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Biomedical subjects

H K Watson

Publications and source records attributed to H K Watson.

90 records · Page 5Linked to original sources
PubMed1982

Composite toe (phalanx and epiphysis) transfers in the reconstruction of the aphalangic hand.

Twenty children with ectrodactyly have had 36 digits reconstructed with toe phalanges inserted into the existing soft tissue finger pouches or pouches constructed with local tissue. Care is taken to preserve the periosteum, epiphyseal plate, and collateral ligaments of the transfers. No surgical microvascular anastomoses are performed, and the entire procedure takes less than 30 minutes. Epiphyseal patency rates in children with a mean follow-up of 3.4 years and a median of 4 years are 90% for those operated on at 6 months to 1 1/2 years of age, 67% in those operated on at 1 1/2 to 5 years, and 50% in children operated on at 5 to 13 years of age. Radiographic growth measurements show average growths greater than 90% of the expected growth based on measurements of the contralateral donor phalanx for all transfers with open epiphyses. These reconstructed digits provide fingers that are sensate, capable of pinch and grasp, and able to tolerate heavy use.

Adolescent↗
PubMed1981

Limited wrist arthrodesis. Part II: Intercarpal and radiocarpal combinations.

Fusion of selected bones of the carpus, occasionally combined with the radius or metacarpal bases, has been used to treat a wide variety of serious pathologic conditions of the wrist. Indications include severe localized degenerative arthritis and posttraumatic changes secondary to subluxation, dislocation, or residual instability resulting in significant pain. The procedure was performed on 28 wrists in 26 patients. There were three failures to obtain union initially, two of which united after secondary grafting procedures. All patients had less pain and most had functional, though limited, ranges of wrist motion. Limited wrist arthrodesis provides a workable alternative to complete wrist fusion and Silastic wrist arthroplasty for many wrists with localized destruction.

Adolescent↗
PubMed1981

Late results with local bone graft donor sites in hand surgery.

In 124 reconstructive hand procedures requiring bone grafts, the hand and forearm were used exclusively as a donor site for autologous cortical and cancellous bone. In 78 cases, the bone was obtained from the distal radius; in 19 it was obtained from the proximal ulna; and in the remaining 27 it was obtained from the metacarpals, carpals, and phalanges. The graft size composition, and the age of the patient determined the donor site. The bone grafts were ample in size to provide good structural support and osteogenic stimulation. After an average follow-up period of 22 months, there were no donor site complications. These findings establish that the local bone graft donor site provides sufficient bone and is clinically safe for use in most procedures in reconstructive hand surgery.

Adolescent↗
PubMed1981

ECG effects of aerobic dance: a study of five exercise-conditioned young women.

Monitoring of the heart rate of five healthy well-conditioned women during an aerobic dance routine showed that maximum rates were within acceptable limits for exercise tachycardia except in one subject, who had paroxysmal supraventricular tachycardia that subsequently converted to sinus tachycardia. Thus, although aerobic dance seems a benign form of exercise, it can be intense enough to trigger dysrhythmias. Before recommending or approving it for any patient, the physician should take into consideration the person's age, health, and physical fitness level.

Adult↗
PubMed1980

Limited wrist arthrodeses. I. The triscaphoid joint.

Limited wrist arthrodesis is the surgical fusion of selected bones of the wrist. In each case the extent of the fusion is determined by the extent of the disease process. Limited wrist arthrodesis of the joints between the scaphoid, trapezium, and trapezoid is indicated in localized degenerative arthritis, radial hand dislocations, and certain instability patterns following ligament rupture (rotary subluxation of the scaphoid). Fusion is easily obtained utilizing a local bone graft donor site. Fusion of the three-bone unit leaves approximately 80% of flexion extension and 66% of radial and ulnar deviation in the wrist.

Arthritis↗
PubMed1980

The Moberg volar advancement flap for digital reconstruction.

