William B. Strecker

Shriners Hospitals for Children, Tampa, Florida, United States

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Publications (25)43.76 Total impact

  • Charles A Goldfarb · Michelle S Burke · William B Strecker · Paul R Manske
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    ABSTRACT: The arthrogrypotic elbow often lacks active flexion. If active elbow flexion can be provided by muscle transfer, patient independence increases and the patient can function in a less conspicuous manner by avoiding adaptive mechanisms. The purpose of this article is to review the outcome of patients with arthrogryposis treated with the Steindler flexorplasty to obtain active elbow flexion. Seventeen elbows in 10 patients with an average age of 7 years were treated surgically with the Steindler flexorplasty procedure. Before surgery none of the patients was able to flex actively the elbow against gravity. All of the patients had at least 70 degrees of passive elbow flexion. Upper-extremity active and passive range of motion, strength of flexion, functional outcome, and patient satisfaction were assessed at an average of 5 years after surgery (range, 2-9 years). After surgery all patients obtained active elbow flexion against gravity averaging 85 degrees (range, 30 degrees -120 degrees ); patients were able to lift an average of 1 kg through their entire arc of elbow flexion. At last follow-up evaluation patients lost an average of 27 degrees of elbow extension. Patients lost forearm rotation but did not lose wrist or finger range of motion. Subjectively, 9 of the 10 patients were satisfied with the outcome of the surgery and would recommend the surgery to others. The Steindler flexorplasty provides improved elbow flexion strength and patient function and should be considered for children with arthrogryposis.
    No preview · Article · Jun 2004 · The Journal Of Hand Surgery
  • Charles A Goldfarb · Michelle S Burke · William B Strecker · Paul R Manske
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    ABSTRACT: PurposeThe arthrogrypotic elbow often lacks active flexion. If active elbow flexion can be provided by muscle transfer, patient independence increases and the patient can function in a less conspicuous manner by avoiding adaptive mechanisms. The purpose of this article is to review the outcome of patients with arthrogryposis treated with the Steindler flexorplasty to obtain active elbow flexion.
    No preview · Article · May 2004 · Fuel and Energy Abstracts
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    ABSTRACT: The purpose of this study was to document the late outcome of a group of patients with Neer grade III/IV proximal humeral physeal fractures who were treated with reduction of the fracture and maintenance of reduction until fracture consolidation. A total of 28 patients treated between 1984 and 1999 at a large children's hospital were included in this study. Nineteen of the 28 patients were 15 years or older (range 5-16 y). All patients were treated in the operating room with closed reduction followed by immobilization (n = 3), closed reduction and pin fixation (n = 20), open reduction and screw fixation (n = 3), or open reduction and pin fixation (n = 2). Postoperatively, all had Neer grade I or II displacement, which was maintained until fracture union. No operative or postoperative complications occurred. At an average follow-up of 4 years, all patients had near-normal glenohumeral motion and excellent strength and uniformly reported regaining full preinjury functional use of the involved extremity. Achieving and maintaining reduction in Neer grade III/IV proximal humeral epiphyseal fractures can be safely performed and results in excellent long-term shoulder function. This is of particular significance in the older adolescent who has minimal remodeling potential.
    No preview · Article · Mar 2003 · Journal of Pediatric Orthopaedics
  • Raja Dhalla · William Strecker · Paul R. Manske
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    ABSTRACT: Since 1987, 16 skeletally immature patients aged 2 to 16 years (mean, 7.9 years) underwent 27 digital lengthening procedures of terminal bones, 20 metacarpals and 7 phalanges, using the distraction callotasis technique. Seven digits were lengthened with 2 fixator half-pins on either side of the osteotomy site (dual half-pin group). Twenty digits, which were too small to accommodate 4 half-pins, were lengthened over a longitudinal intramedullary guidewire with 1 fixator half-pin on either side of the osteotomy site (single half-pin/K-wire group). No bone grafts were needed. The mean preoperative bone length in the dual half-pin group was 30 mm (range, 23-40 mm) and that of the single half-pin/K-wire group was 18 mm (10-30 mm). The mean total length gained was 14 mm (9-23 mm) in the dual half-pin group and 12 mm (6-19 mm) in the single half-pin/K-wire group. The mean percent lengthened was 49% (22% to 96%) in the dual half-pin group and 70% (27% to 136%) in the single half-pin/K-wire group. Eighteen complications occurred: 15 in the 20 cases using the central guidewire (75%) and 3 in the 7 cases without the central guidewire (43%). Only 7 complications required repeat surgery. We conclude that the use of the single half-pin/K-wire technique allows successful and substantial lengthening for bones shorter than 23 mm, making correction surgery possible for younger children. This technique, however, has a greater risk for complications.
