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Biomedical subjects

V L Young

Publications and source records attributed to V L Young.

At least 91 records · Page 5Linked to original sources
PubMed1988

Fracture of the dorsoulnar tubercle of the trapezium.

The dorsoulnar tubercle of the trapezium may fracture, and this fracture may be missed without precise physical examination and correct radiographic studies. If there is persistent localized pain and tenderness in this region and the results of routine wrist radiographic examination are normal, a bone scan should be performed. If there is localized uptake in the area of the trapezium, additional radiographic studies may be necessary to confirm or exclude this fracture. Four patients with this previously unreported fracture and a method for its detection are presented.

Adult↗
PubMed1988

Miniature implantable laser Doppler probe monitoring of free tissue transfer.

A 2.5-mm fiber-optic laser Doppler flowmetry probe has been applied in an experimental dog model as well as in 5 clinical cases to provide continuous readout of deep tissue perfusion. The rectus abdominis muscle in the dog was used for the experimental verification of the probe, which has a linear correlation with flow rate and a rapid response (6 seconds) to arterial occlusion and venous occlusion (20 seconds). Four of the 5 free tissue transfers survived with the laser Doppler instrument correctly identifying the lack of flow, both intraoperatively and postoperatively, in the failed flap. This probe greatly extends the versatility of laser Doppler flow measurement in the clinical setting and may be nearly an ideal probe for monitoring free tissue transfer, particularly muscle.

Animals↗
PubMed1988

The brown recluse spider bite.

A review of the literature confirms that the brown recluse spider bite is a common and sometimes serious clinical entity. Local and systemic manifestations are extremely variable, thus complicating management of the bite. Pathophysiological studies in laboratory animals yield conflicting results and therapeutic recommendations because of technical and species-specific differences. Standard therapies include aggressive, early debridement as well as systemic and intralesional corticosteroids; however, well-controlled clinical studies to establish their efficacy have not been performed. Variable and unpredictable patient responses to the spider bite necessitate a conservative yet vigilant position in managing these bites.

Humans↗
PubMed1987

Characteristics and management of flexor tendon graft disruption.

In order to define the proper management of patients with disruption of a flexor tendon graft, 220 consecutive flexor tendon grafts were reviewed. Patients were divided into two groups--those who did not require a silastic rod prior to tendon grafting (89 grafts) and those who did require a silastic rod prior to tendon grafting (131 grafts). The incidence of tendon graft disruption for these two groups was 1.1% and 7.6%, respectively. Based on an analysis of these 11 graft disruptions, a method of management was devised. The literature is reviewed regarding the incidence and method of management of disrupted flexor tendon grafts.

Adolescent↗
PubMed1986

Carpal avascular necrosis: MR imaging.

The authors evaluated the use of magnetic resonance (MR) imaging in diagnosis of avascular necrosis (AVN) of carpal bones by examining 21 patients with wrist pain and two healthy volunteers. MR images were compared with conventional radiographs in every case and with bone scintigrams in 18 cases. MR imaging was slightly less sensitive than bone scintigraphy in depicting AVN, but in patients who were imaged with long repetition time (TR)/long echo time (TE) sequences in addition to short TR/short TE sequences, MR imaging was found to be more specific. While the authors believe that bone scintigraphy remains the screening test of choice for patients with wrist pain and normal plain radiographs, MR imaging promises to add significant diagnostic information in cases in which bone scans are abnormal.

Adult↗
PubMed1985

Comparison of early passive motion and immobilization after flexor tendon repairs.

Thirty-one flexor tendon repairs in 30 patients managed by early passive motion were retrospectively compared with 31 flexor tendon repairs in 30 patients managed by 3 weeks of postoperative immobilization. Repairs were performed by several surgeons, including plastic surgical residents. There were no statistically significant differences between the two groups comparing age, zone of injury, number of tendons repaired, nature of injury, or associated injuries. No statistically significant difference was found between the two groups when total active and total passive range of motion were compared for repairs in zone I, zone II, zones III and IV, and all zones combined. In the early passive motion group in zone II, there were 12 percent excellent results, 15 percent good results, 23 percent fair results, and 50 percent poor results. In the immobilization group, there were 18 percent excellent results, 8 percent good results, 23 percent fair results, and 53 percent poor results. There was no significant difference between the two groups (p less than 0.05).

Finger Joint↗
PubMed1985

When should nerve gaps be grafted? An experimental study in rats.

