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Biomedical subjects

E H Kuner

Publications and source records attributed to E H Kuner.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Benign and semi-malignant bone tumor and tumorous lesions as a cause of pathologic fracture].

The aim of the treatment in cases of impending or manifest fracture within the area of a benign of semimalignant bone neoplasm is total osseous healing with a complete as possible preservation of function. In case of benign tumors and tumorlike alterations satisfactory results are often achieved by thorough curettage, perforation of sclerotic ridges and extensive cancellous tissue grafts. Relapses are often due to inadequate operative techniques. Semimalignant osteoclastomas require frozen section. Even in cases of disadvantageous localisations (neck of the femur, proximity to acetabulum, proximity to wrist), meticulously executed electrocauterisation allows a more radical operation and the maintenance of function of the joint.

Bone Neoplasms↗
PubMed1989

[Fractures accompanied by injuries of the great vessels in sport and leisure accidents. Diagnosis and management concept].

Extremity fractures with concomitant vascular injuries are surgical emergencies. Especially injuries of the upper extremities require a preoperative angiographic examination for the localization of the vascular lesion. In vascular lesions of the lower extremities a primary angiography is not necessary, if there is an opportunity for an intraoperative radiologic evaluation. In our traumatological department 104 patients were treated over the last 15 years with that combined injury. The concept of immediate stabilization of the fracture with simultaneous or postponed arterial repair has been proved to be appropriate. The fasciotomy as prophylactic procedure of a postischemic compartment syndrome is also a part of our concept during the last years. The late results in our mostly young patients depended on the degree of soft tissue damage and the time of ischemia. The often untreatable nerve lesions contributed to a loss of use of about 30% in the late courses.

Accidents↗
PubMed1989

[Minimal osteosynthesis of fractures of the head of the humerus. Indications, technic, results].

Between 1983 and 1987 minimal osteosynthesis for proximal humeral fractures was performed in 30 patients, 23 women and 7 men, with an average age of 58.5 years. According to the Neer classification there were 10 two-part, 9 three-part and 11 four-part fractures. Internal fixation was achieved with Kirschner wire (n = 9), cancellous screws (n = 4) or tension band (n = 17). The technique of internal fixation with Kirschner wire and lateral tension band is described. Follow-up examination was possible in 26 patients after 14 months. The functional results were excellent in 6 cases, good in 4, satisfactory in 14, and poor in 2 cases. According to Neer's protocol the overall results were excellent in 5 cases, satisfactory in 7 cases, unsatisfactory in 7 cases and poor in 7 cases. The treatment of displaced proximal humeral fractures, especially in elderly patients, is still an unsolved problem. As functional results were satisfactory or even better in three-quarters of the four-part fractures treated, we conclude that internal fixation using Kirschner wire and tension band can be recommended.

Adolescent↗
PubMed1988

[The effect of postoperative cold therapy in joint surgery using a new cooling device].

The effect of continuous cold therapy with a new cooling device in post-operative treatment after knee surgery has been proved. Ten patients with different operations of the knee joint participated in this study. Eight out of ten patients reported no or poor pain, whereas in the control group especially after arthrotomy considerable or violent pain was reported. After arthroscopic operations we found more an decrease of swelling and effusion, after arthrotomy more pain reduction. The subjective feeling of all patients was very good and they were generally very receptive to it.

Arthroscopy↗
PubMed1988

[Sprain and dislocation of the hip joint].

Traumatic dislocations of the hip, while very infrequent injuries, must be treated with the utmost urgency. The later the adjustment is made, the sooner aseptic necrosis of the femoral head and periarticular ossification have to be reckoned with; these may lead to dysfunction. The results of 40 cases are reported, one-half of which was treated with two-week extension and a long period of non-weight bearing, the other half without extension, early mobilisation and partial weight bearing up the 11th week. The results in each group are equally good. Thus, we endorse Lorenz Böhler's proposal to follow the immediate repositioning with a short inpatient treatment and early mobilisation, increasing to full-weight bearing after one week and certifying working capability after 3 to 4 weeks.

Accidents, Traffic↗
PubMed1988

[Conservative treatment of pediatric elbow fractures].