    No preview · Article · Aug 2001 · The Journal Of Hand Surgery
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    ABSTRACT: Pigmented villonodular synovitis is rare in the younger child. Polyarticular involvement in this condition, regardless of patient age, is distinctly uncommon. The authors describe a case of pigmented villonodular synovitis involving multiple joints in a young boy who also had congenital anomalies of the genitourinary tract. Although rare, pigmented villonodular synovitis should be considered in the differential diagnosis of multiple joint swellings in children with congenital anomalies.
    No preview · Article · Mar 1998 · Clinical Orthopaedics and Related Research
  • Donald M. Arms · William B. Strecker · Paul R. Manske · Perry L. Schoenecker
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    ABSTRACT: The records of 97 patients with multiple hereditary osteochondromatosis were retrospectively reviewed. Seventy-eight patients had one or more osteochondroma(s) of one or both forearm(s). Fifty-three operations were performed, of which 41 were excisions of symptomatic osteochondromas or dislocated radial heads. All forearm, wrist, and elbow radiographs were reviewed. Four common radiographic parameters were measured: radial articular angle, carpal slip, relative ulnar shortening, and forearm-third metacarpal angle. Thirty-seven of these 78 patients were contacted by telephone questionnaire. The results indicated that skeletally mature patients do well on a functional basis and are comfortable with their appearance, despite deformity. Surgery can improve aesthetic appearance and provide pain relief when done before or after skeletal maturity. Because of these results, we are less aggressive in the early treatment of forearm deformities.
    No preview · Article · Jul 1997 · Journal of Pediatric Orthopaedics
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    ABSTRACT: Forty-four patients (fifty-two hips) who had static encephalopathy and acetabular dysplasia were managed with a Pemberton osteotomy as part of a comprehensive operative approach. Thirty-three patients had quadriplegia and were unable to walk; the remaining eleven patients had diplegia and could walk. The age at the time of the operation ranged from four years and five months to sixteen years and five months, as an open triradiate cartilage is a prerequisite for the Pemberton procedure. Concomitant operative procedures included a varus rotational osteotomy in fifty of the involved hips, a soft-tissue release in thirty-seven hips, and an open reduction in thirteen hips. The mean center-edge angle preoperatively was -11 degrees (range, -80 to 17 degrees), which improved to a mean of 27 degrees (range, 5 to 62 degrees) at the time of the latest follow-up. The mean duration of follow-up was four years (range, two years to eight years and eight months). At the time of writing, none of the hips had redislocated but one hip had subluxated. Eight of the hips had been painful preoperatively, but none of these was painful at the time of the most recent follow-up. One patient who had not had pain in the hip preoperatively had pain at the time of the follow-up evaluation. There were no complications attributable to posterior uncovering of the hip. The age of the patient at the time of the operation had no discernible effect on the result.
    No preview · Article · May 1997 · The Journal of Bone and Joint Surgery
  • B C Gaddy · W B Strecker · P L Schoenecker
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    ABSTRACT: Thirty-five children who had fractures of the olecranon were reviewed. Age at the time of injury ranged from 0 years 2 months to 15 years 4 months. Fractures were retrospectively classified as type I or II according to the amount of displacement apparent on the initial radiographs. Type I fractures were those with < 3 mm of displacement, and type II were those with displacement of > or = 3 mm. Type I fractures (n = 23) were treated with closed methods, and splint or cast immobilization was maintained for an average of 3 weeks. All 23 type I fractures had satisfactory results on follow-up. Type II fractures (n = 12) were treated with open reduction and internal fixation. Greater intraarticular displacement was often seen intraoperatively than had been appreciated radiographically. Ten of 12 patients with type II fractures were available for follow-up; all had satisfactory results. Restoration of the articular surface in children with olecranon fractures optimizes joint function and growth potential. The amount of fracture may be more than is apparent on plain radiographs.
