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Biomedical subjects

R W Culp

Publications and source records attributed to R W Culp.

At least 37 records · Page 2Linked to original sources
PubMed1993

Proximal row carpectomy: a multicenter study.

Twenty patients underwent proximal row carpectomy and were retrospectively evaluated for pain, motion, grip strength, functional activity, and x-ray changes at a mean follow-up of 3 1/2 years. For nonrheumatoid patients, motion decreased 15% after surgery, mean grip strength improved 22%, and 82% believed their conditions were improved and said they would repeat the procedure. The procedure failed in all three patients with rheumatoid arthritis. Patients with mild preoperative arthritic changes had better results than those with advanced disease.

Adult↗
PubMed1993

Palmar midcarpal instability: results of surgical reconstruction.

We reviewed the cases of 13 patients who underwent 15 surgical procedures for palmar midcarpal instability from 1981 to 1989. Six patients had a limited midcarpal arthrodesis, and nine patients had one of four different soft tissue reconstructive procedures. One hundred percent clinical follow-up was obtained at an average of 48 months. All six of the limited midcarpal arthrodeses were successful. Six of the nine soft tissue reconstructions failed. However, one procedure, a distal advancement of the ulnar arm of the arcuate ligament combined with a dorsal capsulodesis, restored stability in three of five wrists. We concluded that patients with palmar midcarpal instability may have significant disability that may be refractory to nonsurgical management. Limited midcarpal arthrodesis provides definitive treatment.

Activities of Daily Living↗
PubMed1992

Arthroscopic surgery of the knee: its role in the support of U.S. troops during Operation Desert Shield on USNS mercy.

The role of arthroscopy in the preconflict deployment of a large number of military troops is not well defined. Between September 1990 and January 1991, while deployed to the Persian Gulf for Operation Desert Shield 73 patients underwent on-board elective arthroscopy on the USNS Mercy. There were 71 men and two women with an average age of 27 years (range 19-47). Indications for arthroscopy included clinical diagnosis of meniscus tear, acute hemarthrosis, chronic effusion, and intra-articular loose body. Findings at the time of arthroscopy included 34 patients (47%) with meniscus tears; 17 (23%) with anterior cruciate ligament tears; five (7%) with isolated grade II-IV chondromalacia involving the patella, trochlea, femoral condyles, or tibial plateaus; six (8%) with synovitis; four (5%) with osteochondritis dissecans of the medial femoral condyle; two (3%) with a medial retinacular tear secondary to patella dislocation; and 10 (14%) with normal arthroscopic examinations. Forty-nine patients (66%) were returned to duty at an average of 6 days postoperatively, obviating the need to evacuate these patients from the Middle East theatre.

Adult↗
PubMed1992

Mason type II radial head fractures: operative versus nonoperative treatment.

The most appropriate treatment of Mason type II radial head fractures remains controversial. Recommended treatment has included closed reduction and immobilization, resection, or open reduction and internal fixation. The cases of 29 Mason type II radial head fractures treated at Naval Hospital Oakland from 1983 to 1989 were identified. Twenty-six or 90% were available for detailed follow-up. All cases underwent standardized elbow evaluations and results were compared using an elbow score based on a 100-point scale. The parameters evaluated were pain, motion, elbow and grip strength, and function in activities of daily living. In addition, injury and follow-up radiographs were analyzed. Mean follow-up was 18 months. There were 10 cases treated by open reduction and internal fixation and 16 cases treated by closed means. At final follow-up, the operatively treated group had a mean elbow score of 92 and 90% good/excellent results. The nonoperatively treated group had a mean elbow score of 77 and 44% good/excellent results. This difference was statistically significant (p less than 0.01). Radiographic analysis revealed a higher incidence of articular depression, displacement, and joint narrowing in the nonoperatively treated group. We conclude that displaced radial head fractures treated nonoperatively have a higher incidence of pain, functional limitations, loss of strength, and radiographic evidence of arthritis when compared to those treated by open reduction and internal fixation.

Adult↗
PubMed1992

Arthroscopic surgery of the knee on the U.S. Naval Hospital Ships during Operation Desert Shield.

Between September 1990 and January 1991, while deployed to the Persian Gulf for Operation Desert Shield, 118 patients underwent arthroscopic surgery of the knee on the U.S. Naval Hospital Ships USNS Mercy and USNS Comfort. There were 113 men and 5 women, with an average age of 28 years (range, 19-59 years). The most common findings at the time of arthroscopy were meniscus tears (53%), anterior cruciate ligament tears (29%), and normal arthroscopic examinations (9%). There were three complications, two hemarthroses and one superficial portal site infection. Seventy patients (59%) were able to be returned to duty at an average of 6 days post-operatively, obviating the need to evacuate these patients out of the Middle East theater to Europe or the United States, thus avoiding additional delay, expense, and loss of the service member to his military unit.

Adult↗
PubMed1990

Neural injuries associated with supracondylar fractures of the humerus in children.

