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E Markgraf

Publications and source records attributed to E Markgraf.

At least 19 recordsLinked to original sources
PubMed2005

[Psychoreactive disorders after motor vehicle accidents. Is it possible to predict the development of psychoreactive disorders after motor vehicle accidents?].

The aim of this study was to assess common risk factors for the early development of psychoreactive disorders during traumatological treatment and to estimate their predictive potential. The sample consisted of 126 consecutive patients with accidental injuries recruited in an emergency room of the university hospital. We assessed this population 1 week (T1) and-on average-8 months following the accident (T2). At T1 34.5% of all patients indicated moderate and 26.4% strong symptoms of an acute stress disorder; 26.7% of all patients assessed at T2 suffered from severe post-traumatic symptoms. Linear regression analysis, using morbidity status at T2 as the dependent variable, allowed the explanation of 46.2% of the variance. The degree of early acute stress symptoms, injury, and pain intensity contributed significantly to the predictive model. We conclude that a substantial proportion of severely injured accident victims that will develop PTSD can be screened to some degree by the assessment of early stress disorder, the degree of their injury, and pain intensity, enabling secondary prevention of trauma-dependent symptomatology.

Accidents, Traffic↗
PubMed2002

[Late results following avulsion injuries of the thumb].

Out of the 127 amputated thumbs replanted at our unit during the last 15 years, there were 27 avulsion injuries. The average age of the 24 male patients was 33 years, that of the three female patients was 34 years. 70 % of the injuries were occupational accidents. Among the 27 patients, 21 had a complete and six an incomplete avulsion of the thumb. The level of avulsion-amputation was at the MP-joint ten times, between MP and IP joint ten times and at the IP-joint seven times. The healing rate of the subtotally avulsed thumbs was 100 %, that of the completely amputated thumbs 36 %. The most important post-operative complications observed were venous and secondary arterial thrombosis, whereby most of them occurred within the first 24 hours after replantation. The duration of ischaemia had a significant influence on the healing rate. In 80 % of the cases reconstruction of nerves have been carried out secondarily. A two-point discrimination was achieved in two cases only. The osteosynthesis was done almost exclusively with K-wires. Ten of 19 patients had to change their profession, while nine of them were able to return to their previous jobs, which in these cases were pre-dominantly white collar jobs. Another patient went for early retirement (he was a painter). All 19 patients followed-up had a range of movement of their saddle joints which was sufficient for the needs of most of the activities of daily life. Stiffness of the MP and IP joints was a common finding but had little functional impact, as it has been reported by other authors previously. We conclude from the results presented that in cases of avulsion injury of the thumb replantation is a procedure with significant chances of success.

Accidents, Occupational↗
PubMed2002

[Microvascular complications following replantations and revascularisations].

PURPOSE/BACKGROUND: What are the options for early diagnosis, treatment and prevention of the occlusion of microvascular anastomosis after replantations? METHOD AND (CLINICAL) MATERIAL: This is a retrospective analysis of 336 cases involving primary microvascular repair after an injury between 1984 and 2000. In 272 cases this was a revascularisation and in 187 a replantation. In 23 cases the vascular anastomosis was located proximal to the wrist (macroreplantations) and 313 times distal to it (microreplantations/-revascularisations). RESULTS: Vascular complications developed in seven and 54 cases respectively. 40 % of these 61 patients showed a severe soft tissue compromise or/and had sustained an injury known to cause widespread intima lesions (15 avulsions, six crush injuries, one blast, one gun shoot, one RTA). 37 of the 61 patients had been injured by circulating saws. There were 34 arterial and 22 venous occlusions, four no-reflow-syndromes and one HIT-syndrome. Almost 90 % of these vascular complications occurred within the first four post-operative days, 50 % even within the first 36 hours. Treatment was surgical in 39/61 cases and conservative 22 times. In 55 % (33/61) of all cases this treatment was successful. CONCLUSION: With an overall incidence of 1 : 6 vascular crisis is not only the most consequential but also the most common post-operative complication after replantations. Timely operative and/or non-operative therapeutic measures can save more than half of the replants affected.

Amputation, Traumatic↗
PubMed2001

[Influence of etiology and morphology of traumatic vascular injuries on outcome, risk of amputation and mortality].

In a retrospective trial 159 vascular injuries in 149 patients were registered between 1987-1996. Extremity vessels were injured in 76% of the cases. The same incidence was observed in blunt and penetrating mechanisms. Blunt vascular injuries were associated with an higher rate of live threatening organ damage, longer times of ischaemia (6.5 versus 3.0 h) and an higher mortality (9.7 versus 20.3%) than penetrating injuries. We have found an increased mortality rate in all cases with concomitant trauma of CNS, chest, abdomen or bones. The overall amputation rate in all peripheral vascular injuries has been 22.6%. The functional outcome has been reduced by nerve lesions, amputation and the sequelae of fractures.

Amputation, Surgical↗
PubMed2000

[The Marjolin's ulcer": a malignant and rarely complication after burn trauma of the upper extremity - a case report].

The,Marjolin's ulcer" is a malignant lesion which is developed especially at chronic wounds after burn trauma. The latency from primary trauma to the malignant transformation is about 30 years. The lesion is more aggressive than other squamous cell carcinomas. We report on the combined radiation and surgical therapy of an 65-year-old patient with this lesion on the right hand and regional lymph node metastases. The extensive tissue defect after wide excision was reconstructed with a reversal radial forearm flap.

