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Biomedical subjects

H Srinivasan

Publications and source records attributed to H Srinivasan.

At least 37 records · Page 2Linked to original sources
PubMed1983

Universe of finger postures and finger dynamography. A conceptual methodological tool for assessing and recording the motor capacity of the finger.

The sum total of all postures actively possible at a joint constitutes its "universe of postures". This universe can be identified by its limits. The universe of a biarticular system like the finger can be mapped out visually, by identifying the limiting postures, plotting them as points in a graph sheet in which the postures of the MP joint are represented in the horizontal axis and the postures of the PIP joint are represented in the vertical axis, and connecting the points serially. The closed figure thus obtained represents the universe of postures of the finger and shows at a glance the motor deficits of the finger as a whole. It also remains as an objective record of the universe, available for comparison after treatment. This method of evaluation of the finger has been found to be particularly useful in assessing fingers with paralytic problems. Such a visual representation of the universe, called "dynamogram" here, can also be used for kinesiological studies.

Biomechanical Phenomena↗
PubMed1982

Internal stabilization in the thumb.

An analysis of the thumb as an articular chain, with the biarticular tendon displacement used as a model, is presented. Comparison of the extensor pollicis longus/flexor pollicis longus (EPL/FPL) tendon displacement ratios at the three joints, as determined from cadaver studies, shows that the thumb will be unstable, with a persistent tendency to extend at the carpometacarpal (CMC) joint and flex at the interphalangeal (IP) joint when it is under the exclusive control of the EPL and FPL muscles. In addition, according to the model, with stabilization of the CMC joint, the MCP joint will tend to extend and the IP joint will flex. Clinical data from thumbs of leprosy patients with thenar paralyses largely confirm these predictions and the validity of this approach in studying the functional behavior of the thumb.

Biomechanical Phenomena↗
PubMed1982

Discrepancy in the histopathological features of leprosy lesions in the skin and peripheral nerve. Report of a preliminary study.

Simultaneous biopsies of the skin and a cutaneous nerve were done in 36 randomly selected leprosy patients and the histopathological features of the lesion in the two tissues were compared. A discrepancy was noticed in 21 instances. In 19 of these cases the lesions in the nerve were found to be immunologically more deficient and were also bacillated, even when the skin lesion had cleared or regressed. The implications of the findings are discussed and the need for further studies is emphasized.

Adolescent↗
PubMed1982

Correction of the paralytic claw-thumb by two-tailed transfer of the superficialis tendon through a window in the flexor retinaculum.

The results of correction of 39 paralytic claw-thumbs in 34 leprosy patients with combined ulnar and median nerve paralysis by transfer of the flexor superficialis tendon through a small window in the flexor retinaculum are reported. The motor tendon was split into two slips, one passed lateral and the other volar to the metacarpophalangeal joint of the thumb. Both slips were sutured to the tendon of the extensor pollicis longus. The volar slip was used in an attempt to restore muscle balance at the metacarpophalangeal joint. Satisfactory abduction was obtained in 90 percent of the cases, and excessive tip flexion during abduction-opposition was abolished in 85 percent of the cases. However, undesirable flexion of the proximal phalanx occurred in 10 thumbs when held actively in abduction-opposition.

Adolescent↗
PubMed1982

Steroid therapy in recent "quiet nerve paralysis" in leprosy. Report of a study of twenty-five patients.

Nerve trunks may "quietly" get paralysed in a proportion of leprosy patients without going through a stage of acute or subacute neuritis. A study of 25 male patients with quiet paralysis of 57 nerves shows that such paralysis, which may be complete or incomplete, can occur in any type of leprosy and may involve any nerve trunk. Steroid therapy for six months reversed the motor paralysis to a satisfactory extent in about 75% of the nerves. Recovery rate was higher in nerves other than the ulnar nerve, and when paralysis was incomplete or of short duration. There was no recurrence of paralysis after stopping steroid therapy. Except for mooning of the face noticed in two patients, no serious side effects attributable to prolonged steroid therapy occurred in the subjects included in this trial.

Adolescent↗
PubMed1981

A simple method for assessing abduction of the thumb.

A simple method of assessing thumb-web contracture by fitting an appropriate precalibrated triangular wooden disc in the gap between the first and second metacarpal is described. Abduction of the thumb in the plane of the palm can also be measured in a similar manner using a different set of discs.

Anthropometry↗
PubMed1979

Movement patterns of interosseus-minus fingers.

