesis for rotatory subluxation of the scaphoid.

Rotatory subluxation of the scaphoid is a well known lesion that is relatively common and results in instability of the wrist. It has been well accepted that because of the subluxation of the scaphoid, degenerative changes in the wrist may develop rapidly, and for that reason correction of the subluxation in its early stages is indicated. Over the past thirteen years, many cases of rotatory subluxation of the scaphoid in various stages of the pathological process have been successfully treated with a triscaphoid arthrodesis of the wrist (fusion of the scaphoid, trapezium, and trapezoid) at the Connecticut Combined Hand Surgery Service. A follow-up of thirty patients with an average length of follow-up of three years and eleven months is described. From this experience, a classification system and treatment plans for each type of rotatory subluxation of the scaphoid have evolved.

Adolescent↗
PubMedDate not supplied

The effect of wrist guards on bone strain in the distal forearm.

There are increasing epidemiologic and biomechanical data suggesting that wrist guards are effective in preventing wrist injuries in snowboarders and in-line skaters. However, there have been few studies designed to determine how they function. In this study we explored the load-sharing function of wrist guards at subfailure loading levels. To do so, we measured bone strain in the distal radius, distal ulna, and midshaft of the radius in cadaveric forearms with and without two types of commercially available wrist guards. We also measured construct stiffness and energy absorption during testing. Our most significant findings were that dorsal and volar distal radius bone strain were reduced with both wrist guards, and wrist guards increased energy absorption. We also found a reduction in dorsal distal ulnar bone strain, but only with the one guard in which the volar plate was elevated off the heel of the hand. In our loading configuration, wrist guards did not increase bone strain at the radial midshaft. These findings provide insight into how wrist guards protect the wrist: during low-energy falls they function partly by load-sharing, as well as by absorbing impact energy.

Aged↗