Biomedical subjects
Publications and source records attributed to J M Protas.
Three patients were treated for snapping scapholunate subluxation in four wrists, with disabling pain in three wrists. Conventional roentgenographic techniques were not helpful in diagnosing any of these wrist problems. No complete description of the precise abnormality encountered was found in the surgical or roentgenographic literature. Three of the involved wrists have had surgical correction with good early results.
Fractures of the lateral margin of the distal tibia are usually avulsion fractures of the anterior or posterior tibial tubercle, caused when the anterior or posterior inferior tibiofibular ligament fails to tear during an injury. Since they are generally the result of external rotation and abduction, they are almost always seen in association with other fractures and ligamentous injuries at the ankle joint. While their presence usually does not change the therapeutic approach, occasionally a large fragment may require a separate fixation screw. Fractures of the posterior tibial tubercle should not be confused with fractures of the posterior articular margin (posterior malleolus), which have a worse prognosis.
In four patients with symptoms suggesting carpal instability (five wrists), fluoroscopic study of the wrists in motion was undertaken after plain film and arthrographic studies showed wither normal or nonspecific findings. Videotape recordings were made continuously of the fluoroscopic image. The examinations revealed that carpal instability can be due to a momentary subluxation that is demonstrable only by observation through a range of motion. Fluoroscopic observation of carpal motion is a useful supplement to static methods in the study of wrist injuries and in these cases gave decisive information not obtainable by other means.
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