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C Tschauner

Publications and source records attributed to C Tschauner.

31 records · Page 2Linked to original sources
PubMed1994

[Sonography of the infant hip. Sources of error, progress and current clinical relevance].

Effective prevention of late dysplastic dislocation of the hip (DDH) has become a reality since reliable diagnosis has been possible at an early stage by means of the original sonographic method according to Graf. A correct sonographic diagnosis must be instantly followed by adequate, biomechanically rational, and consistent therapeutic management and long-term follow-up. The results of a strictly comparative follow-up study emphasize the enormous progress in the quality of therapeutic results gained when routine sonographic newborn hip "screening" is performed directly in the maternity wards: successful anatomical healing with conservative treatment is regularly obtained without femoral head necrosis, without surgery and without late DDH, and costs less when sonographic assessment is done within the first days of life. For this reason, the Austrian government has included sonographic neonatal hip screening in its general health prevention program-and also reimbursed the cost of this preventive procedure-since 1992.

Austria↗
PubMed1993

[The effect of ultrasonography screening of hips in newborn infants on femur head necrosis and the rate of surgical interventions].

We compared two similarly sized groups of sonographically unstable or decentered hips with comparable initial findings, both treated by standardized conservative primary treatment. The results show that an early definite diagnosis improves the prognosis. If built on a secure initial diagnosis rationally grounded and efficient conservative therapy can be initiated and followed through on. Since the treatment is started extremely early, the hip can benefit from the considerably greater potential for spontaneous development present in the first three months of life. In this way we can shorten the treatment time considerably and also complete it at a younger age. Finally, early treatment also reduces the risk of the complication of necrosis of the femoral head and significantly decreases the rate of surgical procedures. Only a sufficiently well executed and comprehensively organized sonographic neonatal screening program can produce a definite very early diagnosis and with it almost 100% successful early treatment of all grades of disturbances of hip maturity. Sonographic screening of the newborn is a very important piece in the jigsaw of prophylaxis and primary prevention in our public health care program.

Acetabulum↗
PubMed1993

[Ultrasonographic anatomy and ultrasonographic assessment of the transverse arch of the foot].

A new and original sonographic technique to document the morphology of normal feet and splay feet is presented: a standard sectional plane cuts the transverse arch from the plantar side using the sesamoids of the first metatarsal bone and the head of the fifth metatarsal bone as reference points. A 5-MHz linear transducer and a rather simple custom-made platform with an integrated gel-pad are required in order to get reproducible results. The morphology of the transverse arch can be characterized by the "transverse arch index Q" as the parameter of the relative height of the transverse arch. Based on this transverse arch index Q, splay feet can be distinguished from normal feet in a statistically significant way (p < 0.01). Furthermore, grading of splay feet is possible and a documentation of rigidity/flexibility of the forefoot in splay feet; thus, the decision on whether to use conservative or operative treatment can additionally be based on sonographic documentation, and the results of surgical reconstruction of the transverse arch can be checked and documented sonographically.

Female↗
PubMed1992

[Scoliosis and spondylolisthesis in children and adolescents].

The genuine structural scoliosis is characterized by a rotation of the vertebral bodies. Clinically suspect cases require an exact radiographic assessment. Treatment is based on the radiographically found COBB-angle: physiotherapy, brace and different types of surgical instrumentation are the most common therapeutic procedures. Early diagnosis is essential for the final therapeutic result! Spondylolisthesis can only be diagnosed by X-ray. Surgical stabilization is necessary if pain, instability or progressive gliding are found. The extent of surgical procedures depends on the stage of the gliding process. Therefore early diagnosis is desirable.

Adolescent↗
PubMed1992

[Ultrasound diagnosis of hip dysplasia--current status and future perspectives].

Hip sonography provides a safe pathoanatomical assessment of a newborn hip joint at the earliest possible moment. Based on this safe diagnosis an adequate biomechanical treatment can be started instantly. The mean age of healing even of originally decentered hip joints is 7.5 months, if earliest sonographic diagnosis and adequate biomechanical treatment are performed correctly. Secondary hip surgery can be reduced to a minimum. Cost-benefit-analysis, too, supports the institution of a general sonographic screening of all newborn hip joints.

Austria↗
PubMed1990

Earliest diagnosis of congenital dislocation of the hip by ultrasonography. Historical background and present state of Graf's method.

