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Biomedical subjects

R D Leffert

Publications and source records attributed to R D Leffert.

31 records · Page 2Linked to original sources
PubMed1978

Technical problems with ulnar nerve transposition at the elbow: findings and results of reoperation.

Ten patients who had persistent or recurrent paresthesias, muscular weakness, or sensory loss following transposition of the ulnar nerve at the elbow were explored. Operative findings included compression of the nerve at the intermuscular septum or at the entrance to the cubital tunnel, dense scarring after intramuscular transposition, and constriction by fascial slings. The average interval from the previous operation to re-exploration was 13 months. All patients were improved following neurolysis and submuscular transposition. Recovery was incomplete in nine patients. The average follow-up was 14.5 months.

Adolescent↗
PubMed1976

Patterns of neuromuscular activity following tendon transfer in the upper limb: a preliminary study.

Early results of a continuing study of the electrical activity of muscles after transfer, with an integrated system of electromyographic and video tape recording, recorded motions of the simple voluntary type, mostly with isometric contractions. A triceps-to-biceps transfer showed activity in the new motion one day after operation. A partial transfer of the pectoralis major (Clark) demonstrated isolated activity of the transfer after one year. A superficialis transfer to clawed ring and little fingers functioned to flex the metacarpophalangeal joints and to extend the interphalangeal joints. Transfer of superficialis to finger extensors showed that antagonists acted to provide unresisted extension. The original phasic activity of a muscle was retained in a study of extensor indicis proprius to thumb for opposition. New phasic activity was shown in transfer of extensor carpi radialis longus to digital flexors. In two instances of transfer of spastic wrist flexors to wrist extensors, the original phasic activity was retained, but in only one was the function assumed by the transfer even though wrist extension was improved.

Adult↗
PubMed1974

The vincula; with particular reference to their vessels and nerves.

The blood vessels and nerves of the vincula in the human hand were studied by anatomical dissection, serial histological section, and angiography. The segmental blood supply of the flexor tendon through the vincula was seen to come from constant branches of the digital vessels that pierce the fibrous sheath proximal to both the proximal and distal interphalangeal joints. These were traced with their accompanying nerves into the flexor tendons. Communication between the interosseous circulation and that of the tendons was demonstrated. The clinical implication of these findings and their application to tendon surgery are discussed.

Angiography↗
PubMedDate not supplied

Clavicle malunion.

The clavicle fracture that has united with deformity or shortening may have an adverse effect on normal shoulder girdle function. We report on 4 patients in whom a malunited fracture of the clavicle was believed to be a contributing factor to shoulder girdle dysfunction. In each patient, the functional status of the involved limb was improved after corrective osteotomy at the site of deformity, realignment, and plate fixation.

Adult↗
PubMedDate not supplied

Direct injury to the axillary nerve in athletes playing contact sports.

We performed long-term followup (31 to 276 months) of 11 contact athletes who had sustained isolated injuries to their axillary nerves during athletic competition. There were no known shoulder dislocations. Electromyographs were taken of 10 patients, and all patients had confirmation of clinically defined injuries that were confined to their axillary nerves. Nine injuries were sustained while tackling opposing players in football; two were sustained in hockey collisions. In seven athletes, the mechanism of injury was a direct blow to the anterior lateral deltoid muscle. In four athletes, there were simultaneous contralateral neck flexion and ipsilateral shoulder depression. At followup, all patients had residual deficits of axillary sensory and motor nerve function. There had been no deltoid muscle improvement in three patients, moderate improvement in two patients, and major improvement in six patients. However, shoulder function remained excellent, with all athletes maintaining full range of motion and good-to-excellent motor strength. Axillary nerve exploration and neurolysis in four patients did not significantly affect the outcomes. Although no patient had full recovery of axillary nerve function, 10 of 11 athletes returned to their preinjury levels of sports activities, including professional athletics.

Adolescent↗