Biomedical subjects

F H Sim

Publications and source records attributed to F H Sim.

242 records · Page 14Linked to original sources

PubMedDate not supplied

Distal upper extremity function following proximal humeral resection and reconstruction for tumors: contralateral comparison.

BACKGROUND: Most functional analyses after limb salvage operations about the shoulder have focused on proximal function with the assumption that distal function is largely unaffected. This analysis examines distal function objectively. METHODS: Objective laboratory data regarding distal upper extremity strength after reconstructive procedures for tumors near the shoulder joint was collected over a 16-year period. Thirty-two patients were able to participate fully in the data collection at an average most recent follow-up duration of > 3.5 years. RESULTS: Statistically significant reductions on the involved side compared with the uninvolved side in grip, forearm pronation, forearm supination, elbow flexion, and elbow extension strength were documented (p < 0.05). The magnitude of reduction in strength diminishes distally, with the greatest effect in this group of patients being observed in elbow extension, followed by elbow flexion, forearm supination, and forearm pronation. Grip strength consistently showed the least amount of strength reduction compared with the uninvolved side, even within resection and reconstruction groups. Subjective patient rating of dexterity was no less than 3 of 5. Ninety percent of patients rated their dexterity 4 of 5 (52%) or 5 of 5 (38%). CONCLUSIONS: Despite the insistence of "normal" function in the distal upper extremity after limb salvage procedures, complete normality is not maintained. However, the degree of maintenance of distal function appears to be high, especially for grip strength and forearm pronation strength, and patient satisfaction is acceptable.

Adolescent↗

PubMedDate not supplied

Sports stress syndromes of the hand and wrist.

Many injuries to the hand and wrist may be seen in the practice of sports medicine. Most of these injuries are well known and the details of their diagnosis and treatment are well documented. However, even among this group, certain injuries frequently escape detection or are not monitored carefully enough to detect their frequent residual complications. These injuries are particular sources of problems. Some little known diagnoses are seldom considered, but any diagnosis, even a presumptive one, is better than applying vague, descriptive, but nondefinitive terms to an athlete's injury. Although the ideal treatment is not yet available for any of these injuries, a lack of diagnosis will often mean that treatment is haphazard or nonexistent.

Athletic Injuries↗

PubMedDate not supplied

Injury potential in modern ice hockey.

The majority of the damaging forces to the soft tissue, bone, and articular joint structures of modern hockey players during the energetic activities involved in the game are attributable to impact action during high-speed motion. In addition, non-contact musculoligamentous injuries are common because of the complex forces that are involved. The injury potential of this sport is assessed indirectly from the force and motion involved. The experimental method of measuring the kinematic motion and the impact forces inherent to the sport are presented. Although hockey is a fast and furious game with high injury potential, fortunately the number of serious injuries is not as great as one might expect.

Athletic Injuries↗

PubMedDate not supplied

Three-dimensional kinematics of the taped ankle before and after exercise.

The practice of prophylactic ankle taping or wrapping to reduce the incidence of inversion ankle sprains in athletes has come under attack. The purpose of this study was to measure objectively one ankle taping technique's ability to withstand the stresses placed upon it by a standardized exercise routine. Electrogoniometers were used to measure the three-dimensional ankle motion of 20 subjects walking on a level surface and a 10 degrees sideslope. The evaluations were carried out under these three conditions: (1) both ankles untaped, (2) both ankles taped before exercises, and (3) both ankles taped after exercise. The results from this study indicate that the tape does indeed restrict those motions associated with inversion ankle sprain. Methods similar to those described in this study could be used in the evaluation of many current training room practices and thereby provide an objective rationale for their application.

Adult↗

PubMedDate not supplied

Repair and reconstruction of rotatory instability of the knee.

We studied the results of treatment in 110 of 129 consecutive patients who had knee instability for which they underwent reconstruction of the knee ligaments at the Mayo Clinic. Thirty-one patients underwent different types of extraarticular reconstruction. Nine (29%) had recurrence of the knee giving way, and 11 (36%) had objective signs of instability on examination. Fifty-five patients underwent combined extraarticular and intraarticular reconstruction with either the Lam-Jones patellar tendon (PT) procedure (21 knees) or the Zarins-Rowe semitendinosus and iliotibial band (ST & ITB) procedure (34 knees). Only two knees (10%) with PT procedure and three knees (9%) with ST & ITB procedures continued to have giving way. Three patients in each group had recurrence of instability. Twenty-four knees with acute instability had either primary repair (17 knees) or primary reconstruction with ST & ITB procedures (7 knees). The results in these knees were superior to the results in the knees reconstructed for chronic instability. On the basis of our 2 year results, we believe that a combined intraarticular and extraarticular reconstruction is the procedure of choice in chronic knee instability and is a useful procedure in acute knee instability with irreparable tears of the anterior cruciate ligament.

Adolescent↗

PubMedDate not supplied

Ice hockey injuries.

Ice hockey is a team sport that has recently grown in popularity not only in the United States but also in Canada and Europe. With this increase in popularity has come a growing concern about the number and severity of injuries. The world literature on the biomechanics and physiology of ice hockey was reviewed in an attempt to evaluate the forces and mechanisms involved in the game. The influence of rule and equipment changes on injury patterns was particularly studied. Several studies on the epidemiology of injuries, providing data on the types of injuries and the mechanisms of those injuries, were analyzed to determine the conclusions that could be supported and those that require further study. Possible changes in the patterns and types of injury are outlined.

Athletic Injuries↗

PubMedDate not supplied

Surgical treatment of metastatic disease of the femur.

Nearly every malignant neoplasm has been described as having the capability to metastasize to bone. Of the estimated 1.2 million new cases of cancer diagnosed annually, more than 50% will eventually demonstrate skeletal metastasis. Advances in systemic and radiation therapy have led to a considerable improvement in the prognosis of patients with metastatic disease. As a result, orthopaedic surgeons are being asked with increasing frequency to evaluate and treat the manifestations of skeletal metastases. The femur is commonly the site of large impending lesions and complete pathologic fractures. Although the health status of some patients may preclude operative intervention, established pathologic fractures of the femur and metastatic lesions deemed likely to progress to imminent fracture generally should be treated surgically. A rational approach to selection of the proper treatment for these problems includes consideration of the patient's overall medical condition and the type, location, size, and extent of the tumor. Treatment principles are the same regardless of location. A construct should ideally provide enough stability to allow immediate full weight bearing with enough durability to last the patient's expected lifetime. All areas of weakened bone should be addressed at the time of surgery in anticipation of disease progression. To minimize disease progression and possible implant or internal fixation failure, postoperative external-beam irradiation should be considered.

Femoral Fractures↗

PubMedDate not supplied

Replacement of the proximal humerus with a ceramic prosthesis: a preliminary report.

Insertion of a multicomponent ceramic prosthesis with extracortical fixation to the conically reamed shaft of the humerus was performed in 7 patients after resection of 4 malignant and 3 benign tumors of the proximal humerus. The length of the replacement ranged from 9 to 18 cm. Fixation was secure in all but one patient, who sustained a fracture through the proximal humerus. Subluxation occurred in 3 patients but posed no difficulty, except in one patient who required revision for a dislocation. Functionally, little active motion is achieved, but the implant provides a spacer to permit efficient use of the hand and elbow. No patient has had local recurrence of the tumor. One patient died one year postoperatively from an unrelated second primary cancer. Although the preliminary results are encouraging, further investigations are necessary on the mechanical aspects of the cone fixation principle and of the techniques of shoulder muscle reconstruction to improve the function of the prosthetic joint.

Adult↗