In conclusion, animal experiments have shown the following: (1) extensive elevation (mobilization) of a nerve from its bed does not interfere with its capacity to regenerate as long as the longitudinal epineural vessels are preserved, (2) suturing nerve ends under tension has a deleterious effect on the final results, (3) when a segment of nerve has been resected, the remaining nerve and the site of repair can lengthen to accommodate joint extension (within limitations), (4) if there is a segmental loss of nerve and if the nerve ends can be approximated with 10-0 epineural sutures, even if the joints must be fully flexed, the result is better than using a nerve graft, and (5) when a graft is required, it is important to avoid reversing the nerve graft. We believe direct nerve repair is preferred when flexion of the joints and mobilization of the nerve ends permits approximation with 10-0 epineural suture.

Animals↗
PubMed1985

Massive scrotal edema as a complication of abdominoplasty.

Massive scrotal edema is an unreported complication of abdominoplasty. This patient's postoperative decompensation of medial thigh and scrotal lymphatic return may well have been due to an occult lymphedema tarda or previously compromised lymphatics from the fibrosis of venous stasis disease and obesity.

Abdomen↗
PubMed1984

Drug treatment and flap survival.

Some investigators found that isoxsuprine, propranolol, or heparin would increase skin-flap survival in loose-skinned animals. We evaluated the effects of these three drugs in the pig, an animal with skin circulation similar to that of humans. Four hundred ventrally based skin flaps that have a proximal axial portion and a distal random portion were made on the flanks of 40 pigs. There were eight study groups: control, isoxsuprine preoperatively and postoperatively, propranolol preoperatively and postoperatively, isoxsuprine postoperatively only, propranolol postoperatively only, heparin, single-stage surgical delay, and two-stage surgical delay. Flap survival was improved by the two-stage surgical delay when compared with the control flaps, flaps from pigs receiving a drug, or flaps from pigs having a single-stage surgical delay (p less than 0.001). When compared with the control flaps, neither isoxsuprine, propranolol, heparin, nor single-stage surgical delay significantly increased flap survival.

Administration, Oral↗
PubMed1984

Flexible-implant arthroplasty and finger replantation.

We performed flexible-implant arthroplasty in three metacarpophalangeal joints in two patients at the time of finger replantation. We believe flexible-implant arthroplasty is preferable to permanent arthrodesis for most patients.

Adolescent↗
PubMed1984

Proximal interphalangeal joint sprains.

We report the first series of proximal interphalangeal joint sprains and reviewed 50 sprains in 48 patients. The majority of patients were males injured at work. The radial collateral ligament was injured about twice as often as the ulnar ligaments. The little finger was injured significantly less than the others. Proximal interphalangeal joint sprains can be diagnosed by the following: pain localized to the injured ligament, swelling greatest at the site of the injured ligament, tenderness greatest at the site of the injured ligament, pain at the site of the injured ligament during lateral stress, and/or mild lateral instability on radiographs or physical examination during stress testing. All patients required several different splints for treatment; in decreasing frequency, we used immobilizing, coupling, dynamic proximal interphalangeal flexion, dynamic proximal interphalangeal and distal interphalangeal flexion, and dynamic proximal interphalangeal extension splints. The mean active range of motion before treatment was 70 degrees and after treatment was 95 degrees. Significantly more patients had loss of full extension than had loss of full flexion. Forty-six percent of the patients had no pain after treatment, 46 percent had mild pain, 8 percent had moderate pain, and none had severe pain. Patients treated within 4 weeks of their injury (group 1) gained significantly greater range of motion (35 degrees) than those treated between 5 and 14 weeks after their injury (10 degrees) (group 2).(ABSTRACT TRUNCATED AT 250 WORDS)

Athletic Injuries↗
PubMed1982

The groin flap in severe hand injuries.

We reviewed 27 patients who required 28 groin flaps for repair of hand injuries. Flap necrosis due to ischemia developed in 18% of the patients. Flap ischemia did not develop after elevation of the flap or partial division of the pedicle. All flap necroses occurred after final (total) division of the pedicle (p less than 0.05). Flap necrosis was more common following immediate insetting of the flap than after delaying the inset, but this difference was not statistically significant. Flap necrosis did not develop if the pedicle was divided in two stages, with the first stage consisting of either preliminary ligation of the superficial circumflex iliac vessels or full-thickness division of a portion of the width of the flap. Our complication rate was much lower than that previously reported for groin flaps.

Adolescent↗
PubMed1980

Operative mobilization of stiff metacarpophalangeal joints: dorsal versus volar approach.

The effectiveness and merits of the dorsal and volar approaches for release of structures contributing to metacarpophalangeal joint stiffness were studied in 61 joints in 23 patients. Seventy-six percent of the joints in the volar group gained greater than 50 degrees passive motion compared to 29% in the dorsal group. Forty-four percent of the joints in the volar group gained greater than 50 degrees active motion compared to 16% in the dorsal group. Discussion of surgical technique and postoperative management reveals that the advantages of the volar approach are most evident during postoperative management, while the main advantage of the dorsal approach is better operative exposure.

Finger Joint↗