Since Graf in 1978 introduced sonography into examination of hip dysplasia and hip dislocation, we survey an experience of more than 38,000 infant hips. At the present sonography of the infant hip is a standard and superior to traditional diagnostic methods especially in infants under three months of age, if the following minimum requirements are fulfilled: 1. THEORETICAL AND PRACTICAL TRAINING OF THE METHOD: anatomic identification (landmarks, standard situation, standard plane), description and nomenclature of the sonographic hip types according to GRAF, measurement (bony roof angle "alpha", cartilage roof angle "beta"), dynamic examination, therapeutic consequences and follow-up, points of weakness and errors of measurement. 2. CERTAIN TECHNICAL STANDARDS OF THE ULTRASOUND INSTRUMENT: linear scanner, 5 MHZ (newborn: 7.5 MHZ). POSITIONING-DEVICE (patent: Fa Radl, A-8010 Graz-Austria) 3. SUFFICIENT DOCUMENTATION: projection similar to a ap-radiograph of the right hip, image scale never less than 1:1, black on white, two ultrasound scans per hip in the standard-plane. Suitable Systems: multiformat, dry copy, computer printout. Follow-up-studies have proved that in our region approximately five percent of hips under the age of three months require treatment, and that prognosis is better the earlier therapy is started. For this reason we recommend a sonographic screening of the newborn not later than six weeks of age.

Age Factors↗
PubMed1990

[Sonographic neonatal screening of the hip joint--luxury or necessity?].

Based on the ultrasound investigation of 19,666 babies (1981-1988), 6341 of them directly at the maternity ward, we picked out the group of sonographically unstable or decentered hip joints, which must be treated instantly. Almost 50% of these hips did not show any clinical signs of instability! At follow-up the subgroup of sonographically screened hip joints showed optimal results after consequent earliest treatment: 100% physiological results of CE-angle (Wiberg and Engelhardt), no femoral head necrosis. Ultrasound screening is the only tool to detect definitely all newborn hips requiring therapy. Earliest treatment is the pre-condition of anatomical healing up. Thus--a general sonographic newborn screening is indispensable.

Follow-Up Studies↗
PubMed1987

[Does the IIa hip need treatment? Results of a longitudinal study of sonographically controlled hips of infants less than 3 months of age].

In a randomized retrospective study we followed hips classified as Type II a by ultrasound. The classification as "Type IIa" only was found inadequate. It is important to further differentiate the so-called physiologically immature hip, namely to distinguish between joints that, while immature, are appropriate for age [Type IIa(+)], and those hips with a maturation deficit exceeding a tolerable degree [Type IIa(-)]. The follow-up showed that hips classified as Type IIa(-) and treated before the age of 6 weeks had a clearly better healing result than the hips treated only after the sixth week. Thus, to achieve optimal healing and to keep to a minimum the dysplasias requiring treatment after 3 months' age, an ultrasound study of the hip should be done as early as possible. The total percentage of ultrasonically recognized abnormal joints requiring treatment (independently of the patient's age) was 6.6%. This corresponds to the regional average before the advent of ultrasound. However, because of extensive very early screening in our area, we found not a single hip dislocation later then at the age of 10 weeks during the last 2 years.

Hip Dislocation, Congenital↗
PubMedDate not supplied

[Maturation curve of the ultrasonographic alpha angle according to Graf's untreated hip joint in the first year of life].

In addition to Graf's classification into different hip-types a maturation-curve of the sonographic alpha-angle was established in order to optimize the differentiation between mature hip joints and those ones which need follow-up and those ones which need treatment at any time within the first year of life. The results obtained are confirming our present knowledge about the spontaneous maturation of physiologically immature hip joints: The mean-value of the alpha-angle crosses the 60 degrees-borderline at about the age of two months, then reaches an about 64 degrees-level at about four months. This 64-degrees-level is more or less unchanged up to the end of the first year of life.

Age Factors↗
PubMedDate not supplied

[Sonographic screening of neonates' hips. Analysis of the years 1986-1988 and comparison with 1977-1979].

Establishing a sonographical neonate hip screening program in three nearby counties has made us able to simplify our management in socalled "congenital dysplasia of the hip". Earliest diagnosis has led to a percentage of conservative treatment of 95% and therefore to a reduction of surgical interventions and less inpatient treatment. Our results force us to urge a state covering sonographical neonate hip screening done by educated specialists (Orthopaedic surgeons, Paediatricians, Radiologists).

Hip Dislocation, Congenital↗