Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 7 de 7
Filter
1.
Chirurg ; 93(2): 165-172, 2022 Feb.
Article in German | MEDLINE | ID: mdl-34132823

ABSTRACT

BACKGROUND: The treatment of pediatric femoral shaft fractures has undergone an increasing change in recent years. The previously predominant treatment procedures were extensively replaced by minimally invasive techniques (e.g. elastic stable intramedullary nailing, ESIN). The aim of this study was the comparison of complication rates depending on patient factors as well as various treatment procedures. MATERIAL AND METHODS: This study involved a retrospective X­ray morphometric evaluation of data. The patient files and X­rays of 101 children who were treated at 2 level I trauma centers were analyzed. RESULTS: Conservative treatment was carried out in 19% of the cases. Among the surgical procedures the ESIN technique was predominant (n = 60). Complications that needed revision occurred in 10% of the children after conservative treatment. Revision surgery had to be carried out in more than 6% of the cases in children who were surgically treated. Among the surgical procedures ESIN stabilization demonstrated the lowest revision rate with only 3%. Children under three years and adolescents had a higher risk for developing complications. If the ESIN wires used were too thin in relation to the diameter of the medullary cavity there was an increased probability of complications of around 30%. CONCLUSION: This study revealed a moderate risk of complications in the treatment of femoral shaft fractures in children. The risk of complications after external fixation and conservative treatment was the highest in this study. Overall, the ESIN technique showed the lowest risk of complications. The results of this study could confirm the known limitations of the ESIN technique depending on age and body weight.


Subject(s)
Femoral Fractures , Fracture Fixation, Intramedullary , Adolescent , Bone Nails , Child , Child, Preschool , Femoral Fractures/surgery , Fracture Fixation, Intramedullary/adverse effects , Fracture Healing , Humans , Postoperative Complications/etiology , Reoperation , Retrospective Studies , Treatment Outcome
2.
Unfallchirurg ; 123(10): 797-806, 2020 Oct.
Article in German | MEDLINE | ID: mdl-32242257

ABSTRACT

BACKGROUND: Refixation with resorbable implants is a common surgical treatment in patients who suffer an injury with shearing of an osteochondral flake due to trauma of the knee or the upper ankle joint. To date there are no studies which outline long-term outcomes for this procedure. The aim of this study was to evaluate long-term clinical and magnetic resonance imaging (MRI) results after refixation with resorbable polylactide (PLLA) implants. MATERIAL AND METHODS: In this retrospective study 12 patients with 13 injuries were examined 13.9 years (±1.2 years) after refixation of an osteochondral fragment of the knee (10 patients) and the upper ankle joint (2 patients) with a mean size of 3.33 cm2 (±2.33) by resorbable polylactide (PLLA) implants (nails, pins, screws, Bionx, Tampere, Finland). To objectify the clinical results eight established clinical scores (VASS, Tegner, Lysholm, McDermott, KSS, WOMAC, AOFAS, FADI+Sports) were used. Furthermore, the morphological integration of bone and cartilage was assessed by MRI (3 T) using proton-weighted and cartilage-sensitive 3D double-echo steady-state (DESS) sequences. The morphological results were objectified with a modified MRI score according to Henderson et al. RESULTS: After 13.9 years (±1.2) the patients with an injury of the knee as well as of the upper ankle joint showed good to excellent results (knee: VASS 1.2 (±1.7), Tegner 4.4 (±1.3), Lysholm 85.7 (±12.2), McDermott 90.7 (±8.6), KSS 189 (±14.2), WOMAC (6.16% (±8.45)) (upper ankle joint: VASS 2.5 (±2.5), Tegner 5.5 (±1.5), Lysholm 87 (±13), McDermott 88 (±12); WOMAC (8.54% (±8.54), AOFAS 75.5 (±24.5), FADI+Sports 118 (±18)). In all cases there was evidence of good integration of the osteochondral fragment in MRI. In five patients there was moderate subchondral cyst formation (∅ ≤1 mm); however, mild changes of the cartilage contour were found in all patients. The mean modified Henderson score achieved was 14.4 (±2.0, best 8, worst 32), which corresponds to a good morphological result. CONCLUSION: Because of good clinical and morphological results shown by MRI, refixation through resorbable implants (PLLA) can be recommended for treatment of traumatic osteochondral flakes.


