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Biomedical subjects

L R Scheker

Publications and source records attributed to L R Scheker.

31 records · Page 2Linked to original sources
PubMed1990

Vascularized fibular osteocutaneous graft: surgical technique and clinical study.

This paper presents a detailed description of the dissection of the vascularized fibular osteocutaneous graft. The fibular graft is vascularized by the peroneal artery. A cutaneous vessel takes origin from the peroneal artery within 2 cm of the fibular midpoint in more than 90% of legs. The reliability of this vessel allows a skin island to be transferred with bone, to act as a monitor of vascularity and provide for skin loss. Ten clinical cases confirmed the reliability of the surgical dissection when centred at the midpoint of the fibula.

Adolescent↗
PubMed1990

Upper extremity wound management.

Many hand infections can produce permanent disability if not treated promptly and aggressively. Glass wounds and paint or grease gun injections can result in serious deep infections and often require immediate treatment in the operating room. The following common infections challenge the treating physician regarding their indications for surgical versus nonsurgical treatment. Caught early, infection of the nail fold (paronychia) responds to soaks in warm saline, oral antibiotics, and elevation of the affected part; in later stages, incision and drainage are necessary. Felons, subcutaneous abscess of a digit's distal pulp, must always be treated surgically, however. Herpetic whitlow, caused by herpes simplex, looks similar to other infections of the digit but pursues a self-limited course, resolving in 3 to 4 weeks; surgical treatment is strongly contraindicated. If erythema and drainage persist following proper treatment of hand infections, osteomyelitis should be ruled out with appropriate x-rays.

Anti-Bacterial Agents↗
PubMed1990

Timing and decision-making in the treatment of congenital upper extremity deformities.

With growth and development, the hand undergoes profound structural and functional changes. Congenital anomalies lead to development of aberrant functional patterns. Appropriate timing of surgical correction is essential to minimize deformity and prevent development of aberrant function before set patterns of cortical control have occurred. By the same token, certain anomalies should not be treated surgically since such treatment may interfere with function. A clearer understanding of pathologic anatomy of deformities such as radial club hand, hypoplastic thumb, and thumb duplication has enabled a more rational surgical approach. Microsurgery has an increasing role to play in the treatment of these deformities.

Age Factors↗
PubMed1989

Triggering secondary to an untreated partially-cut flexor tendon.

A case is reported where a flap cut of the radial slip of the flexor digitorum superficialis triggered on the proximal border of the A2 pulley within a healed intact tendon sheath. Shaving the flap resolved the problem. This illustrates another post-traumatic mechanical cause of triggering after partial division of flexor tendons.

Adult↗
PubMed1988

The lateral arm free flap in releasing severe contracture of the first web space.

To permanently release severe contracture of the first web space, suitable additional skin must be provided. Local skin is often insufficient and is unable to fill the depths of the space. Pedicle flaps are bulky, require a second operation for division, and frequently demand further procedures for revision. A precisely tailored lateral arm free flap allows unparalleled correction to be achieved with one surgical intervention. The operation can be performed under regional anaesthesia with morbidity restricted to one extremity.

Adult↗
PubMed1987

Lateral arm composite tissue transfer to ipsilateral hand defects.

Different applications in the use of the ipsilateral lateral arm free flap in 29 patients treated in our unit from November 1983 to December 1984 are described. The flap was used in both elective and emergency reconstruction with a success rate of 96.5%. This flap is elevated from the same limb as the injured hand, permitting the entire operative procedure to be performed with the patient under a single regional block anesthesia, both flap and recipient sites being prepared synchronously in a bloodless field.

Adolescent↗
PubMed1985

The value of the photoplethysmograph in monitoring skin closure in microsurgery.

Excessive tension during skin closure may impair flow in a free tissue transfer. Objective methods to observe skin perfusion have been developed. One of these, photoplethysmography, is commonly used for postoperative observation of flow in free flaps. This article demonstrates that valuable information can be obtained with photoplethysmography during wound closure also.

Adult↗
PubMed1983

The radial forearm flap: a versatile method for intra-oral reconstruction.

The radial forearm flap is ideal for intra-oral reconstruction, offering thin, pliable predominantly hairless skin to replace oral mucosa. The vascularity of the area allows considerable variation in the design of this fasciocutaneous flap and offers the possibility of including bone as an osteocutaneous flap. Furthermore, the vascular anatomy of the flap simplifies the technical aspects of free tissue transfer. Based on ten clinical cases the design of the flap is described and its versatility in differing clinical situations is illustrated. The advantages of this method of intra-oral reconstruction are discussed and evaluated.

Adult↗
PubMed1983

Primary veloplasty or primary palatoplasty: some preliminary findings.

Staged palatal closure was carried out in 30 children. The soft palate was closed at 9 months and the hard palate at 5 years. These patients were followed up for 7 years, and it was found that although the incidence of lateral crossbite was reduced in both unilateral and bilateral cases, the speech results were less satisfactory than those obtained with total palatal closure. In this series, there were two fistulae at the junction of the hard and soft palate. This was related to difficulty in closing this area in some patients at the time of the second operation. As a result, the procedure is not advised. An alternative palatal closure technique is described. This technique consists of nasal layer closure, careful dissection and reconstruction of the levator musculature, transverse division of the nasal layer, insertion of a buccal flap for lengthening, and closure of the oral layer with Veau flaps without dissection behind the tuberosities and with almost total closure of the lateral donor sites on the palatal shelves. In this way there is minimal scarring, particularly in the retrotuberosity area. This is felt to be important since it would seem from studies of facial growth that this is a much more significant area than the palatal shelves.

Child, Preschool↗
PubMed1982

The long term results of intra-oral split-skin grafting.

A long term review has been carried out to assess the results of intra-oral split-skin grafts in the closure of defects produced by the excision of intra-oral, predominantly malignant, lesions. The technique of grafting, the quality of the final result and the possibly disabling complications are related in great part to the site of the original lesion and the extent of the surgical excision required.

Follow-Up Studies↗
PubMed1981

Bone marrow grafting in the secondary closure of alveolar-palatal defects in children.

The material presented in this paper is a preliminary report on the use of bone marrow grafting in the secondary closure of alveolar palatal defects in young children with mixed dentition. A group of patients is presented in whom successful closure of an alveolar fistula was achieved with improvement of the eruption pattern of the teeth adjacent to the cleft due to new bone formation that allowed early orthodontic alignment. The concept of the formation of a dynamic growing bone from bone marrow grafting is discussed.

Alveoloplasty↗