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Biomedical subjects

V R Hentz

Publications and source records attributed to V R Hentz.

11 recordsLinked to original sources
PubMed1992

The pulp plasty: a composite graft for complete syndactyly fingertip separations.

Composite grafts of skin and subcutaneous fat harvested from the glabrous non-weight-bearing areas of the foot were used to graft 34 fingertips after separation of 23 complete syndactyly webs in 13 patients. Simple complete syndactylies accounted for 17% and complex complete syndactylies accounted for 83%; synonychia was encountered in 70%. Follow-up averaged 13.9 months (minimum, 2 months, maximum 33 months). All patients had 100% take of the composite graft. Subjective gradings were 94% good, 6% fair, and there were no poor results. This technique provides a relatively normal contour and satisfactory pad to the fingertip.

Adipose Tissue↗
PubMed1992

Efficacy of immobilization following aspiration of carpal and digital ganglions.

In a prospective study 69 carpal and digital ganglions were aspirated, multiply punctured, and digitally ruptured. Fifty percent of the wrists and digits were immobilized for 3 weeks and 50% were mobilized early. Follow-up was 1 year. Immobilization in our study did not significantly improve the results of treatment. During the course of the study, 51% of all ganglions did not recur. The outcome was successful in 52% of the wrists and digits that were immobilized and in 50% of those that were not. Forty-six percent of the dorsal carpal ganglions did not recur. Treatment was successful in 48% of dorsal carpal ganglions in which the wrists were immobilized and in 45% of those that were not. Similar percentages were found for palmar and digital ganglions. From our results, we conclude that immobilization does not significantly improve the successful treatment of ganglions over perforation and aspiration alone.

California↗
PubMed1991

Brachial plexus microsurgery in children.

From this review, the following points have emerged: 1. The typical obstetrical palsy is a traumatic lesion caused by forced lowering of the shoulder during delivery. 2. While the lesion may affect all the roots, the upper roots are usually ruptured, whereas the lower roots (if involved) are always avulsed. 3. Spontaneous recovery is possible, but its quality depends on how early recovery of previously paralyzed muscles begins. If the biceps have not started to recover by 3 months, the final result will be poor. It is at this time interval that a surgical decision should be made. 4. Surgical repair is always possible, usually by grafting, though repair can be difficult if significant numbers of avulsions have occurred. 5. The results of surgical reconstruction are better than are the results of spontaneous evolution, at least in those patients who reach the age of 3 months without evidence of recovery of the biceps. For example, more than half of the patients recover a nearly normal shoulder after grafting C5, C6 lesions in Gilbert's series, whereas in the same control population of patients, none achieved this result spontaneously. 6. Palliative treatment of the sequelae of birth palsies is difficult, and the results obtained are rarely totally satisfactory. It is for these reasons that the initial surgical intervention should be on the plexus itself in those instances meeting the criteria established above. It is important to make this decision as quickly as possible before neuroplasticity is diminished and joint contractions have occurred.

Brachial Plexus↗
PubMed1991

A comparison of suture and tubulization nerve repair techniques in a primate.

This study compared standard methods of nerve repair, epineurial or perineurial sutures with a technique termed fascicular tubulization using a biodegradable polyglycolic acid tube in a nonhuman primate model. Electrophysiologic analysis demonstrated that the percentage of proximal axons that conducted across the repair site did not significantly differ among the three techniques while epineurial suture repairs were associated with significantly longer conduction delays across the repair site compared with the other two techniques. Even though fascicular tubulization using the current polyglycolic acid tube resulted in regeneration equal to the currently perceived best suture repair technique, associated technical problems with the current tube design indicate that this fascicular tubulization technique cannot, at present, be considered as an alternative to present clinically used nerve suture techniques.

Animals↗
PubMed1979

Changing perspectives in surgical hand rehabilitation in quadriplegic patients.

Every motivated quadriplegic patient with resources for strong wrist extension, and lacking irreversible pathological features, is a candidate for reconstruction of at least a basic strong pinch. This basic pinch is better than that obtained with a prosthesis. We feel that this possibility exists in no less than 75 percent of our quadriplegic patients.

Hand↗
PubMed1979

Management of pressure sores in a specialty center. A reappraisal.

We report a study on the surgical management of 145 pressure sores in 115 patients treated in a spinal cord injury center. There is a definite trend toward better education of these patients, who do not develop their first pressure sores until years following the injury. When the patient comes in for an ulcer, he is usually healthy and the ulcer is small and clean. In such instances the ulcer can be excised and closed, preferably with a myocutaneous flap, and the patient can usually begin sitting by the 21st post-operative day. In the ideal setting he may be discharged to his home on a custom-fitted (for pressure) cushion within 4 to 5 weeks, without increasing the risk of recurrence. Prophylaxis for the future is, probably, the most essential part of the treatment.

Debridement↗
PubMed1977

Common hand problems.

The principles illustrated in this brief survey are germane to all surgery. They cross whatever boundaries exist between specialties; in the hand, there are no divisions into parts for general, plastic, orthopedic, or neurosurgeons. They are essential to the success and parallel Boyes' description of Bunnell's influence in "the restoration of function, a careful detailed evaluation of the problem and a skillful manipulation of the parts, to accomplish the planned result. Solutions were sought and planned by thinking in broad terms of function, but the surgery is executed with maximum attention to details.

Amputation, Traumatic↗
PubMed1977

Abduction-pronation and recession of second (index) metacarpal in thumb agenesis.

Thumb dysplasia imposes a proportionately greater functional deficit than does dysplasia of any other digit. To simulate an opposable unit, the child with but four normal fingers naturally will turn to the next most radial (index) digit and by abducting and pronating will widen his first cleft. When the thumb is absent bilaterally, formal neurovascular pollicization of at least one index digit is the logical choice. The inherent deficiencies in formal pollicization, however, may detract from its use in certain instances, for example, unilateral thumb aplasia or thumb aplasia associated with radial club hand. A simpler procedure performed at age 3 or 4 years avoids many of these deficiencies while still creating a more functional pinch and grasp. Through a small web incision, the index metacarpal is separated from the adjacent metacarpal. The base of the index metacarpal is sectioned and shortened 1.5 cm. The digit is recessed, rotated and abducted radially and palmarly, then immobilized by a K-wire fixation to its base. Since 1960, 17 procedures have been performed with good functional results and acceptable appearance.

Bone Diseases, Developmental↗