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Biomedical subjects

A Imhoff

Publications and source records attributed to A Imhoff.

At least 19 recordsLinked to original sources
PubMed1997

[Snowboard sports technique, injury pattern, prevention].

Although, in Europe, snowboarding is a young sport, it has already established itself and, in common with Alpine skiing, is represented in the Olympics. Its biomechanical aspects (technique, shoeboard connection), lead not only to a typical pattern of movements, but also to a snowboard-specific pattern of injuries, which differs from that seen with Alpine skiing. In the case of snowboarding, the upper limbs are appreciably more often involved in injuries than are the lower extremities. The most common injuries are fractures of or close to the wrist. Since many children and adolescents are to be found among snowboarding fans, the percentage of epiphyseal injuries is high. Depending on the style employed-Alpine or freestyle-the risk of lower limb injuries differ in terms of ankles and knee injuries. Through the use of special protective equipment, such as gloves provided with extra protection for wrist and fingers, (possibly also helmets, knee and elbow protectors for beginners), together with improvements in technique in a snowboard school, and the optimisation of the materials used by the industry, the risk of injury can be reduced.

Arm Injuries↗
PubMed1997

[Comparison between magnetic resonance imaging and arthroscopy for the diagnosis of knee meniscal lesions].

PURPOSE OF STUDY: The authors evaluated the use of MR-imaging of the menisci compared to arthroscopy considered as the gold standard by which all noninvasive imaging procedures of the knee have to be measured. MATERIAL AND METHODS: In a prospective study, we evaluated the use of MRI in 50 patients with clinically suspected disorders of the meniscus, followed by an arthroscopic examination by an experienced arthroscopist. MRI studies were performed after clinical evaluation and were interpreted by an experienced radiologist, who had no knowledge of the clinical findings. RESULTS: The accuracy of the diagnosis from MRI was 78 per cent for the medial meniscus (sensitivity 79 per cent and specificity 78 per cent) and 94 per cent for the lateral meniscus (sensitivity 50 per cent and specificity 98 per cent). The average age of the patients was 34 years, with a range from 3 to 73 years. The imaging studies revealed 9 false positive test and suggested that the meniscus was either degenerated or form in the horizontal plane. In all 9 menisci the abnormal MR imaging signal was limited to the posterior horns. The positive predictive value was 59 per cent and the negative predictive value was 94 per cent representing a moderate level of diagnostic certainty, both in patients who had a positive result and in those who had a negative result. High predictive negative value of MRI indicates that a negative MRI is quite reliable for meniscal lesions. DISCUSSION: Problems of MR-imaging are the popliteus tendon sheath and the transverse ligament. This ligament is seen in association with a large branch of the lateral inferior geniculate artery, and may be mistaken for a grade 3 signal intensity in the anterior horn of the lateral meniscus. CONCLUSION: A normal MRI allows to eliminate a meniscal lesion and so there is no need for a diagnostic arthroscopy. But with a pathologic MRI there is a risk to establish too often the diagnostic of a meniscal lesion rather then to identify structural modifications as a degeneration.

Adult↗
PubMed1995

Arthroscopic subacromial decompression with and without the Holmium:YAG-laser. A prospective comparative study.

The purpose of this study was to critically evaluate the results of laser-assisted arthroscopic subacromial decompression (ASD) and compare them with the results of a conventional arthroscopic procedure. In a prospective study, 52 patients with stage II and III (partial tear) impingement syndrome undergoing ASD were divided into two consecutive groups. The first 18 patients underwent conventional arthroscopic surgery using shaver and electrocautery (group S). The following 34 patients underwent ASD with the Holmium:YAG-laser (22 watt) and without electrocautery (group L). Subjective, objective, and functional results were assessed using the constant score preoperatively and postoperatively at specific intervals up to 1 year. The greatest improvement in the laser group was seen in the areas of pain with activity, pain at night, activity and movement at 1 week and at 6 weeks. The patients in group L also showed significantly better values for abduction power (P < .05). There were no complications in either group. Radiographic evaluation with the outlet view, preoperatively and postoperatively, showed an adequate bone resection in all cases. The postoperative Constant score for group L was significantly better. The average score increased from 54.7 to 79.8 in group L and from 50.3 to 68.7 in group S. Because of the low level of postoperative pain, the absence of adhesions and the almost complete lack of swelling, the patients in group L were able to regain full range of shoulder motion sooner than those in group S.