A retrospective review of displaced extension-type supracondylar fractures of the humerus in 101 children who were seen consecutively revealed eighteen associated neural injuries in thirteen children. Nine of the neural injuries in eight patients spontaneously resolved at a mean of 2.5 months (range, 1.5 to five months) after injury. The remaining nine lesions in five patients were explored at a mean of 7.5 months (range, five to fourteen months) after injury, because clinical and electromyographic studies showed no return of function. Neurolysis was performed on eight of the nerves that were explored (in five patients), and the remaining radial nerve was found to be completely lacerated and needed nerve-grafting. The length of follow-up after neurolysis averaged twenty-five months (range, thirteen to forty-four months). All five patients had functional recovery, as documented by range-of-motion, grip-strength and lateral pinch-strength, and von Frey and two-point-discrimination sensory testing. The patient who had had nerve-grafting never recovered neural function, and tendon transfers were needed. We concluded that observation and supportive therapy is the preferred initial approach for children who have a neural injury associated with a closed, displaced supracondylar fracture of the humerus. However, if there is no clinical or electromyographic evidence of return of neural function at five months after injury, exploration and neurolysis should be performed. If the nerve is in continuity, the prognosis after neurolysis is excellent.

Adolescent↗
PubMed1989

Kienböck's disease in a patient with Crohn's enteritis treated with corticosteroids.

In a patient with Crohn's enteritis treated with oral corticosteroids simultaneous Kienböck's disease and femoral head osteonecrosis developed 2 years after the administration of corticosteroids. The patient had no history of trauma or any other risk factor known to be associated with Kienböck's disease. This case suggests that corticosteroid administration may be an additional factor in the multifactorial causes of Kienböck's disease.

Adrenal Cortex Hormones↗
PubMed1987

Supracondylar fracture of the femur following prosthetic knee arthroplasty.

Sixty-one supracondylar fractures above prosthetic knee replacements in 58 patients were reviewed with a mean follow-up time of 3.7 years (range, 9 months to ten years). The mean interim between arthroplasty and fracture was 2.9 years (range, intraoperative to ten years). Twenty-seven cases demonstrated notching of the anterior femoral cortex. Seventeen patients suffered from a severe neurologic disorder. Group A consisted of 30 patients with 31 fractures treated by open reduction and internal fixation or revision arthroplasty. Follow-up study revealed 25 unions, three malunions, one nonunion, and two above-knee amputations for deep sepsis. Four of 31 patients had increased pain levels or change in ambulatory status postoperatively. Group B consisted of 30 fractures in 28 patients treated by casting alone or traction followed by cast bracing. Follow-up examination showed 17 unions, seven malunions, and six nonunions. Fifteen of the 30 patients had increased pain levels or change in ambulatory status after treatment. Casting produced significant decreases in motion in both groups. The results indicate that this fracture is associated with anterior notching of the femoral cortex and preexisting neurologic disorders. Patients with a supracondylar fracture following prosthetic knee arthroplasty are best managed by secure internal fixation and early motion.

Aged↗
PubMed1987

Lyme arthritis in children. An orthopaedic perspective.

The cases of forty-three children with clinical and serological evidence of Lyme arthritis that was diagnosed between August 1983 and July 1985 were evaluated. The mean length of follow-up was twenty months, with a range of five to thirty months. All of the children lived in or had visited an area where the disease was known to be endemic. Arthritis was the presenting feature in more than half of the children, and half of the children had initially consulted an orthopaedic surgeon, none of whom made the correct diagnosis. Only twenty patients had a history of erythema chronicum migrans, the characteristic rash that precedes the arthritis, and for only nineteen children was there any recollection of having been bitten by a tick. Three patients had Bell palsy and one had a popliteal cyst in conjunction with the arthritis. All of the patients had oligoarticular involvement. The knee was involved in all but two patients. Recurrent attacks of synovitis were common. Effusion was the only radiographic abnormality that was observed, and it was found in thirty-two patients. The sedimentation rate was elevated in thirty of thirty-six patients. Immunofluorescent serology for Lyme disease, which is sensitive and specific, was uniformly positive. Of thirty-three patients who were treated with oral administration of penicillin or tetracycline alone, thirty-one responded, while two patients who had recurrent attacks of the disease responded to parenteral administration of antibiotics. The remaining ten patients responded to combinations of orally and parenterally administered antibiotics. Longer follow-up is needed to further document the apparently low rate of relapse after antibiotic therapy in this young population.

Adolescent↗
PubMed1972

The Mount Sinai Hospital Library, 1883 to 1970.

A history of the Mount Sinai Hospital Library in New York City from its inception in 1883 to 1970 is presented. From its modest beginnings the growth and development of the library is reviewed through eight decades. The paper reports the library's expanded role in the Mount Sinai School of Medicine of the City University of New York.

History, 19th Century↗
PubMedDate not supplied

The effect of ice application versus controlled cold therapy on skin temperature when used with postoperative bulky hand and wrist dressings: a preliminary study.

Skin temperature of the hands of 12 volunteers was monitored. The hands were placed in bulky dressings and treated with a standard ice bag (group I) or a new cooling blanket (group II). The contralateral hands served as controls. The mean difference in skin temperatures between group I and controls was 1.5 degrees F, while the difference between group II and controls was 13 degrees F. Temperatures of the controls did not decrease with time. Newer cooling devices appear to be more efficacious than standard ice bags in accurately and significantly lowering skin temperature when used with traditional bulky hand dressings.

Bandages↗