Between 1978 and 1982, 146 children with elbow fractures were treated at the Department of Traumatology of the Freiburg University Hospital. Forty-two children received conservative treatment and in 104 an operation was performed. The possibilities for conservative treatment of the elbow joint in children are discussed together with our results. Out of 47 supracondylar fractures of the humerus, 25 were treated conservatively (28%, dislocation grade 1; 48%, grade 2). Good or very good results were achieved in more than 76%. Unstable grade 3 fractures often involve rotation of the elbow; in 35% of such cases, conservative treatment leads to a cubitus varus. Operative stabilization is definitely indicated here. Neither serious changes in the carrying angle nor ischaemic contractures were seen. Out of 24 intra-articular fractures of the distal humerus, only 4 were treated conservatively; only fractures without dislocation are regarded as an indication for conservative treatment. Fractures of the neck of the radius were treated conservatively in 6 out of 12 cases. There was angulation of the radius head of more than 30 degrees in 4 cases, necessitating a closed reduction. The follow-up of these children shows very good results in all cases.

Adolescent↗
PubMed1987

[Open versus arthroscopic meniscectomy: on meniscectomy by arthrotomy].

Articles in the general press, radio and television give the impression that the open operation method for the meniscus is obsolete and passé. With a row of arguments such as ambulant treatment, lower costs, reduced morbidity and shorter operation time etc. attempts are made to demonstrate its advantages. There are comprehensive opinions on each individual point and results from the literature are compared with those of a personal postexamination about open meniscal resection. It can definitely be shown, however, that the postoperative effusion rate by open operation is much lower than with the arthroscopic method. It must be stressed that the arthroscopic operation may cause considerable damage particularly in the cartilage of the joints. It has been determined that for the arthroscopic operation great experience and technical ability is necessary. If these and adequate technical equipment are not guaranteed, then the open method is regarded as the far superior.

Arthroscopy↗
PubMed1987

[Dislocation fractures of the proximal humerus--results following surgical treatment. A follow-up study of 167 cases].

167 patients with fracture dislocations of the proximal humerus--operated upon between 1970 and 1980--were followed up on an average 43.2 months after the accident. Fractures were classified according to Neer in two-part-(n = 24), three-part-(n = 60) and four-part-fractures (n = 61) as well as fractures of the articular surface (n = 21). 20.4% of all fractures were complicated by a neurological lesion. In 31% of all cases a good or excellent result was obtained. The functional result and the rate of avascular head necrosis were dependent on the type of fracture, that means the number of displaced parts. Results after 23 head prostheses were disappointing. The analysis of functional results and the rate of avascular head necrosis after different types of operation proved that minimal fixation with K-wire or tension-band was slightly superior to plate fixation.

Adolescent↗
PubMed1987

[Diagnosis and therapy of acute infections of the knee joint].

Infections of the knee joint have to be considered as emergency cases. They must be treated by immediate surgical intervention. Otherwise irreversible cartilage lesions will occur already after one week. An immobilization decreases the exchange of substrates within the knee joint and impedes the resistance to infections. An early functional follow-up treatment should be performed. The therapy conception resulting from these considerations includes a lavage and following continuous passive mobility therapy on a motor bar. This method has proved successful during the last years and led to clearly improved results.

Arthritis, Infectious↗
PubMed1987

[Results of osteosynthesis of medial femoral neck fractures with the angled plate].

Among 82 patients still alive after osteosynthesis of femoral neck fractures between 1974 and 1983, 67 (i.e. 81.7%) were controlled clinically and radiologically. The average follow-up period was 57.0 months. The average age of 36 men was 45.3 years, the average age of 31 women was 56.1 years. Fractures were divided in lateral and medial femoral neck fractures, the medial fractures were classified according to Pauwels and Garden. The rate of avascular head necrosis mounted 20.7%, the rate of non union 13.8%. Both complications were dependent on the type of fracture. Besides reduction and impaction of fragments time of operation proved to be important: In 37 fractures type Garden III and IV the rate of avascular head necrosis was 3-fold higher after secondary osteosynthesis than after emergency operation at the day of accident. Our concept in treatment of femoral neck fractures is based on these factors: Emergency operation, decompressive capsulotomy, valgus reduction, impaction of the fragments and internal fixation to allow movement.

Adult↗