Adult↗
PubMed1994

Retrospective comparison of four intra-articular anterior cruciate ligament reconstructions using three evaluation systems.

In a retrospective study, 57 patients were examined following an intra-articular cruciate ligament reconstruction. The patients were divided into four groups according to the type of repair and the lapse of time between injury and operation. Twenty-five patients had undergone reconstruction with a semitendinosus tendon after acute instability (AST) and six, after chronic instability (CST). Eleven patients had received an acute reconstruction using the middle third of the patellar tendon (APT), as had 15 with chronic instability (CPT). The mean follow-up time was 48 months for the AST group, 60 months for the CST, 33 months for the APT, and 36 months for the CPT. In order to compare the groups, we used the Lysholm and OAK scores and the IKDC evaluation system. The only statistically significant difference found involved the IKDC evaluation system between the AST and CST groups. No significant decrease in activity level was noted in any of the groups. With the exception of the CST group, the preoperative Lachman test disappeared significantly at follow-up in all groups. The side-to-side difference of anterior tibial displacement measured with the KT 2000 at 25 degrees knee flexion and a load of 89 newtons was 1.32 mm for the APT group, 2.44 mm for the AST group, 2.47 mm for the CPT group, and 3.33 mm for the CST group. This side-to-side difference was not significant in the APT group. In the CPT group, arthrofibrosis was found in 27% of the patients, which led to reoperation. Reconstruction of the anterior cruciate ligament using the semitendinosus is no longer indicated for chronic instability. ACL-plasty with the middle third of the patellar tendon restored practically normal stability in acute ACL insufficiency.

Acute Disease↗
PubMed1994

[MRI-controlled rehabilitation of femur head dislocation fracture].

As exemplified by the case of a 58-year old patient with a femoral head fracture dislocation, which could not be reduced for 15 hours, the early stage of femoral head revitalisation is well documented by computed tomography before and after reduction, as well as MR imaging after 6 weeks, 6 months and one year.

Athletic Injuries↗
PubMed1994

[Relevance of proton spin tomographic meniscus diagnosis in correlation with arthroscopy].

Arthroscopy of the menisci is considered the gold standard by which all noninvasive imaging procedures of the knee are measured. In a prospective study we evaluated the use of MRI in 50 patients in whom a disorder of the meniscus was suspected clinically; this was followed by an arthroscopic examination by an experienced arthroscopist. The MR studies were performed after clinical evaluation and were interpreted by an experienced radiologist, who had no knowledge of the clinical findings. The accuracy of the diagnosis from MRI was 78% for the medial meniscus (sensitivity 79% and specificity 78%) and 94% for the lateral meniscus (sensitivity 50% and specificity 98%). The average age of the patients was 34 years, with a range of 3-73 years. The imaging studies revealed 9 false-positive tests and suggested that the meniscus was either degenerated or torn in the horizontal plane. In all 9 menisci the abnormal MR imaging signal was limited to the posterior horns. The positive predictive value was 59% and the negative predictive value was 94%, representing a moderate level of diagnostic certainty both in patients who had a positive result and in those who had a negative result. The high predictive negative value of MRI indicates that a negative MRI is quite reliable for meniscal lesions. The problem areas in MR imaging are the popliteal tendon sheath and the transverse ligament. This ligament is seen in association with a large branch of the lateral inferior geniculate artery and may be mistaken for a grade 3 signal intensity in the anterior horn of the lateral meniscus.

Adolescent↗
PubMed1993

[Anterior cruciate ligament-plasty with the Insall iliotibial tract transfer. Long-term results after 5 years].

