Search PubMed⌕ Search

Biomedical subjects

C J Wirth

Publications and source records attributed to C J Wirth.

At least 163 records · Page 9Linked to original sources
PubMed1976

[Chronic recurrent dislocation of the elbow joint (author's transl)].

This paper discusses 3 recurrent dislocations of the elbow joint. As possible cause for the etiology of the dislocation the author offers the post-traumatic flattening of the semilunar notch of the ulna. In 2 cases, a successful repair using the Kapel procedure was performed.

Adolescent↗
PubMed1976

[Rotatory instability of the knee joint in cases of previously treated "Unhappy Triad" (author's transl)].

The combined injury of the ligaments and capsular structures of the knee joint always causes rotatory instability as the sum of all or some a.m. injuries (Slocum; Nicholas). This has to be taken into account in the operative treatment. We have followed 14 patients with old "unhappy triad" injuries who had been operated upon with the question in mind whether the usual procedures with reefing of the ligaments or plastic replacements including meniscectomies, but without paying attention to the lax posterior capsule could correct the typical anteromedial rotatory instability. The results showed that this was true only in about half the cases. The remaining patients continued to complain about instability in the operated knee joint. Objectively, the pre-operatively positive rotatory drawer sign remained unchanged. Therefore we conclude that the anteromedial rotatory instability of the knee joint can be improved by the procedure devised by Slocum and Nicholas.

Adult↗
PubMed1976

[Fresh combination injuries of the knee joint--diagnosis and treatment (author's transl)].

The diagnosis of fresh combination injuries of the knee joint is difficult. It is under all circumstances mandatory, occasionally by employing general anesthesia, to establish a diagnosis and the extend of the injury to decide on a conservative or surgical approach. Partial ruptures of the capsule and ligaments may be treated conservatively, complete ruptures are a surgical must. Between 1963 and 1974 we operated on 35 knees in 34 patients after afresh combination injury of the knee joint. 14 patients (15 knees) could be followed between 2 and 10 years postoperatively. All patients were satisfied with the result and were participating in sports. The objective results were excellent in 2, good in 12 and sufficient in 1. Knee joint stability could be reestablished in all knees. Follow-ups of a similar group of 14 patients after reconstructive treatment of an old "unhappy triad" showed considerably poorer results both subjectively and objectively. We conclude that fresh complete ruptures of the ligamentous and capsular structures of the knee joint have to be surgically repaired immediately to prevent permanent damage.

Adult↗
PubMed1976

[Closed injuries to capsular and ligamentous structure of MP I joint--diagnosis and treatment (author's transl)].

7 new and 9 old injuries of the MP I joint primarily involving the ulnar capsule and ligaments have been reevaluated for treatnent and results. In old cases, the operative result could be classified as excellent and good in 7, while 2 were considered as failures. These results have been used to discuss the mechanism and diagnosis of ruptures of the MP I joint ligaments. Primary surgical treatment of fresh ligamentous injuries is far superior than plastic reconstruction of old injuries.

Adult↗
PubMed1976

[Plastic substitutes for old cruciate ligament ruptures. I. Material, methods, and indications (author's transl)].

A report was made of 101 old cruciate ligament ruptures which were reconstructed at the Orthopedic Hospital in Munich between 1963 and 1975. On the basis of this material, it was confirmed that the anterior ligament is predominantly affected. Injuries of the knee ligaments and, therefore, the cruciate ligaments were acquired by 67 of the 101 patients during the course of sport activity. Football had a particularly high injury quota. Single, isolated cruciate ligament injury was found in 17 cases. Combination injuries with stress on the medial structures of the knee joint were found in 84 cases. 39 cases came to surgery more than 2 years after the accident. In 29 cases, some type of surgery had been carried out previously. The measures used to restore function of the cruciate ligament in addition to tightening the anterior cruciate ligament were Brückner-plasty using the distally flapped medial third of the ligamentum patellae, the free ligamentum-patellae transplant, Augustine-plasty, distally flapped tendoplasty from the pes-anserinus group, Hey-Groves fasciaplasty as well as anterior cruciate ligament-plasty using the ventrally flapped internal meniscus. The necessity of reconstructing additional ligamentous lesions to eliminate complex instabilities was stressed. A plaster fixation is always carried out postoperatively in the lying cast on the thigh. This plaster fixation is completed by restorative measures at the collateral ligaments through a pelvic girdle. Remobilization should begin 6 weeks after the operation. Its length as well as the final result is determined by the condition of the joint before treatment, the technique applied and the postoperative complications.

Adolescent↗
PubMed1976

[The plastic replacement of old ruptured cruciate ligaments. II. Late results (author's transl)].

We discuss the results of postoperative examinations of 66 patients, who were treated at the Orthopaedic Hospital of the University of Munich by different methods of ligament grafts for old ruptures of the cruciate ligaments. Distally attached tendons of the pes anserinus group as replacement material show better results than distally attached medial thirds of the patella tendon. Biomechanical reasons are discussed, which have led to the changing of this method by using the medial one third of the patella ligament as a free graft. Advantages and disadvantages of fascia lata and the meniscus as a cruciate graft are discussed, a final judgement of the long term results is impossible with their small number of cases. In total an agreable subjective result was achieved in two thirds of the cases (60.6 per cent), an objective result from "very good" to "agreable" in more than three quarters of all cases (86.4 percent) be reparative procedures at the crucitate ligaments. Tightening or grafting of the collateral ligaments are discussed for its influence on the result of the cruciate graft. It is found, that with insufficient lateral stabilisation of the joint an eventually remaining anterior-posterior instability is increased as a rotatory instability. Finally it can be said, that only the repair of the loose posterior capsule in all ligament grafting procedures can lead to a final stabilisation of the knee joint.

Adult↗
PubMed1975

[Elongation of the anterior cruciate ligament--reefing or displacing (author's transl)].

Among old injuries involving the cruciate ligaments elongation of the anterior cruciate ligament is found in 20%. Follow-up examinations revealed that the purse-string suture technique does not guarantee permanent tightness of the anterior cruciate ligament. In consideration of the unsatisfactory results obtained by the purse-string suture technique it is suggested to effect tightness of the anterior cruciate ligament by the transfer of its distal insertion. The technique is described.

Follow-Up Studies↗
PubMed1975

[Synovectomy and prosthetic substitution of rheumatic knee joints (author's transl)].

Synovectomy and alloarthroplasty are the prinicpal forms of surgical treatment of rheumatoid arthritis (RA) of the knee joint. The aim of both procedures is the reduction or elimination of the painful condition, the quantitative reduction of analgesics and hormone preparations, and improvement of function. Synovectomy removes the principal pathogenetic area of RA. The indications, contra-indications, valve technique of the two methods are gone into. The problems of rehabilitation are referred to.

Aged↗
PubMed1975

[Diagnostic problems in new and old injuries].

Due to mass participation in certain sports combination injuries of the knee joint have greatly increased in number. To a certain extend injuries of the cruciate ligaments are typical. According to our own follow-up studies the immidiate suture of the ligaments leads to better results than late reconstructions which emphasises the early diagnosis of an injury to the cruciate ligaments. Old and new injuries to these ligaments present diagnostic problems. Therefore the mechanism of injury, the symptomatology, and both clinical and radiological possibilities for the diagnosis of damage to the cruciate ligaments are demonstrated.

Acute Disease↗