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Biomedical subjects

S H Kozin

Publications and source records attributed to S H Kozin.

15 recordsLinked to original sources
PubMed1995

Treatment of thumb ulnar collateral ligament ruptures with the Mitek bone anchor.

Complete thumb ulnar collateral ligament (UCL) injuries usually require primary repair. The ulnar collateral ligament is often torn from its insertion site and reattachment is difficult. Seven patients underwent repair with the Mitek bone anchor (Mitek Surgical Products, Norwood, MA) for complete ulnar collateral ligament disruptions. A Stener lesion was found in four patients. Follow-up examination was at approximately 1 year. All patients regained a stable metacarpophalangeal joint to valgus stress. X-ray films demonstrated accurate placement of the bone anchor with protraction of the metallic wings within cancellous bone. Range of motion revealed a 7% loss of metacarpophalangeal flexion-extension and a 21% loss of interphalangeal motion. Pinch strength in apposition averaged 98% and in opposition 97% of the uninvolved hand. Grip strength was 96% of the contralateral extremity.

Adult↗
PubMed1995

Wrist arthroscopy.

Miniaturization of arthroscopic equipment has allowed wrist arthroscopy to emerge as a powerful surgical tool in orthopedic surgery. The magnified view of the arthroscope has provided a new understanding of carpal anatomy and disease. Arthroscopy improves surgeons' ability to diagnose wrist disorders and enables them to perform operative procedures with less morbidity than would occur in open procedures.

Arthroscopy↗
PubMed1994

Atypical Mycobacterium infections of the upper extremity.

Thirty-three patients with culture-positive atypical Mycobacterium infections of the upper extremity underwent surgical debridement and antimicrobial therapy. The causative atypical organism was M. marinum in 12 cases, M. avium-intracellulare in 7, M. terrae in 4, M. chelonei in 4, M. kansasii in 3, M. fortuitum in 2, and M. ulcerans in 1. The tenosynovium was the most common location of infection (14 patients). The average follow-up period was 36 months. Duration of antimicrobial therapy averaged 10 months. The average delay between onset of symptoms to correct diagnosis was 1 year. There were seven superficial infections; six were caused by M. marinum and one was caused by M. ulcerans. All of these cutaneous infections resolved following incisional or excisional biopsy and pharmacologic therapy. The remaining 26 infections involved the deeper tissues, and M. avium-intracellulare was the most common organism. The immune status of the host was an overwhelming predictor of eventual outcome. In the 15 patients with competent immune systems, resolution occurred in 13. However, in the immunocompromised patient population, only 4 of the 10 had resolution of deep infection at time of the follow-up evaluation.

Adolescent↗
PubMed1994

Tension wire fixation of avulsion fractures at the thumb metacarpophalangeal joint.

Avulsion fractures of the thumb metacarpophalangeal joint require adequate treatment to prevent instability or articular incongruity. Open reduction and internal fixation may be difficult because of the small fracture fragment size. Nine patients underwent acute open reduction and tension wire fixation of displaced or rotated avulsion fractures. Follow-up examination was at approximately 26 months. All fractures healed in anatomic alignment without instability or articular incongruity. Pain, stiffness, and loss of pinch, were subjectively rated as none in six patients and mild in three. The injured thumb demonstrated firm stability in extension and 30 degrees flexion in all patients. Metacarpophalangeal and interphalangeal motion averaged 77% and 97% of the opposite hand respectively. Planar and palmar abduction averaged 96%. Pinch strength in apposition averaged 97% and in opposition 99% of the uninvolved hand. Grip strength was 96% of the contralateral extremity.

Adolescent↗
PubMed1994

The use of MRI in the diagnosis of occult hip fractures in the elderly: a preliminary review.

Establishing the diagnosis of a non-displaced hip fracture in an elderly patient can be a prolonged and costly procedure, involving hospital admission, several days of bed rest, and a bone scan 3 to 5 days later. The authors evaluated 10 hips in 10 patients with a questionable diagnosis of non-displaced hip fracture. Magnetic resonance imaging (MRI) soon after admission revealed four patients with acute hip fractures who were subsequently treated. The other six patients, whose scans were negative for either femoral neck or intertrochanteric fractures, were mobilized. The authors show that, through the use of an immediate MRI study of a questionable hip fracture, the prolonged recumbency and inherent costs associated with awaiting a positive bone scan can be avoided.

