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Biomedical subjects

H Gellman

Publications and source records attributed to H Gellman.

62 records · Page 4Linked to original sources
PubMed1988

Late complications of the weight-bearing upper extremity in the paraplegic patient.

Paraplegic patients rely almost exclusively on their upper extremities for weight-bearing activities such as transfers and wheelchair propulsion. Eighty-four paraplegic patients whose injury level was T2 or below and who were at least one year from spinal cord injury were screened for upper extremity complaints. Fifty-seven (67.8%) had complaints of pain in one or more areas of their upper extremities. The most common complaints were shoulder pain and/or pain relating to carpal tunnel syndrome. Twenty-five (30%) complained of shoulder pain during transfer activities. Symptoms were found to increase with time from injury. As the long-term survival of spinal cord injured patients continues to improve, an increased awareness of the complications of the weight-bearing upper extremity is necessary to keep these patients functioning in society.

Arm↗
PubMed1987

Repair of severe muscle belly lacerations using a tendon graft.

Fourteen patients with 58 severe forearm muscle belly lacerations had muscle repair using tendon grafts. At mean follow-up of 14 months, results of manual muscle testing (N = 58) were: grade 5, 42%, grade 4, 14%, grade 3, 9%, grade 2, 9%, grade 1, 12%, and grade 0, 15%. Mean grip strength of the injured extremity, in pounds per square inch, was 33.5 compared with 83.4 on the noninjured side. Tendon excursion and joint mobility were maintained, and there were no postoperative complications. Tendon grafting of severe muscle lacerations is an effective method to overcome extensive defects.

Adolescent↗
PubMed1987

Adjunctive hyperbaric oxygen therapy in the treatment of chronic refractory osteomyelitis.

Twenty-eight consecutive patients with chronic refractory osteomyelitis uncomplicated by persistent fracture nonunion, septic arthritis, total joint arthroplasty, or major systemic disease (immune deficiency, malignancy, malnutrition, renal or hepatic failure) were treated from January 1980 through December 1985 to evaluate the potential benefits of hyperbaric oxygen (HBO) therapy. Patients were classified by a staging system taking into account: the bone involved; subchondral, periarticular bone involvement; extent of bone involvement; quality of soft-tissue envelope and vascular supply; and general health status of the patient. Using this staging system patients were assigned to either hyperbaric oxygen therapy or control status after their initial debridement. Hyperbaric oxygen therapy on a 100% oxygen, 2 atmospheres pressure, 2-hour duration, one dive per day, six dives per week regimen was utilized in 14 of the 28 patients. Hyperbaric oxygen had no effect on length of hospitalization, rapidity of wound repair, initial clinical outcome, or recurrence of infection noted to date.

Adolescent↗
PubMed1987

Selective tarsal arthrodesis: an in vitro analysis of the effect on foot motion.

Five different intertarsal arthrodeses were simulated in 15 fresh cadaver feet/ankles utilizing external fixation. Pin placement was verified radiographically. Range of motion measurements were performed before pin placement, after pin placement, and after simulated arthrodesis. The deficit in foot motion created by selected limited intertarsal fusions was then measured. The prearthrodesis range of motion measurements were found to be dorsiflexion (DF), 27 degrees; plantarflexion (PF), 57 degrees; total inversion (INVT), 29 degrees; eversion total (EVT), 22 degrees; hindfoot varus (VRH), 16 degrees; hindfoot valgus (VLH), 12 degrees. The deficits in motion after arthrodesis were as follows. Ankle (tibiotalar): DF, 50.7%; PF, 70.3%; INVT, 8.7%; EVT, 9.4%; VRH, 34.6%; VLH, 27.8%. Hindfoot arthrodesis (Tibiotalar calcaneal): DF, 53%; PF, 71.3%; INVT, 49.5%; EVT, 47.6%, VRH, 100%; VLH, 100%. Pantalar (Tibotalar calcaneal cuboid navicular): DF, 62.8%; PF, 82.2%; INVT, 71.7%; EVT, 67.4%; VRH, 100%; VLH, 100%. Triple (Talocalcaneal cuboid navicular): DF, 12.5%; PF, 15.5%; INVT, 50%; EVT, 51.4%; VRH, 60.5%; VLH, 60.5%. Total tarsal arthrodesis: DF, 78.5%; PF, 90.2%, INVT, 87.5%; EVT, 83.6%; VRH, 100%; VLH, 100%.

Ankle Joint↗
PubMed1986

Carpal tunnel syndrome. An evaluation of the provocative diagnostic tests.

In order to evaluate the usefulness of provocative tests (wrist-flexion test, nerve-percussion test, and tourniquet test) in the diagnosis of carpal tunnel syndrome, the results of provocative testing were evaluated in a group of patients (sixty-seven hands) with electrodiagnostically proved carpal-tunnel syndrome and in a group of fifty control subjects. The sensitivity and specificity of each test were calculated. The wrist-flexion test was found to be the most sensitive while the nerve-percussion test, although least sensitive, was most specific. The tourniquet test was quite insensitive and not very specific, and should not be used as a routine screening test in the diagnosis of carpal tunnel syndrome.

Carpal Tunnel Syndrome↗
PubMed1985

Carpal tunnel syndrome: associated abnormalities in ulnar nerve function and the effect of carpal tunnel release on these abnormalities.

Twenty of 59 hands (34%) of patients with carpal tunnel syndrome had abnormalities in sensibility testing of both median and ulnar nerves by either two-point discrimination, Semmes-Weinstein monofilament testing, or both. Before surgery, 53% of patients complained of paresthesias and/or numbness in ulnar nerve distribution. Eighty percent of the hands had abnormal Semmes-Weinstein monofilament testing of the ulnar nerve. Thirty-five percent had abnormal two-point discrimination. Forty-one percent had abnormal electromyographic testing of the ulnar nerve. All hands had median nerve decompression alone. Guyon's canal was not released. After surgery, 89% of patients had improvement in paresthesias and/or numbness of the ulnar nerve. Ninety-four percent had improvement in Semmes-Weinstein monofilament testing. Eighty-six percent had improvement in two-point discrimination. Patients with a residual abnormality in ulnar nerve sensibility also had continued abnormality in median nerve sensibility. A significant percentage of patients with carpal tunnel syndrome also have signs and symptoms of ulnar nerve compression. Most improved with carpal tunnel release alone.

Carpal Tunnel Syndrome↗