harris gellman | University of Miami (original) (raw)

Papers by harris gellman

$Research paper thumbnail of Adjunctive Hyperbaric Oxygen Therapy in the Treatment of Chronic Refractory Osteomyelitis$

Journal of Trauma-injury Infection and Critical Care, Jul 1, 1987

ABSTRACT

Journal of Bone and Joint Surgery, American Volume, Jun 1, 1986

In order to evaluate the usefulness of provocative tests (wrist-flexion test, nerve-percussion te... more In order to evaluate the usefulness of provocative tests (wrist-flexion test, nerve-percussion test, and tourniquet test) in the diagnosis of carpal tunnel syndrome, the results of provocative testing were evaluated in a group of patients (sixty-seven hands) with electrodiagnostically proved carpal-tunnel syndrome and in a group of fifty control subjects. The sensitivity and specificity of each test were calculated. The wrist-flexion test was found to be the most sensitive while the nerve-percussion test, although least sensitive, was most specific. The tourniquet test was quite insensitive and not very specific, and should not be used as a routine screening test in the diagnosis of carpal tunnel syndrome.

PubMed, May 1, 1990

Of the 422 primary malignant tumors of bone and soft tissue treated at one institution between 19... more Of the 422 primary malignant tumors of bone and soft tissue treated at one institution between 1968 and 1988, the 29 found in the upper extremity in children are reviewed. In the latter group, there were 13 patients with osteosarcoma; one was lost to follow-up shortly after diagnosis, one was alive and disease free four years after surgery, two are currently being followed, and nine are dead. All of the four patients with Ewing's sarcoma died. Three patients had chondrosarcoma; one was lost to follow-up after surgery, and the other two were disease free at four and 14 years' follow-up. Two of the nine patients with soft-tissue sarcomas died as a result of their tumors.

American Academy of Orthopaedic Surgeons eBooks, 1998

PubMed, 1995

Acute carpal tunnel syndrome secondary to intraneural hemorrhage of the median nerve is an unusua... more Acute carpal tunnel syndrome secondary to intraneural hemorrhage of the median nerve is an unusual event. Most reports involve hemophiliacs. Only rarely has this disorder occurred in a patient receiving anticoagulation therapy, and in these cases there is usually a history of trauma. We recently treated a 42-year-old patient receiving Coumadin medication who presented with acute carpal tunnel syndrome and who denied any history of trauma. Following the initial carpal tunnel release and drainage of hematoma, the patient was restarted on anticoagulation therapy and developed recurrent bleeding requiring a second surgical exploration. The patient eventually experienced complete recovery of median nerve and hand function.

$Research paper thumbnail of Scaphoid fractures and scaphoid nonunion. Diagnosis and treatment$

PubMed, Nov 1, 1994

Scaphoid nonunion can cause pain, loss of wrist motion, and loss of grip strength. Because initia... more Scaphoid nonunion can cause pain, loss of wrist motion, and loss of grip strength. Because initial roentgenograms are not always definitive, patients suspected of having a scaphoid fracture despite negative initial radiographs should undergo bone scan. Treatment of acute nondisplaced fracture of the scaphoid generally nonoperative, involving immobilization in a cast. Treatment of scaphoid nonunion is generally operative, and many procedures and their associated risks are reviewed. There is no consensus about the clinical implications of scaphoid malunion.

PubMed, Apr 1, 1991

A number of complications can result from surgical treatment of carpal tunnel syndrome. They can ... more A number of complications can result from surgical treatment of carpal tunnel syndrome. They can be diminished with the use of a longitudinally directed incision, complete visualization of the median nerve, and an understanding of the anatomic variations of the median nerve. However, some complications (eg, a painful scar, infection, and wrist weakness) may not be completely prevented.