Subject(s)
Cartilage, Articular , Bone Nails , Follow-Up Studies , Humans , Knee Joint , Magnetic Resonance Imaging , Retrospective Studies
3.
Z Rheumatol ; 66(5): 388-94, 2007 Sep.
Article in German | MEDLINE | ID: mdl-17717675

ABSTRACT

The wrists are affected in the long-term in 90% of people with rheumatism and are often (42%) the first manifestation of a destructive disease. The functionality of the wrist and the whole hand is of great importance because in many cases loss of function of the wrists leads to severe limitations. Local and operative treatment of the wrist in rheumatoid arthritis (RA) is one of the main duties in rheuma-orthopaedics. For operative treatment there is a finely tuned differential therapeutic spectrum available. The diagnostic indications take the local and total pattern of affection, the current systemic therapy as well as patient wishes and patient compliance into consideration. In the early stages according to LDE (Larsen, Dale, Eek), soft tissues operations such as articulo-tenosynovectomy (ATS) are most commonly carried out. In further advanced stages osseus stabilisation must often be performed. At this point a smooth transition from partial arthrodesis to complete fixation is possible. After initial euphoria, arthroplasty of the wrist is being increasingly less used for operative treatment due to the unconvincing long-term results and high complication rate. With reference to the good long-term results of all operative procedures, in particular early ATS with respect to pain, function and protection of tendons, after failure of medicinal treatment and persistence of inflammatory activity in the wrist, patients should be transferred to an experienced rheuma-orthopaedic surgeon.


Subject(s)
Arthritis, Rheumatoid/surgery , Hand Deformities, Acquired/surgery , Wrist Joint/surgery , Arthritis, Rheumatoid/diagnostic imaging , Arthrodesis , Hand Deformities, Acquired/diagnostic imaging , Humans , Prosthesis Design , Prosthesis Implantation , Radiography , Synovectomy , Synovial Membrane/diagnostic imaging , Tendon Transfer , Wrist Joint/diagnostic imaging
4.
Brain Res ; 727(1-2): 99-106, 1996 Jul 15.
Article in English | MEDLINE | ID: mdl-8842387

ABSTRACT

Mid-sagittal magnetic resonance images of 104 normal individuals were analyzed to assess whether or not the corpus callosum or parts thereof is sexually dimorphic in favor of females. Subjects were 56 males and 48 females, both groups being closely age matched. The outline of the corpus callosum was divided into seven subareas, using three different orientations. A comparison was made between subareas with the divisions based on different orientations. Results showed significant differences (P < 0.05) in all cases, with one exception in females. No significant sexual dimorphism was found, with the exception of one subarea in one of the orientations which was significantly larger in males. No significant correlation was found between corpus callosal area and either cerebral hemispheric area or an estimate of cranial capacity. Relative measures, incorporating these two brain size indicators as covariates, also showed no significant sexual dimorphism. In conclusion, no sexual dimorphism of the human corpus callosum favoring females was found in this study, and it appears that inadequate sampling, differing feature orientation, and inappropriate size correction procedures may have been factors responsible for conflicting results in previous studies.


Subject(s)
Corpus Callosum/anatomy & histology , Sex Characteristics , Adult , Aged , Female , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Reproducibility of Results , Retrospective Studies
5.
Phys Med Biol ; 38(10): 1393-401, 1993 Oct.
Article in English | MEDLINE | ID: mdl-8248287

ABSTRACT

Using an external view of the head, the ability to direct a proton radiotherapy beam at an intracerebral lesion is described, using a biostereometric (BSM) technique. The positions of markers, recognizable on computed tomography (CT) or magnetic resonance (MR) images, at known locations on the skin of a patient's head are related to the site of the lesion seen on the images. The markers' positions are determined by a BSM device, incorporating six video cameras coupled to a computer. A transformation from a coordinate system, defined by the CT or MR images, to another coordinate system, that of the BSM device, allows the proton beam to be directed towards the lesion. Markers used in this work were solid steel spheres for CT and plastic spheres containing oil for MR images.


Subject(s)
Brain Diseases/radiotherapy , Protons , Radiotherapy, High-Energy , Biomarkers , Brain Diseases/diagnosis , Humans
7.
SELECTION OF CITATIONS
SEARCH DETAIL
...