The volar advancement flap described by Moberg in 1964 has been used to restore normal sensation to soft tissue deficits of the thumb. Application of this same technique for finger tip injuries was later suggested by Snow, but differences in digital blood supply led to dorsal tip necrosis and selection of other reconstructive techniques by many surgeons. Other methods have the disadvantages of widened two-point discrimination, a tender pulp scar, or an unacceptable donor site. The volar advancement flap applied to fingers restores normal to nearly normal sensation, an adequate pulp with minimal deformity. Our experience with the volar advancement flap in 69 digits from 1969 to 1978 is reviewed. Preservation of the dorsal perforating vessels is most important in successfully executing this procedure. No dorsal tip or flap necrosis occurred. Two-point discrimination was normal or within 2 mm of contralateral values in every digit. Full range of motion, or less than 5 degrees extension loss, was recorded in all fingers that were normal prior to operation. Our results suggest this to be a safe as well as effective adjunct in the treatment of finger tip injuries.

Adolescent↗
PubMed1980

Limited wrist arthrodesis.

Limited wrist arthrodesis is the surgical fusion of selected bones of the wrist. In each case the extent of the fusion is determined by the extent of the disease process. Limited wrist arthrodesis is an alternative to complete wrist fusion when there is a localized area of degenerative change or instability in the carpus. It relieves pain yet still allows a good range of motion. Since 1968, 36 patients have had 38 limited wrist arthrodeses. Twenty-four cases have involved carpal bones only. Fourteen of these were "triskaphe" arthrodeses: scaphoid-trapezium-trapezoid arthrodeses. Eleven cases have included the radius, and 3 have included the index metacarpal.

Arthrodesis↗
PubMed1979

Treatment of Dupuytren's contracture by extensive fasciectomy through multiple Y-V--plasty incisions: short-term evaluation of 170 consecutive operations.

The zigzag incision with Y-V closure has unique advantages for the treatment of Dupuytren's disease. Much skin can be mobilized to the longitudinal finger axis. There is rarely a need for skin grafting in spite of full correction of the deformity. This approach, combined with properly applied tamponade bulk dressing, allows for early use of the hand with minimal morbidity.

Dupuytren Contracture↗
PubMed1979

The carpal boss: surgical treatment and etiological considerations.

We report on 30 symptomatic cases of carpal boss which were treated surgically. The condition represents a highly localized degenerative arthritis at the base of the middle metacarpal, and is seen primarily in relatively young patients. Symptomatic relief was obtained by excision of degenerated tissue in all these patients.

Adolescent↗
PubMed1977

The palmar approach for the visualization and release of the carpal tunnel. An analysis of 429 cases.

A review of 429 cases of carpal tunnel syndrome in 329 patients confirms the prevalence of this entity among disorders of the hand. Three symptoms are almost diagnostic--daytime numbness, nighttime pain, and morning stiffness of the fingers. The diagnosis is confirmed by findings on physical examination. A relatively simple technique is presented for the exposure and release of the median nerve, using a longitudinal incision in the palm and stopping short of the wrist skin. Limiting the incision to the palmar skin results in an inconspicuous scar, while still providing adequate exposure for a complete anatomical release. An epineural neurolysis of the median nerve was performed in each case, resulting in improvement in the symptoms in all but 4 of these 429 patients.

Adolescent↗
PubMed1976

Ulnar dysmelia.

Eleven patients with hypoplasia and partial or complete aplasia of the ulna (examples of a complex spectrum of postaxial forearm and hand abnormalities) were reviewed. Three types of ulnar deformity were observed: (1) hypoplasia, (2) partial aplasia (ossification of the proximal part of the ulna present at birth); and (3) total aplasia (ossification not development). The roentgenographically "absent" segment of the ulna may be a large fibrocartilaginous anlage attached distally to the distal radial epiphysis or the ulnar side of the carpus, or both. The tethering effect of this band may cause ulnar deviation of the wrist (and hand) and dislocation of th badial head in utero as well as progression of these deformities after birth. Resection of the distal end of the fibrocartilaginous anlage during the first to second year of life is recommended, since the results of this procedure suggest that it reduces the angular growth deformities. It is also suggested that if the one-bone-forearm operation is indicated, it should be deferred until a later age, since complications may be less likely to occur then than at the time that the anlage is resected.

Abnormalities, Multiple↗
PubMedDate not supplied

Congenital anterior subluxation of the distal ulna. A case report.

A healthy 17-year-old girl with painful congenital subluxation of the distal ulna was successfully treated by surgical stabilization of the distal radioulnar joint. This procedure may avoid or delay the need for resection of the distal end of the ulna.

Adolescent↗