    No preview · Article · May 1997 · Journal of Pediatric Orthopaedics
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    ABSTRACT: Thirty-eight hips in 32 patients > or = 18 months of age had closed reduction attempted for developmental dislocation of the hip. Twenty-six hips in 24 patients had an initially successful closed reduction. During cast treatment three of 26 hips had progressive subluxation or dislocation requiring open reduction with or without concomitant osteotomies. The remaining 23 hips, with an average follow-up of 8 + 8 years, are thought to have had a successful closed reduction. Eleven of those hips have required no further surgical procedures and had an average acetabular index of 18 degrees at last follow-up. Twelve of the 23 hips that had successful closed reduction required a femoral or pelvic osteotomy for failure to remodel. Younger age (< 22 months) at the time of reduction and lower grade (I and II) dislocation were favorable prognostic indicators of the likelihood of successful closed reduction.
    No preview · Article · Nov 1995 · Journal of Pediatric Orthopaedics
  • Donald M. Arms · Robert A. Martin · William B. Strecker · Louis A. Gilula
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    ABSTRACT: We present a case that is unusual in two respects. To our knowledge, it is the first clearly documented instance in the literature of a post-traumatic, irreducible nondissociative volar intercalated carpal instability to result from a known wrist flexion force and a known dorsal capsuloligamentous tear. Second, the same wrist revealed a coalition at both intraosseous levels of the proximal carpal row: a synfibrosis at the scapholunate joint and a synostosis at the lunotriquetral joint. Treatment by open removal of an interposed capsuloligamentous flap from the radiocarpal joint, followed by alignment of carpal elements, temporary internal fixation, and repair of the damaged dorsal capsule and ligaments gave an excellent result.
    No preview · Article · Oct 1995 · The Journal Of Hand Surgery
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    ABSTRACT: Twenty-six forearms in 23 patients with marked pronation or supination deformities were treated with osteoclasis. Etiologies included 12 radioulnar synostoses, five brachial plexus injuries, three hemiplegias, two hemimelias, and four other types of deformities. Drill-assisted osteotomy of both the radius and ulna was followed 10 days later by manipulation to the desired functional position. Dominant extremities were placed in 20 degrees pronation, and nondominant extremities in 20 degrees supination. Range of motion was not significantly changed, but the arc of motion occurred in a more functional hand position. Average correction for 15 pronation deformities was 81 degrees and 69 degrees for 11 supination deformities. Two nonunions healed after bone grafting and there were no instances of neuromuscular compromise. Functional improvement was obtained in 25 of 26 forearms.
    No preview · Article · Jan 1995 · Journal of Pediatric Orthopaedics
  • Paul R. Manske · Richard Johnston · Donald L. Pruitt · William B. Strecker
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    ABSTRACT: A limited surgical decompression of the ulnar nerve within the cubital tunnel by incision of the arcuate ligament was effective in relieving pain and dysesthesia in 22 of 27 patients. No patient had any apparent muscle weakness or atrophy preoperatively. Twenty-five patients had evidence of compression of the ulnar nerve within the cubital tunnel at surgery, as noted by narrowing, hyperemia, or attachment of adhesions to the nerve. Three of four patients who had a subsequent anterior transposition obtained partial relief of symptoms.
    No preview · Article · Feb 1992 · Clinical Orthopaedics and Related Research
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    ABSTRACT: We retrospectively reviewed Green procedures and transfer of the flexor carpi ulnaris (FCU) in treatment of spastic forearm pronation, wrist volarflexion, and ulnar deviation deformities. Patient's ages ranged from 3 years 5 months to 16 years 5 months. Surgically, a single volar incision was made and the extensor carpi radialis brevis and/or longus (ECRB, ECRL) were used for insertion. The FCU was tensioned at neutral against gravity and immobilized in 5 degrees of dorsiflexion and 45 degrees of supination. Arc of flexion (47 degrees) did not change but was centered about neutral. Supination improved markedly when operation included a pronator procedure. Quadraplegia athetosis and intellectual impairment did not affect the operative result adversely. Patients aged greater than 12 years showed less functional improvement. Eighty-eight percent had cosmetic improvement, and 79% improved functionally. None had a decreased functional rating.
    No preview · Article · Nov 1991 · Journal of Pediatric Orthopaedics
  • R D Rames · W B Strecker