For the reconstruction of the anterior cruciate ligament we performed the bone block iliotibial tract transfer in 56 patients from May 1984 until December 1987. The results were followed up for 2 to 6 1/2 years (average 53 months). The clinical results showed a positive Lachman test in 20 degrees flexion (3-5 mm) in 50% of the knees. There was no Lachman test ++ or and no sign of pivot shift. At the time of follow-up, the Lysholm-score was very high with 98.67 points. Subjectively, 91.3% of the knees were rated excellent, 4.3% good and 4.3% poor. 93% of the patients were engaged in some kind of sport before their accident, 87% of all patients were able to practice their sport at the same level after the operation. Long-term results after 5 years are consistent with the physiological aspects of this transfer. The immediate fixation of bone allows early motion of the knee and the rehabilitation time is much shorter.

Adolescent↗
PubMed1993

[Magnetic resonance tomography (MRT) of the knee joint: meniscus, cruciate ligaments and hyaline cartilage].

The use of MRT for diagnosing injury to the meniscus, the cruciate ligaments and hyaline cartilage was evaluated retrospectively in 82 knee joints without any knowledge of operative findings. In 49 cases the results were verified by arthroscopy and in 33 cases by arthrotomy. Sensitivity, specificity and diagnostic accuracy of MRT for meniscus lesions was 73.9%, 96.9%, and 94.6%. Corresponding values for lesions of the anterior cruciate ligament were 88.9%, 96.6%, and 94.7%, and for lesions of the hyaline cartilage 62.6%, 96.1%, and 87.9%, respectively. In addition to its high specificity, MRT proved accurate in excluding lesions of the meniscus (97.1%) of the anterior cruciate ligament (96.6%) and of hyaline cartilage (88.8%). A negative finding on MRT therefore makes the presence of a lesion of the meniscus, cruciate ligaments of cartilage unlikely. In such cases one is justified in delaying the use of arthroscopy or arthrotomy.

Adolescent↗
PubMed1993

[Differential diagnosis and therapy of multi-fragment humeral head fracture--an analysis of three clinical studies].

Out of the total number of patients of three Centers for Orthopaedic and Trauma Surgery, 93 comminuted humeral head fractures were clinically and radiologically controlled by means of a retrospective analysis. The classification of the fractures was made according to C.S. Neer, the clinical evaluation according to the Constant-Score. The analysis of the results in relation to the respective therapeutic methods revealed fundamental differences between the various types of fractures depending on the number of fragments. The prognosis of the three-part fractures appears essentially determined by the biomechanical conditions. This means that the therapeutic method has to be applied according to the restitution of the respective position of the fragments. Open reduction and internal fixation (mean Constant-Score 83 resp 91 points) or conservative treatment (78 points) seem to be primarily indicated in these cases. The prognosis of the four-part fractures, on the contrary, is largely determined by the problems of vascular supply of the head fragment, with a high risk of a humeral head necrosis. For this reason a primary prosthetic replacement (mean Constant-Score in case of primary implantation 75 points, compared with 54 points in case of conservative treatment and 52 points for open reduction and internal fixation), should be recommended for this type of fracture. For therapeutic and prognostic reasons, fractures at the proximal end of the humerus require an exact classification on the radiological basis of at least a so-called "trauma series". However, for a more accurate visualisation especially of the region of the lesser tuberosity (which is difficult to assess by means of conventional radiology), and consequently for the precise determination of the number of fracture-parts and their respective positions, we consider a CT Scan to be compulsory.

Adult↗
PubMed1992

[Clinical and radiologic long-term follow-up of Eden-Lang operation in habitual anterior shoulder dislocation].

The incidence of degenerative arthritis after Eden-Lange procedure is judged differently in literature, recently high rates of degenerative arthritis have been reported. 37 patients and the same number of shoulder joints have been evaluated clinically and radiologically after an average follow-up time of 14.9 years. Overall results can be considered as good. Recurrence of dislocation occurred only in one case. Most frequently we observed a limitation of external rotation and overhead performance in sports. The frequency of degenerative arthritis was 17%, clearly less than mentioned elsewhere. The Eden-Lange procedure still can be recommended as a treatment for recurrent anterior shoulder dislocation except for patients with high expectations in physical overhead activities.

