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Biomedical subjects

R D Beckenbaugh

Publications and source records attributed to R D Beckenbaugh.

At least 37 records · Page 2Linked to original sources
PubMed1988

Failed distal ulna resections.

Twenty patients with complaints of pain and limitation of activities for more than 1 year after ulnar head resection (Darrach) were studied. Their ages ranged from 18 to 60 years (mean, 38 years). The initial indications for operation were posttraumatic derangement in 18 patients, radial growth anomaly in 1, and a lesion of the ulna in 1. Follow-up ranged from 29 to 135 months (mean, 61 months). The patients had an average of 2.2 additional operations, with up to seven procedures per patient. Radiographs were compared with those from an equal number of successful Darrach resections chosen randomly, and no significant differences were noted. All 20 patients continue to have difficulties despite several years of treatment. The Darrach resection can result in serious disability, especially in the younger patient and the patient with lax ligaments. Reoperation on these patients is rarely successful.

Adolescent↗
PubMed1987

Carpal tunnel release in patients with diffuse peripheral neuropathy.

Sixty carpal tunnel decompressions were performed in 44 patients with combined carpal tunnel syndrome and peripheral neuropathy. Symptomatic improvement was obtained in 92% of the patients and complete relief of symptoms in 72%. We conclude that peripheral neuropathy is not a contraindication to carpal tunnel decompression.

Adult↗
PubMed1987

Fibular reconstruction for giant cell tumor of the distal radius.

The management of giant cell tumors involving the distal radius has always been a difficult problem. After resection to eradicate a primary or recurrent lesion, transplantation of a nonvascularized fibular autograft was used in 12 patients. Of these patients, ten had good to excellent functional results. The procedure can restore a functionally useful wrist.

Adult↗
PubMed1986

Entrapment of the ulnar nerve by the deep flexor-pronator aponeurosis.

A study of eight patients and 20 cadaveric limbs identified the deep aponeurosis of the flexor carpi ulnaris as a potential site for constriction of the ulnar nerve. The ulnar nerve passes through this aponeurosis approximately 5 cm distal to the medial epicondyle and 2 to 3 cm distal to the cubital tunnel. In two cases of isolated compression at this level, local decompression was successful in relieving the symptoms of ulnar nerve compression. Submuscular transposition is also effective because it places the ulnar nerve deep to this aponeurosis throughout its entire course.

Adult↗
PubMed1985

Distal ulnar recession for disorders of the distal radioulnar joint.

Thirty-six wrists of 35 patients were treated with distal ulnar recession for pain and limitation of motion associated with chondromalacia of the ulnar head, triangular fibrocartilage complex tears, ulnocarpal impingement, and instability of the distal radioulnar joint. Contributing factors were positive ulnar variance in 31 wrists, fracture of the distal radius in five, sprains in 14, premature closure of the distal radial epiphysis in five, and lax ligamentous habitus in five. The ages of the patients averaged 33 years. Clinical findings were local tenderness, crepitus, and instability evident by a positive "piano key" effect. Roentgenographic findings were positive ulnar variance (29 of 36), zero ulnar variance (four), negative ulnar variance (three), positive arthrogram (11 of 19), and "forme fruste" Madelung's deformity (two). The surgical procedure is a modification of the Milch cuff resection with the use of a dynamic compression plate. Recession ranged from 2 to 13 mm (average of 4 mm). Findings at surgery included chondromalacia of the ulnar head (19), tears of the triangular fibrocartilage complex (11), and excessive mobility of the ulnar head (10). At an average follow-up of 24.5 months, results were excellent in 7 wrists, good in 21, fair in four, and poor in four. Poor results in two wrists were upgraded to good after osteosynthesis of a nonunion in one and recessional osteotomy of the radial sigmoid notch in the other. Ulnar recession offers a less destructive alternative to disorders of the distal radioulnar joint than the Darrach resection.

Adolescent↗
PubMed1984

Accurate evaluation and management of the painful wrist following injury. An approach to carpal instability.

A diagnosis of wrist sprain is no longer appropriate. With a proper history and careful physical examination, a specific problem can be suggested. Aids, including motion radiographs, special views, arthrography, technetium-99m scans, and/or tomography, can usually confirm the diagnosis. Only if specific injuries are identified can proper understanding and treatment of the injury be achieved.

Carpal Bones↗
PubMed1983

Implant arthroplasty in the rheumatoid hand and wrist: current state of the art in the United States.

Implant arthroplasty in deforming arthritis of the hand and wrist is a useful procedure that provides pain relief and mobility. Resection arthroplasty enhanced by silicone elastomer interpositional implants remains the standard of comparison and procedure of choice in most areas. Articulated and nonarticulated fixed-fulcrum implants have had limited success. Soft tissue disease significantly limits the eventual success of implant arthroplasty in the rheumatoid hand and wrist.

Arthritis, Rheumatoid↗
PubMed1983

Instability patterns of the wrist.

Carpal instabilities are generally the result of a hyperextension injury. The deformities are mediated through the internal compressive force supplied by the musculotendinous units and are dependent on the extent of injury as well as the precise structures that are disrupted. The scaphoid inherently tends to palmar flex. It will pull the lunate with it if the lunotriquetral integrity has been interrupted, and conversely the lunate and triquetrum will dorsiflex if the scapholunate integrity is disrupted. If the integrity of the oblique external ligaments, particularly the volar (palmar) radiolunate, is disrupted, the entire carpus has a tendency to translate ulnarly. Carpal instabilities are invariably associated with weakness, limitation of motion, and pain.

