Fireworks: advice for a safer Fourth of July.
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Accident Prevention↗
Biomedical subjects
F M Hankin
Publications and source records attributed to F M Hankin.
Preparing surgery house officers for their teaching role.
The medical education literature was reviewed in four categories: (1) general studies of house officer teaching, (2) perceptions of the house officer's teaching role, (3) assessing and improving resident teaching skills, and (4) the teaching role of surgery residents. An agenda for research and development related to surgery resident teaching skills was proposed based on four research questions: (1) What types of teaching skills are most appropriate for surgery residents? (2) How do faculty and student expectations of resident teaching influence surgery resident teaching? (3) What type of intervention is most successful in improving surgery resident teaching skills? (4) What are other outcomes of improved surgery resident teaching besides resident and learner satisfaction? This important teaching role should be more formally and widely acknowledged by surgery faculty, and appropriate teaching skill improvement activities should be provided for all surgery house officers.
Education, Medical, Graduate↗
Nonhuman primate bites.
Nonhuman primate (monkey) bites to researchers and attending animal care staff may present problems in patient management. Such inoculations can transmit serious bacterial and viral infections to the human handlers. Significant local and systemic manifestations can subsequently develop following such an injury. Since Herpesvirus simiae (B virus) is enzootic in Asiatic monkeys of the genus Macaca, and since B virus infection in humans is usually fatal, additional prophylactic and therapeutic measures must be taken when persons are bitten by macaque monkeys. Primate bites require early aggressive intervention.
Acyclovir↗
Traction force profiles associated with the use of a fracture table: a preliminary report.
A load cell was developed that can reliably monitor longitudinal traction forces applied to limbs during several different orthopaedic procedures. This permitted determination of tensile loads and the effects of patient limb positions on tension magnitudes. The relationships between the magnitude and duration of applied tension to functional nerve changes were also studied. This preliminary report reviews traction force data on seven patients for eight operations. Mean peak loads for femoral, tibial, and hip procedures were 686, 356, and 306 N, respectively. Adduction of the limb around a fixed peroneal post caused great increases in traction forces.
Adult↗
Eosinophilic granuloma. The management of solitary lesions of bone.
Solitary eosinophilic granuloma (EG) lesions of bone can represent diagnostic and treatment dilemmas for the orthopedic surgeon. A retrospective review of one institution's experience with isolated EG skeletal lesions over a 30-year period was undertaken. Solitary lesions responded well to most treatment modalities (e.g., curettage, excision, and irradiation) and infrequently resulted in functional impairment. While EG involvement in bone can be a manifestation of a systemic histiocytosis, single-focus skeletal involvement appears to be a benign pathophysiologic process.
Bone Diseases↗
Sport-related fractures and dislocations in the hand.
The long-term prognosis regarding any sport-related injury should remain guarded. Although optimism may be expressed by the physician regarding a specific injury, the athlete must be adequately informed of the natural history of his or her injury. The hand surgeon's management efforts must always be exact and appropriate, but the athlete must understand from the outset that the final functional and cosmetic result may depend more on the nature of the specific injury than on the treatment provided.
Athletic Injuries↗
Pyarthrosis of the knee. Treatment considerations.
Patients with pyarthrosis of the knee can be effectively managed by several different methods. A retrospective review of patients with the diagnosis of septic arthritis of the knee was undertaken to determine the efficacy of two different treatment programs. Multiple-needle arthrocentesis was contrasted with formal arthrotomy drainage. In this series, patients with a longer than three-day history of a knee pyarthrosis and those with Staphylococcus aureus or enteric gram-negative organisms on culture benefited from open drainage procedures in lieu of repeated aspiration techniques.
Adolescent↗
Tendon and ligament attachments in relationship to growth plates in a child's hand.
Dissection of the hand of an eight-year-old female cadaver was performed to determine the relationship of tendon and ligament insertions to the growth plates. These soft tissue attachments can influence the fracture patterns noted in children.
