Biomedical subjects

K L Garvin

Publications and source records attributed to K L Garvin.

41 records · Page 3Linked to original sources

PubMed1980

Peg and dowel fusion of the proximal interphalangeal joint.

The clawtoe or hammertoe deformity if frequently encountered in office practice. The etiology of this condition remains obscure, although intrinsic atrophy or imbalance was suspected as early as 1863 by Duchenne. Arthrodesing the proximal interphalangeal joint converts the more powerful flexor tendon to a flexor of the metatarsophalangeal joint, thereby alleviating pressure on the metatarsal head and distributing the weight more evenly on the forefoot. Arthrodesing is accomplished by the peg and dowel method, with the fourth toe presenting the most technical difficulties. An extensor tenotomy or dorsal capsulotomy of the metatarsophalangeal joint is frequently necessary to realign the toe with the corresponding metatarsal ray. A collodion dressing is used to immobilize the toe for a period of 4 to 6 weeks, with a fusion rate of 97% in 73 toes. All patients were contacted, with 87% responding favorably and stating that they had relief of their pain and were able to resume wearing normal footwear.

Female↗

PubMedDate not supplied

An unopened titanium Greenfield IVC filter: intravascular ultrasound to reveal associated thrombus and aid in filter opening.

A titanium Greenfield filter did not open following placement in the infrarenal inferior vena cava (IVC). Abdominal radiograph and cavogram showed no definite reason for filter malfunction. Intravascular ultrasound (IVUS) demonstrated the unopened filter in the IVC with thrombus binding the legs. The thrombus was disrupted with a catheter, and the filter completely expanded with a balloon. IVUS documented full-filter opening in addition to residual thrombus in the filter following manipulation.

Aged↗

PubMedDate not supplied

Pediatric pelvic ring fractures.

Pelvic fractures are uncommon in children, yet they rank second to those of the skull in terms of complications. Thirty-six pediatric patients who sustained pelvic fractures were retrospectively studied, and a recent follow-up examination was conducted in 29 of the patients. All fractures were classified using Torode and Zieg's system, and the severity of injury was classified using the Modified Injury Severity Score (MISS). Associated injuries occurred in 67% of the patients, with long-term morbidity or mortality in 30%. The high probability of associated injuries must be appreciated, as even minimal bony injury may be associated with life-threatening visceral injuries and morbidity.

Adolescent↗

PubMedDate not supplied

Avascular necrosis of the femoral head after closed intramedullary shortening in an adolescent.

Closed intramedullary shortening has become a popular treatment method for limb-length inequality in adolescents. An important, potentially devastating complication of closed intramedullary fixation only recently described is avascular necrosis of the femoral head. We believe alternative treatment options must be considered to avoid this irreversible and catastrophic complication. A larger series may define the inherent risks of this complication and help determine the ideal treatment for femoral shortening and stabilization in the adolescent.

Adolescent↗

PubMedDate not supplied

Femoral preparation in cemented total hip arthroplasty: reaming or broaching?

Surgical techniques continue to be refined to improve the results of primary cemented total hip arthroplasty. Although there has been much research in the areas of cementation and implant design, little work has specifically addressed how bone preparation can be optimized on the femoral side. On the basis of available scientific data, it appears that the broach-only system has several potential advantages over the traditional ream-and-broach technique. Broaching is usually faster, leaves behind more bone stock, and may improve both microinterlock and macrointerlock. Additionally, the excess bone resulting from broaching without reaming does not seem to compromise fixation at the bone-cement interface. Such differences may become even more important as the indications for cemented hip arthroplasty broaden to include increasingly younger and more active patients, because revision in these individuals is likely. In most cases, reaming is probably counterproductive, although it may be advantageous when used to open the femoral canal, to prevent varus stem orientation, and to manage sclerosis or deformity of bone due to a preexisting hip disorder or the presence of internal fixation devices. Regardless of which method is chosen, good bone surface cleansing and cement penetration remain paramount. More studies comparing reamed and nonreamed preparation are necessary to resolve this controversial issue definitively.

Arthroplasty, Replacement, Hip↗