Carpal Bones↗
PubMed1982

Ulnar lengthening in the treatment of Kienböck's disease.

Twenty patients with Kienböck's disease were treated with a modification of the Persson ulnar-lengthening procedure to remove compressive stress from the damaged lunate. After an average follow-up of thirty-seven months, relief of pain was satisfactory in eighteen patients who had returned to work (nine of whom had strenuous occupations), and two patients were dissatisfied because they had persistent pain and were not able to return to their previous occupations. Non-union at the site of the ulnar osteotomy occurred in three patients who were treated early in the series and was the result of inadequate internal fixation or insufficient duration of protective splinting. All three of the patients had satisfactory results after replating and bone-grafting. The procedure appears to help to maintain carpal height, prevent further collapse of the lunate, encourage consolidation of the fragmented lunate, and increase grip strength. Except for ulnar deviation, which the procedure may further diminish, the postoperative motions of the wrist were moderately improved.

Adolescent↗
PubMed1982

Hip fracture recurrence. A population-based study.

In a large population-based study of hip fracture recurrence in Rochester, Minnesota, the overall risk of any recurrence, ipsilateral or contralateral, was estimated to be 29% by 20 years after initial fracture, 1.6 times greater than expected. The risk of recurrence was greater in patients who had initial fractures associated with moderate trauma and in younger patients. The increased risk among women compared to men was eliminated when the degree of trauma was considered. Ipsilateral recurrence at the same fracture site was less frequent than expected, and the overall increased risk was primarily due to contralateral fractures at the initial fracture site (cervical or intertrochanteric). There was no difference in recurrence rate with respect to site or side of the initial fracture, and no concentration of recurrences was observed for any particular time interval following the first hip fracture.

Actuarial Analysis↗
PubMed1981

A dynamic splint for use after total wrist arthroplasty.

Total wrist arthroplasty has been performed at the Mayo Clinic for the past 5 years. The procedure has necessitated the development of a dynamic wrist splint for post-operative care. This article provides a step-by-step outline for construction of this splint.

Arthritis, Rheumatoid↗
PubMed1980

Kienböck's disease: the natural history of Kienböck's disease and consideration of lunate fractures.

Forty-six patients with Kienböck's disease were evaluated over a 2- to 27-year period; 72% had a history of wrist injury prior to diagnosis; 67% had evidence of fracture or fragmentation of the lunate. Documented fractures of the lunate were identified followed by both the presence and absence of subsequent Kienböck's disease and this may be explained by the variable blood supply of the lunate. Ten patients were not treated; 36 patients were treated surgically. Patients were relieved of pain and had functional wrists whether they were treated or not and regardless of the type of surgical treatment.

Adolescent↗
PubMed1979

Long-term results of resection of the distal ulna for post-traumatic conditions.

Sixty-two patients underwent resection of the distal ulna because of pain or limited motion after wrist trauma. The median length of resection was 23 mm. Injury to the distal radioulnar joint occurred primarily during fractures of the distal radius. Followup time averaged 87 months. The primary surgical indication was pain, but some procedures were performed in an effort to increase motion. All patients improved after surgery. Three patients had residual pain, 25 had mild pain, and 34 had no pain. Supination was greatly improved, with only modest improvement in other wrist motions. Four patients developed ulnar translation of the carpus (from 1 to 3 mm). Pseudoarticulation and ulnar regrowth of the carpus were noted, but neither pseudoarticulation nor regrowth was clinically symptomatic. Grip strength improved significantly after surgery, the average from 45.3 to 78.9% of the unaffected wrist. The presence or absence of radiocarpal arthritis preoperatively had no significant effect on the patients' estimates of results. Overall, 51 patients (82%) had satisfactory results. The primary gains were pain relief, increased supination, and increased strength.

Adolescent↗
PubMed1979

Total joint arthroplasty. The wrist.

Total wrist arthroplasty, which has been performed in 101 patients, has proved to be a satisfactory procedure for the relief of pain and provision of mobility in the deformed wrist involved with rheumatoid arthritis. This procedure should not be performed after traumatic conditions in patients who expect to make heavy use of the wrist. Early cases were associated with technical problems in the development of the concept, but at present the procedure is reliable and is most often preferred to arthrodesis inpatients with rheumatoid arthritis.

Arthritis, Rheumatoid↗
PubMed1978

Total hip arthroplasty.

A review of 333 consecutive Charnley total hip arthroplasties four to seven years after operation showed that twenty-eight patients had died, and three deaths were directly related to the surgery. The survivors had an average improvement of 46.6 points in their evaluation scores to a level of 91.3 points. Four deep infections occurred for which removal of the prosthesis was required. Thirteen hips dislocated postoperatively, and five of them required additional surgery. Three were four sciatic-nerve injuries and all but one resolved. Wear of the acetabular component was evident in seventeen hips, measuring two millimeters in six and one millimeter in eleven. With the marking system used, accurate measurement of wear was not possible. Roentgenographic evidence of loosening of the femoral component was found in 24 per cent of the hips, atributable more often to the quality of cement fixation than to the position of the components (varus-valgus). Varus loosening of two millimeters or more was associated with lower evaluation scores.

Adult↗