[Therapy and prevention in children with inflammatory rheumatic diseases]. / Therapie und Prävention bei Kindern mit entzündlich rheumatischen Krankheiten.

Since 1981, annual four-week holidays have been arranged for children with juvenile rheumatic arthritis, during which the children are cared for by a team of pediatricians, orthopedists, ergotherapists, physiotherapists and assistants trained in psychology. With systematic splint therapy, physiotherapy, and by enhancing drug awareness during these therapeutic holidays significant improvements in joint mobility and subjective wellbeing were achieved. Of the 103 children treated (209 places were available), the majority spent several holidays, with a resulting improvement in joint mobility lasting several years. Through systematic training, adaptation to splints, and physiotherapy acceptance was also enhanced, with a preventive effect for the rest of the year. The success of these measures has encouraged the authors to continue the project.

[Analysis and results following replacement surgery of loose, cemented hip endoprostheses]. / Analyse und Ergebnisse nach Austauschoperation von gelockerten zementierten Hüftendoprothesen.

Between 1971 and May 1981 2380 Total Hip Replacements were performed at the Orthopedic Clinic of the University of Vienna. In 145 patients (6,1%) a revision arthroplasty had to be done, because of loosening of the prostheses. 10 of these patients had to be reoperated once more because of a second failure. All together 76% of the patients were either very or almost content with the result of the operation. Considering only patients with one revision arthroplasty we saw 87% good and very good results. The average hip movement was 93 degrees in flexion, 20 degrees in abduction and 24 degrees in adduction. They had a fairly good walking capacity and have not been reduced in their daily work. The revision arthroplasty of a loosened total hip replacement can be advised to the patients, even though the second operation is larger and of higher risk to the patients than the first one.

[Subcutaneous tenotomy of the sternocleidomastoid muscle as therapy in muscular torticollis]. / Die subcutane Tenotomie des M. sternocleidomastoideus als Therapie des muskulären Schiefhalses.

This study reviews the cases of 49 patients with congenital muscular torticollis after an average follow-up of seven years, who were treated with subcutaneous sternomastoid tenotomy. An excellent result was found in 18 patients (37%), a good result in another 18 patients (37%), while the result of 13 patients (26%) must be regarded as unsatisfactory. There were no severe complications to be seen. These results are compared with other operative technics of treatment of muscular torticollis and the poor results are analyzed. We believe that subcutaneous sternomastoid tenotomy is a good method for treatment of muscular torticollis, with the advantage of avoiding any ugly scar.

Thermography as a means for quantitative assessment of stump and phantom pains.

Exact differentiation into stump and phantom pain is required when pain is reported after amputation. In a majority of cases appropriate treatment can improve the pain. Thermography is simple and gives a good indication of the circulation in the stump without operative intervention. It provides a key to the nature of the pain in stump and phantom. Although typical patterns occur for pain in the stump or phantom, in this study the thermographic image could confirm the presence of phantom pain, but it could not rule out errors or false statements.

[Central regulation of breathing in idiopathic scoliosis (author's transl)]. / Zentrale Atemregulation bei idiopathischer Skoliose.

Idiopathic scoliosis is in nearly 80% associated with an EEG deviating from a normal pattern. Therefore a possible cerebral dysfunction as one of the etiologic factors in the development of idiopathic scoliosis is discussed. In consequence, we studied the central respiratory regulation in 26 patients with idiopathic scoliosis by means of CO2 response with the CO2 rebreathing technique, also vital capacity (VC), maximal voluntary ventilation (MVV), respiratory minute volume at 50, 60 and 70 mm Hg arterial pCO2 and EEG. The CO2-index (1/min/mm Hg CO2) was significantly lower in patients with idiopathic scoliosis (0.92 +/- 0.43) than in normals (1.5 +/- 0.3). The decrease of CO2-index is mainly associated with the smaller VC of the patients (76 +/- 26% of predicted). There is no sign of an additional influence of cerebral dysfunction. Patients with idiopathic scoliosis are able to utilize 70% of the individual breathing reserve like normals when stimulated with CO2. The EEG and the VC show a negative correlation. This may possibly be due to a compensation of the preexisting cerebral dysfunction. VC however decreases during the natural course of disease. No significant correlation could be found between CO2-index and the angle of scoliosis, indicating the absence of a causal relation between the degree of deformation itself and the function of the center of respiratory regulation.

[Cerebral dysfunction in patients with idiopathic scoliosis]. / Zerebrale Dysfunktion bei Patienten mit idiopathischer Skoliose.

To determine a possible involvement of CNS in the etiology of the socalled idiopathic scoliosis, some 115 clinically neurologically and psychically inconspicuous patients suffering from idiopathic scoliosis and some 35 patients with congential scoliosis have been submitted to EEG control. The idiopathic scoliosis group showed a significant percentage of divergence from normal EEG results found in the average normal population. The type and the genesis of the cerebral dysfunction as well as a possible correlation with the etiology of the idiopathic scoliosis are discussed below.