Aged↗
PubMed2000

[Injuries and being injured. Hidden wounds after accident injuries].

Motor vehicle accidents may cause apart from physical also psychological aftermath. Despite of posttraumatic psychologic symptoms may remit after 2-3 months, 10-20% of the injured persons will develop sustainable psychopathological symptoms. This report aims at an overview on possible psychopathological disturbances and their perpetuating conditions. Possible treatments are shown and the necessity of an interdisciplinary cooperation with the aim of a secondary prevention is emphasized.

Accidents, Traffic↗
PubMed2000

[Pelvic injury].

Explore the source record for details and available documents.

Fracture Fixation↗
PubMed1999

[Fibrolipomatous hamartoma of the nerve--a rare etiology of macrodactyly. A case report].

Fibrolipomatous hamartoma of nerve is a rare, tumor-like fibro-fatty growth arising from the epi- and perineurium. It mainly affects peripheral nerves and the median nerve in particular. An association with Klippel-Trenaunay syndrome and macrodactyly has been described. We present a 30-year-old patient, in whom the diagnosis of Klippel-Trenaunay syndrome had been made at the age of two, based on macrodactyly of the right hand. Because of increasing functional limitation and pain, the patient was referred to our department, after angiographic exclusion of Klippel-Trenaunay syndrome, for operative reduction of the tumor. Histologic examination revealed a fibrolipomatous hamartoma of the nerve. Further treatment consisted of surgical tumor reduction, which resulted in satisfactory recovery of function in the right hand. After eight months follow-up, the patient was able to perform all normal daily activities, and there was no evidence of recurrence of the lesion. Diagnostic evaluation of macrodactyly is necessary, since there may be an underlying cause such as fibrolipomatous hamartoma of a nerve, which if corrected early by surgical excision may prevent long-term disability.

Adult↗
PubMed1998

[Joint empyema].

Bacterial joint infection is rare but may have an unfavourable functional aotcome. The different stages of purulent arthritis, depending on the pathophysiological developments, require different treatment measures. Clinical examination, analysis of joint tap and arthroscopy are crucial for diagnosis. Surgical management comprises: (1) open or arthroscopic débridement with intensive flush lavage; (2) postoperative drainage and flush lavage; (3) early and continuous active and passive motion. Recovery will be complete only if therapy is instituted as early as possible (within 3 days). Joint empyema must therefore be treated as a surgical emergency.

Adult↗
PubMed1998

[Late outcome of severed extensor tendons in the area of the hand and fingers].

In the care and further treatment of patients with hand injuries, a necessary requirement of the hand surgeon is that he be able to cope with the interlocking factors that are no longer influential, for example, the type and extent of the trauma or the age of the patient; the influential factors are a thought-out care plan, atraumatic action with regard to optimal restoration of the hand. This also showed a retrospective analysis of results and post-examination from flexor tendon injuries in the hand of 298 patients, who were surgically cared for from 1984 to 1994 at the surgical clinic of the University of Jena. Of the 298 patients 119 patients with 198 flexor tendon injuries (165 fingers and 33 thumbs) were followed up. For objective assessment of the treatment results, the assessment scheme Buck-Gramcko was used.

Adolescent↗
PubMed1998

[Traumatic peripheral vascular injuries].

2-4% of vascular injuries need operative reconstruction. In polytraumatized patients the rate is even 10%. Arterial vascular repair should precede venous reconstruction and orthopaedic stabilization due to limb threatening ischemia. Penetration or blunt vascular trauma result either in acute blood loss, ischemia or compartmental compression. Reperfusion syndrome leads to vital threat of patient. Clinical assessment, measurement of limb pressures using a Doppler device and use of duplex ultrasonography are reliable adjuncts in the rapid evaluation. Arteriography is rarely indicated and should be spared for patients with abnormal physical examination. Minimizing ischemia (6-8 h) is an important factor in maximizing limb salvage. Vascular repair include direct anastomosis or lateral suture repair mostly combined with primary shortening of the extremity. In most cases autogenous vein graft is required. Rethrombosis, arteriovenous fistula and pseudoaneurysms are possible complications. Stabilisation of the fracture has priority over vascular reconstruction. The initial steps to success are surgical debridement, adequate bony stabilization mostly by external fixation, revascularisation of vascular injury, immediate fascial decompression and early soft-tissue reconstruction. The best results are obtained when a multidisciplinary approach is used combining expertise in orthopedic surgery, vascular surgery and plastic surgery.

Arteries↗
PubMed1997

[Analysis of primary management of bladder malfunction in traumatic paraplegic patients].

UNLABELLED: Intermittent catheterisation is the demanded therapy of bladder paralysis during the spinal shock. We investigated the realisation of this concept. In 1994 after first treatment in other hospitals 97 patients were treated in the Thuringian Spinal Cord Centre Sülzhayn. The primary treatment of the paralysed bladder was: indwelling catheter: 44 patients (45.4%), suprapubic catheter: 30 patients (30.9%). Only 15 patients (15.5%) were catheterized intermittently. No urological treatment was carried out in seven cases. CONCLUSION: The primary treatment of bladder analysis in spinal cord injured patients has to be improved.

Adult↗