Journal of Craniofacial Surgery, Jul 1, 2009

PubMed, 2000

For the patient presenting with early symptoms (< 6 months) I usually start treatment with a dose... more For the patient presenting with early symptoms (< 6 months) I usually start treatment with a dose pack of methylprednisolone, analgesics, and daily occupational/physical therapy for 2 weeks (Fig. 2). If they do not respond within the first week, I add stellate ganglion blocks and acupuncture to the treatment regimen. For patients presenting with established chronic pain, I immediately start them on a dose pack of methylprednisolone for 1 to 2 weeks, a nonsteroidal anti-inflammatory such as indomethacin, 50 mg 3 times a day for 10 days and then switch to 75 mg twice daily until there is a response. Amitriptyline is helpful for sleep and depression and also has a beneficial effect on blood flow. Calcium channel blockers (nifedipine) may help improve peripheral circulation by its effect on vascular smooth muscle. In this patient group, I almost always start stellate ganglion blocks on the first visit. I have the patient try at least 2 blocks before deciding whether or not blocks are helpful. Many patients will not respond to the first block, but will start to respond after the second block. If the blocks are helping, I recommend 3 blocks a week, every other day for 3 weeks. Patients get the most benefit from their blocks if they have occupational or physical therapy immediately following the block. Surgical sympathectomy may be helpful but only in patients who have responded to sympathetic blockade.

Hand Clinics, Nov 1, 1996

Orthopedic Clinics of North America, 1992

Tennis elbow (lateral epicondylitis) is the pattern of pain most commonly seen at the origin of t... more Tennis elbow (lateral epicondylitis) is the pattern of pain most commonly seen at the origin of the wrist extensors from the lateral epicondyle of the humerus and less commonly seen at the origin of the flexor-pronator from the medial epicondyle. This article discusses methods of diagnosis and both conservative and operative treatment techniques.

Clinical Orthopaedics and Related Research, Apr 1, 1983

Springer eBooks, Dec 31, 2016

Journal of Bone and Joint Surgery, American Volume, May 1, 1993

$Research paper thumbnail of Comparison of short and long thumb-spica casts for non-displaced fractures of the carpal scaphoid$

Journal of Bone and Joint Surgery, American Volume, Mar 1, 1989

A prospective study was undertaken of fifty-one patients who were randomly assigned to treatment ... more A prospective study was undertaken of fifty-one patients who were randomly assigned to treatment with either a long or a short thumb-spica cast for a non-displaced fracture of the carpal scaphoid. The duration of follow-up was at least until union; the average follow-up was twelve months. Twenty-eight fractures were treated with a long thumb-spica cast and twenty-three, with a short thumb-spica cast. The hands that initially were treated with a long thumb-spica cast were placed in a short thumb-spica cast after six weeks. Fractures that initially were treated with a long thumb-spica cast united at an average of 9.5 weeks and those that were maintained in a short thumb-spica cast, at an average of 12.7 weeks. There were no non-unions and two delayed unions in the fractures that initially were treated with a long thumb-spica cast, compared with two non-unions and six delayed unions in those that had only a short thumb-spica cast. Fractures of the proximal or middle third of the carpal scaphoid had a significantly shorter time to union when they were treated initially in a long thumb-spica cast. Fractures of the distal third did well regardless of the type of immobilization.(ABSTRACT TRUNCATED AT 250 WORDS)

Journal of Bone and Joint Surgery, American Volume, Mar 1, 1990

In eleven patients who had traumatic tetraplegia, the pronator teres tendon was transferred to th... more In eleven patients who had traumatic tetraplegia, the pronator teres tendon was transferred to the flexor digitorum profundus tendons to restore active flexion of the fingers. At the same time, in ten of these patients the tendon of the brachioradialis was transferred to the tendon of the flexor pollicis longus, and in the eleventh patient the brachioradialis tendon was transferred to the tendon of the flexor digitorum superficialis of the small finger, to restore pinch. The average time between injury and operation was thirty-four months. The average length of follow-up after operation was thirty-four months. Ten patients gained functional active flexion of the fingers, and they reported improved performance of activities of daily living. When the wrist was in 30 degrees of extension, the average active grasp strength was twenty-one millimeters of mercury and the average key-pinch strength was 2.2 kilograms. The average active flexion of the fingers from the resting position, measured from the tip of the finger to the distal palmar crease, was 1.5 centimeters. Only one patient did not gain active flexion of the fingers. Of the entire group, this patient had the least function of the hand on preoperative evaluation; retrospectively, he seemed to be a poor candidate for operation, since the strength of the pronator teres muscle and the sensibility of the hand were insufficient for useful function. We concluded that, in selected tetraplegic patients, transfer of the pronator teres tendon to the flexor digitorum profundus tendons provides useful active flexion of the fingers.