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Biomedical subjects

W D Engber

Publications and source records attributed to W D Engber.

At least 37 records · Page 2Linked to original sources
PubMed1987

Ganglions of the wrist and digits: results of treatment by aspiration and cyst wall puncture.

In a prospective study, 87 carpal and digital ganglions were aspirated, multiply punctured, and digitally ruptured. Fifty percent of wrists and digits were immobilized for 3 weeks and 50% were mobilized early. Mean follow-up was 22 months. Thirty-six percent (31/87) of all ganglions treated showed a successful outcome. Twenty-seven percent (16/60) of dorsal carpal, 43% (6/14) of palmar carpal, and 69% (9/13) of palmar digital ganglions did not recur. Immobilization significantly improved the results of treatment of dorsal carpal ganglions. Forty percent (12/30) of those in the immobilization group and 13% (4/30) of those in the early mobilization group had a successful outcome (p less than 0.05).

Fingers↗
PubMed1986

Expanding applications for the Herbert scaphoid screw.

A distinctive new bone screw developed for the management of scaphoid fractures and nonunions promises to have expanding applicability. Its utilization for osteochondral fractures, small joint arthrodeses, osteochondritic lesions, and fractures involving small bones is described. Its unique design affords significant advantages over more conventional management techniques of these problems.

Arthrodesis↗
PubMed1986

Metastatic breast cancer in the femur. A search for the lesion at risk of fracture.

Clinical records and radiographs of 203 female patients with 516 metastatic breast lesions located in the proximal femur were examined retrospectively to determine: the dimensions of those lesions that were at risk of fracture; and the relationship of other variables (bone pain, body habitus, age, and radiation treatment) with the occurrence of a pathologic fracture. Twenty-three patients sustained 26 pathologic fractures. Their average age, height, and weight were not significantly different from the 180 patients without fractures. Similarly, moderate to severe bone pain was experienced by a great majority of the total patient population, yet only 11% sustained fractures. Fifty-six patients received radiation treatment of a femoral metastasis. Ten of these patients subsequently sustained fractures. Radiation treatment relieved bone pain but did not have any consistent curative effect on the lesion itself. Finally, the authors were unable to identify either a specific percent involvement of the bone or a critical diameter for metastases that fractured because: 296 (57%) of the 516 metastases were permeative lesions and unmeasurable; 14 (54%) of the 26 pathologic fractures observed occurred through unmeasurable lesions; and the 12 measurable lesions that fractured had the same range of percent involvement as the 208 measurable lesions that did not fracture. Breast metastases at risk of fracture cannot be identified by measurements obtained from standard radiographs alone.

Adult↗
PubMed1985

Nonoperative treatment of traumatic dislocations of the extensor digitorum tendons in patients without rheumatoid disorders.

Traumatic subluxation and dislocation of the extensor digitorum tendons are uncommon in patients without rheumatoid disorders. Management of the acute injury is not well defined in the orthopedic literature. Two cases of traumatic dislocations of the extensor digitorum tendon were seen acutely in young persons without rheumatoid disease. These patients were successfully managed by early closed reduction and immobilization. This treatment had yielded good hand function to date, without recurrence of the dislocation. One of these cases was particularly unusual in that the direction of the tendon dislocation was radial. This particular injury has not been previously described.

Adult↗
PubMed1985

Trigger wrist: a case report.

Previously published reports on trigger wrist have described triggering of the fingers at the wrist. We observed a case of true triggering of the wrist that was due to a nodule in the extensor carpi radialis longus tendon as it entered the second dorsal compartment. Reduction tenoplasty of the traumatic nodule and release of the second dorsal compartment relieved all symptoms. This is the first reported case that is accurately identified as trigger wrist.

Adult↗
PubMed1984

An irreducible phalangeal epiphyseal fracture-dislocation. A case report.

A 20-month-old infant sustained an irreducible epiphyseal fracture-dislocation of a proximal interphalangeal joint. The dorsal dislocation of the joint was associated with a 90 degree rotational displacement (Salter-Harris Type I fracture) of the epiphysis of the middle phalanx. This injury, which seems not to have been described previously, required open reduction through both volar and dorsal incisions because the intact collateral ligaments and extensor central slip did not permit adequate distraction of the joint.

Finger Injuries↗
PubMed1983

Double-entrapment radial tunnel syndrome.

A symptomatic double-level entrapment of the posterior interosseous branch of the radial nerve is described. In addition to the more common level of compression at its entrance into the supinator, the posterior interosseous nerve may be entrapped at its exit from the supinator or at multiple levels.

Anti-Inflammatory Agents↗
PubMed1983

Congenital dislocation of the peroneal tendons in the calcaneovalgus foot.

Congenital dislocation of the peroneal tendons is a rare and infrequently reported deformity of the foot in the neonate. Four cases of this deformity associated with a congenital calcaneovalgus deformity of the foot have been treated and followed to the resolution of both of the deformities. The calcaneovalgus foot proved more resistant to correction and required more prolonged and aggressive treatment than was usual when it was found as an isolated deformity. All four patients demonstrated other stigmata of intra-uterine malposition and oligohydramnios or both. Our anatomical studies suggested that the superior peroneal retinacular ligament was the critical stabilising structure for the peroneal tendons. A concept of the pathogenesis of this deformity is discussed and a proven regimen for its treatment presented.

Adult↗
PubMed1982

Reactive synovitis from particulate silastic.

A reactive synovitis secondary to intra-articular particles of silicone elastomer developed in three patients who had undergone Silastic hemiarthroplasty. In an attempt to duplicate this phenomenon, we used an animal model in which finely ground particulate silicone elastomer was introduced into the knee joints of adult New Zealand White rabbits. In three of thirteen rabbits (p = 0.066) histological evidence of inflammatory changes developed in the synovial tissue, similar to those seen in our patients. Intraarticular particulate silicone elastomer created by abrasion of a Silastic hemiarthroplasty may be responsible for the development of an iatrogenic reactive synovitis.

Adult↗
PubMed1981

Cleft hand and pectoral aplasia.

An association of congenital musculoskeletal anomalies is described. This association is characterized by ipsilateral absence of pectoral muscles, generalized mild hypoplasia of the upper extremity, and severe cleft hand deformities. The importance of recognizing this association lies mainly in genetic counseling.

Abnormalities, Multiple↗
PubMed1980

Palmar cutaneous branch of the ulnar nerve.

With recent attention being placed on the median palmar cutaneous nerve, a surgical approach, ulnar to the axis of the ring finger ray, has been advocated for median nerve decompression at the wrist. Painful hypothenar neuromas have developed in two patients with this type of incision. After dissecting 21 cadaver forearms and hands, three classic and two variants of the ulnar palmar cutaneous nerve were identified and found to emerge in the subcutaneous tissue ulnar to the ring finger ray. The terminal branches supplied the hypothenar skin and extended radially to the ring finger ray axis. Because of these anatomic findings, we recommend an incision in line with the ring finger ray axis in an attempt to avoid injury to both ulnar and median palmar cutaneous nerves.

Cadaver↗
PubMed1979

Syndactyly with Larsen's syndrome.

The association of syndactyly with Larsen's syndrome is reported. A revised listing of syndromes which may be associated with syndactyly is presented.

Abnormalities, Multiple↗