Cadaver↗
Bilateral giant cell tumour of the distal radius: a case report.
A case of bilateral distal radius giant cell tumour of bone is reported. Each lesion appears to have arisen de novo rather than as a metastasis.
Adult↗
Partial pelvic resection as an alternative to hindquarter amputation for skeletal neoplasms.
Selected neoplasms of the bony pelvis can be effectively treated by partial pelvic resection, rather than by traditional hemipelvectomy. Eleven patients with skeletal neoplasms were managed by partial pelvic resections with limb sparing. These cases demonstrate that good postresection results can be achieved without reconstructive joint procedures.
Activities of Daily Living↗
Hand problems in pregnancy.
The most frequently encountered hand disorders in pregnancy are carpal tunnel syndrome and de Quervain's tenosynovitis. Conservative therapy should be initiated to minimize patient discomfort. Appropriate splinting is the cornerstone of treatment in pregnant women. Surgery is usually not indicated in this patient population.
Carpal Tunnel Syndrome↗
Softball sliding injuries. A prospective study comparing standard and modified bases.
In a previous retrospective study, base sliding was found to be responsible for 71% of recreational softball injuries. As most injuries occurred following rapid deceleration impact against stationary bases, quick-release (breakaway) bases were evaluated as a means to modify this mechanism of injury. Six hundred thirty-three softball games were played on breakaway-base fields and 627 games were played on stationary-base fields. Forty-five sliding injuries (7%) occurred on the stationary-base diamonds and only two sliding injuries (less than 1%) occurred on the breakaway-base fields. Implementing the use of breakaway bases in recreational softball leagues could potentially achieve a significant, cost-effective reduction of injuries.
Adult↗
Carpal instability with volar flexion of the proximal row associated with injury to the scapho-trapezial ligament: report of two cases.
Volar flexion intercalated segment instability may develop after many different injuries to the skeletal and ligamentous architecture of the wrist. We describe two cases in which the presumed cause of instability was an injury to the extrinsic volar scapho-trapezial ligament complex.
Adolescent↗
Septic polyarthritis and its relation to systemic disease processes. A report of three cases.
In the case of a postoperative joint infection, the orthopaedic surgeon is frequently blamed. Certain intrinsic disease processes, however, make a joint more susceptible to infection. In these three reports of septic polyarthritis, all patients had underlying systemic disorders, including rheumatoid arthritis, diabetes mellitus, and hemophilia A. Two of the three patients had had no recent surgical procedures. This suggests that the development of a pyarthrosis may depend at least as much on the patient's underlying systemic condition as on the surgeon and his or her technique.
Adult↗
Skin protection during external fixation frame pin insertion: an alternative method.
Local skin necrosis and pin tract infections are common sequelae following the application of external fixation skeletal frames. Drill guides are effective instruments that help to minimize these problems. Standard nasal speculums are readily available in most operating rooms and can also be used to protect skin and soft tissues during pin insertion.
Bone Nails↗
The treatment of intercostal-brachial neuromas by posterior intercostal neurectomies. A case report.
The development of sensory neuromas in a postoperative field is a recognized and undesirable complication. Neuroma formation can impair patient cooperation and postoperative function. Treatment efforts are frequently unrewarding and may contribute to the patient's frustration. Intercostal-brachial neuromas which develop following first rib resections are representative of this problem. Posterior intercostal neurectomy may provide an alternative treatment modality.
Brachial Plexus↗
Symptomatic relief following carpal tunnel decompression with normal electroneuromyographic studies.
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Retraction Notice↗
Gamekeeper's thumb.
Injuries to the ulnar collateral ligament of the thumb metacarpophalangeal joint can result in significant pain and instability. Patients with this injury have severe difficulties with pinching and grasping objects. Avulsions of this collateral ligament from the proximal phalanx and midsubstance tears provide the usual mechanisms of injury. Complete ruptures usually require surgical treatment. Cast immobilization is usually satisfactory for partial tears.
Adolescent↗