Aged↗
PubMed1994

Gamekeeper's thumb. Early diagnosis and treatment.

Injuries to the ulnar collateral ligament complex in the thumb are common and require prompt attention. Early diagnosis is essential and must differentiate a partial ligament sprain from a complete disruption. Accurate diagnosis requires a precise examination and roentgenographic evaluation. Provocative maneuvers and stress radiographs may be necessary to delineate the extent of injury. Partial injuries are treated effectively by thumb spica immobilization. Complete ruptures require operative intervention and anatomic repair. To optimize outcome, the operative procedure requires meticulous technique and should result in minimal morbidity. Late ulnar collateral ligament reconstruction is more complicated and inferior to early surgical repair.

Biomechanical Phenomena↗
PubMed1994

Bilateral femoral head fracture with posterior hip dislocation.

Bilateral posterior hip dislocations with femoral head fractures are rare. We report the case of a 71-year-old woman who was an unrestrained driver involved in a head-on motor vehicle collision. The right hip was stable after reduction, while the left hip was felt to be unstable. Bilateral bipolar endoprostheses were inserted via standard posterior approaches. Fracture fragments composed approximately 35% of the femoral head in both hips. We believe an elderly polytrauma patient with a significant femoral head fracture may benefit from primary arthroplasty as a treatment option, especially in cases of bilateral injury.

Aged↗
PubMed1992

Index finger pollicization for congenital aplasia or hypoplasia of the thumb.

Sensation, strength, dexterity, length, and range of motion were evaluated after index finger pollicization in 10 patients (14 hands). Diagnoses included congenital absence of the thumb (10 hands) and hypoplasia (4 hands). Average age at operation was 7 years, and follow-up averaged 9 years. Patients with unilateral pollicization averaged 67% grip strength, 60% lateral pinch, 56% palmar pinch, and 39% three-point pinch as compared with the normal contralateral hand. Manual dexterity averaged 70% efficiency as compared with normal standards defined according to age and sex. However, 55% of the patients, when stressed, used side-to-side pinch. It was noted that in those patients who used side-to-side pinch performance averaged 54% of normal standards, compared with 93% in patients who used tip-to-tip pinch for prehension.

Child↗
PubMed1992

Injuries to the perilunar carpus.

Injuries involving the perilunar carpal bones require accurate diagnosis and appropriate treatment to prevent carpal instability and collapse. Carpal anatomy and wrist kinematics must be clearly understood before these injuries are evaluated. In addition, the recognition of subtle intercarpal disruptions is improved by an appreciation of the sequential stages of progressive perilunar instability through the vulnerable carpal zone. With consideration of these concepts, a methodical approach to perilunar carpal injuries is presented to improve early recognition and treatment of these complex injuries.

Carpal Bones↗
PubMed1985

Effect of amiodarone on the pharmacokinetics of phenytoin, quinidine, and lidocaine in the rat.

Previous studies have shown that amiodarone can depress certain aspects of hepatic drug metabolism in the rat. This effect was assessed in vivo by investigating the single dose intravenous pharmacokinetics of phenytoin (10 mg/kg), quinidine (25 mg/kg) and lidocaine (7.5 mg/kg) in rats pretreated for three days with a single daily 100 mg/kg intraperitoneal dose of amiodarone hydrochloride. Compared to vehicle treated controls, significant reductions of 61% and 35% in the respective total clearances of phenytoin and quinidine were observed in the presence of amiodarone. Likewise, the elimination half-lives of phenytoin and quinidine were also significantly prolonged after amiodarone pretreatment. Lidocaine pharmacokinetic parameters were unchanged in the presence of amiodarone. These results suggest that altered hepatic drug clearance may play a part in the recently described clinical drug interactions between amiodarone and either phenytoin or quinidine.

Amiodarone↗