Adolescent↗
PubMed1992

[Chronic posterior shoulder dislocation].

The posterior dislocation of the shoulder is frequently unrecognized for many days, months or even years after the initial accident. After the presentation of its clinical and radiological features, as the different ways of its treatment, some cases will illustrate this entity, too frequently missed or wrongly treated.

Adult↗
PubMed1988

[Habitual peroneal tendon dislocation].

Between 1945 and 1985 a total of 54 patients were treated for recurrent dislocation of the peroneal tendon. 30 cases were operated on employing five various surgical techniques. 31 patients denied trauma as being the cause, which therefore made constitutional weakness of the retention apparatus of the peroneal tendon responsible. The pathogenesis is described in detail. The period of follow-up is 13.2 years (2-40). 80% of the operated patients became absolutely trouble-free. Only in one single case did a relapse occur.

Adolescent↗
PubMed1988

[Synovial chondromatosis].

Synovial chondromatosis is a rare, mostly benign, and monoarticular disorder of unknown cause, and it is characterized by multiple calcified bodies. It mostly affects the knees, the hips, the elbows, or the shoulders of adult men. The radiographic appearance is characteristic, but the presence of cartilaginous metaplasia on histological examination is conclusive. Excision of the chondral bodies and synovectomy is the treatment of choice and usually gives good results with a low risk of recurrence.

Adolescent↗
PubMed1988

[Etiology and pathogenesis of synovitis villonodosa pigmentosa].

Articular pigmented villonodular synovitis is a benign synovial disease of unknown etiology. It is a proliferative disorder of the synovium that can involve the joints, tendon sheaths, and bursae. There is a predilection for involvement of the lower extremities, particularly the knees. There are two histologically similar lesions of pigmented villonodular synovitis: "nodular" and "diffuse" pigmented villonodular tenosynovitis. The typical clinical course consists of progressive and painful swelling of the involved joint. Cystic erosions without sclerosis and invasion of adjacent bone from intra-articular synovial lesions are the typical roentgenographic manifestations. The surgical treatment of the lesions is discussed. A review of the literature is given and our own material on 47 patients is presented to illustrate the different features of the disease.

Adolescent↗
PubMedDate not supplied

Comminuted humeral head fractures: a multicenter analysis.

Three centers' experience with 93 comminuted humeral head fractures were clinically (Constant score) and radiologically (Neer) analyzed. The results revealed fundamental differences between the various types of fractures depending on the number of fragments. For three-part fractures open reduction and internal fixation (mean Constant scores 83 and 91 points, respectively) or conservative treatment (78 points) seem to be indicated. The prognosis for four-part fractures is determined largely by the vascular supply of the head fragment with a high risk of humeral head osteonecrosis. For this reason primary prosthetic replacement (mean Constant score, 74 points compared with 54 points for conservative treatment and 52 points for open reduction) should be recommended for this type of fracture. In conclusion, we stress the importance of fracture type directing the therapeutic modality.

Aged↗
PubMedDate not supplied

[The femoropatellar pain syndrome. Conservative and surgical therapy in a long-term comparison (10-20 years) and their therapeutic consequences].

Long term results in conservative and operative treatment (10-20 years) and their therapeutical consequences. There are many factors involved in the aetiology and pathogenesis of the patellofemoral pain syndrome. Increased pressure over the lateral facet with or without reduced pressure over the medial of the patella resulting from lateral positioning of the patella and different anatomical variants not of the patella, but of the condyles must be considered as well functional variants in the muscular and ligamentous system. Overviewing the literature we compare the long term results of operative versus conservative treatment. 75 patients, treated by the method of Maquet-Roux, and 150 patients, treated conservatively, showed satisfactory results in 72%, a Lysholm Score of 90.8 in the "Maquet"-group, but 89.9 points in the "conservative"-group with a follow-up of 23 years. In the "conservative"-group 52% had no signs of arthrosis, in the "Maquet"-group there are only 30% without signs of arthrosis. The X-ray examination had mostly shown a further stage of arthrosis not only in the femoropatellar, but also in the femorotibial compartment, especially in the "Maquet"-group.

Adolescent↗