The patterns of isolated metacarpophalangeal-joint flexion and isolated interphalangeal-joint extension movements in eighty fingers with intact extrinsic and lumbrical muscles but no interossei (so-called interosseus-minus fingers) were studied. The pattern of metacarpophalangeal flexion resembled that seen in fingers with paralysis of all intrinsic muscles. From this it was inferred that in the interosseus-minus finger the lumbrical muscles are inactive during this movement. The pattern of isolated interphalangeal extension in the interosseus-minus fingers showed an improvement over that in totally intrinsic-minus fingers, suggesting that the lumbrical muscles reduce the extending forces at the metacarpophalangeal joint to some extent. Active participation of the interosseus muscles appears to be necessary for carrying out the movements of isolated metacarpophalangeal flexion and interphalangeal extension.

Adolescent↗
PubMed1979

Clinical features of paralytic claw fingers.

A study of 221 claw fingers of fifty-one leprosy patients with ulnar or combined ulnar and median-nerve paralysis showed that the severity of the deformity was determined mostly by the completeness of paralysis of intrinsci muscles, and to a lesser extent by the duration of paralysis. There was no predilection for severe deformity in any one finger. Recurrent dislocation of the extensor tendon from the knuckle of the metacarpophalangeal joint was observed mostly in fingers that were completely deprived of all intrinsic muscles. No satisfactory explanation could be found for this. Flexing the wrist facilitated opening of the claw finger, but the effect was more evident at the metacarphophalangeal joint than at the proximal interphalangeal joint.

Adolescent↗
PubMed1977

Nerve abscess in lepromatous leprosy. A case report and a discussion of pathogenesis.

An instance of nerve abscesses developing in a patient with lepromatous leprosy is reported. The pathogenesis of nerve abscess in lepromatous leprosy is briefly discussed. It appears that such abscesses may develop (i) from an ENL lesion in the nerve during ENL reaction, (ii) because of exacerbation of existing lepromatous lesion, (iii) arise as an "exacerbation nodule", (iv) due to quiet necrosis in a lepromatous granuloma, or (v) it may be iatrogenic.

Abscess↗
PubMed1977

Movement patterns of intrinsic minus fingers. Role of intrinsic and extrinsic muscles in finger posture control.

A detailed study of the patterns of two movements (pure metacarpophalangeal flexion and pure interphalangeal extension) in intrinsic minus fingers shows that the long extensors and long flexors produce simultaneous movement at the metacarpophalangeal and interphalangeal joints. A comparison of the patterns of these movements in totally intrinsic minus and interosseous minus fingers shows that in the latter the lumbricals are probably largely inactive during attempted pure metacarpophalangeal flexion and contribute to restrain metacarpophalangeal extension considerably during attempted pure interphalangeal extension. Active participation by the interosseous muscles appears necessary for completing these movements.

Fingers↗
PubMed1976

Heel ulcers in leprosy patients.

The incidence, causes, clinical presentation and management of ulcers of heel in the insensitive feet of leprosy patients are described. It is pointed out that heel ulcers usually arise as the result of injury and infection and are eminently preventable. Various surgical and non-surgical measures needed for preventing recurrence of the ulcer are also discussed.

Heel↗
PubMed1976

Patterns of movement of totally intrinsic-minus fingers based on a study of one hundred and forty-one fingers.

A detailed study of metacarpophalangeal flexion and interphalangeal extension movements of 141 fingers with complete intrinsic-muscle paralysis due to leprosy showed that long flexors and long extensors produce movement at the metacarpophalangeal and proximal interphalangeal joints simultaneously, and not successively as is generally believed. The amounts of flexion resulting from long flexor activity are almost equal at the two joints and metacarpophalangeal flexion is achieved without excessive flexion of the proximal interphalangeal joint, but this is masked by the claw-finger deformity. The movement resulting from activity of the long extensor is complex and there are three or more qualitatively different patterns of extension. Although the long extensor produces simultaneous extension at the metacarpophalangeal and proximal interphalangeal joints, the latter consistently lags behind the former so that full extension is not achieved at the proximal interphalangeal joint even when the metacarpophalangeal joint is maximally extended. The diverse patterns of extension are not related to duration of degree of clawing or to any particular finger.

Adolescent↗
PubMed1975

A note on the Mulder-Landsmeer phenomenon.

Mulder-Landsmeer phenomenon (inability to activiely straighten the interphalangeal joints fully when the metacarpophalangeal joint of a finger is passively held in maximal hyperextension) was confirmed in the normally hypermobile South Indian fingers. A powerful but limited de-extension of the proximal phalanx was noticied, in normagers, during completion of interphalangeal extension when the metacarpophalangeal joint was passively held in maximal hyperextension...

Biomechanical Phenomena↗