    No preview · Article · Jul 1991 · Orthopedics
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    ABSTRACT: Since 1963, 25 patients have undergone Sever-L'Episcopo transfers for obstetrical birth palsy at the St. Louis Unit of the Shriners Hospital for Crippled Children. A follow-up of 2-6 years was possible with a retrospective review of 16 patients. Substantial improvement in shoulder external rotation as well as subjective functional improvement was obtained by all patients. Three transient and one permanent axillary nerve palsies resulting from this procedure are reported.
    No preview · Article · Jul 1990 · Journal of Pediatric Orthopaedics
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    ABSTRACT: The normal and abnormal radiographic appearances of various hand and wrist surgical procedures have been presented. It is hoped that increased familiarity with these procedures and their radiographic features will lead to more meaningful radiographic interpretations by consulting radiologists.
    No preview · Article · Mar 1990 · European Journal of Radiology
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    ABSTRACT: The normal and abnormal radiographic appearances of various arthroplasties of the hand and wrist have been presented. It is hoped that increased familiarity with these procedures and their radiographic features will lead to more meaningful radiographic interpretations by consulting radiologists.
    No preview · Article · Feb 1990 · European Journal of Radiology
  • William B. Strecker · Mark W. Via · Susan K. Oliver · Perry L. Schoenecker
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    ABSTRACT: Spastic equinus deformity is common in patients with cerebral palsy. Since 1981, 612 anterior transpositions of the Achilles tendon as described by Murphy have been performed. One hundred patients with at least 30 months' follow-up were selected and retrospectively reviewed. Good correction of the equinus deformity was obtained without the need for prolonged bracing. No patient had a calcaneal gait or recurrence of equinus.
    No preview · Article · Jan 1990 · Journal of Pediatric Orthopaedics
  • Terrence R. Orr · Bruce A. Bollinger · William B. Strecker
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    ABSTRACT: An easily learned and applied method of accurately determining the blind zone of the femoral head is presented. This method is based on a geometric analysis of individual pins relative to the subchondral plate as apparent on mutually perpendicular roentgenograms. This method can be used with fluoroscopy or plain radiographs for intraoperative or postoperative evaluation.
    No preview · Article · Jul 1989 · Journal of Pediatric Orthopaedics
  • P R Manske · J A McCarthy · W B Strecker
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    ABSTRACT: The Herbert bone screw was used to treat 22 selected patients with established scaphoid nonunions. The indications for its use included evidence of avascular necrosis, proximal third fracture fragment, previous bone graft, fracture angulation or displacement, and a bipartite scaphoid. Treatment resulted in radiographic and clinical evidence of healing in 16 patients; 4 patients were symptom-free, but had incomplete healing as evidenced by radiograph; and 2 patients had persistent symptoms with radiographic evidence of nonunion.
    No preview · Article · Jan 1989 · Orthopedics

Publication Stats

406 Citations
43.76 Total Impact Points

Institutions

  • 1995-2004
    • Shriners Hospitals for Children
      Tampa, Florida, United States
  • 1988-1997
    • Washington University in St. Louis
      • • Department of Orthopaedic Surgery
      • • Department of Radiology
      San Luis, Missouri, United States