[Tenography of the peroneal tendon sheath. A means for diagnosing dislocation of the peroneal tendon].
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Ankle Injuries↗
Biomedical subjects
E Orthner
Publications and source records attributed to E Orthner.
[Changed biomechanics of the upper ankle joint following reduction of the fibula].
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Adult↗
[Results of the conservative treatment of injuries of the palmar capsule-ligament system of the interphalangeal joints of the long fingers].
Results are presented following conservative treatment of 79 patients for injuries of the palmar plate of the proximal interphalangeal joint. There was in addition, a slight shell-shaped chip in the base of the middle phalanx of 73 patients. These results show that the functional results are influenced by the age of the patient and the length of the immobilization. 36 of 43 (83.7%) patients under 30 years old, who were immobilized for two to three weeks, had very good results. Immobilization for a longer period of time brought very good results for only nine of fifteen (60%) patients. In the group over thirty years, seven out of fifteen (46.7%) patients had very good results with up to three weeks' immobilization. With longer periods of immobilization, only one out of six (16.7%) had a very good result. The authors recommend fourteen days immobilization in a finger cast with the proximal interphalangeal joint at 15 degrees and the metacarpophalangeal joint at 80 degrees of flexion. Operative correction should only be considered in cases with a tendency to sublux.
Adult↗
[Value of primary stabilization of femoral shaft fractures in patients with simple and multiple injuries].
There is a variety of opinions about the optimal time when to stabilise femoral shaft fractures. The data of 100 patients were analysed in order to compare primary versus secondary intramedullary stabilisation. The rate of wound infections and of other concomitant complications was significantly lower after primary osteosynthesis which is therefore superior to secondary stabilisation in both kinds of patients--those with single and those with multiple injuries. In the group of 50 patients with immediate surgery four complications altogether were found, including one wound-infection, whereas in the group of 50 patients with delayed surgery there was a total of twelve complications, including five wound-infections and six cases of fat- and pulmonary-embolism. The average duration of stay in hospital was only 17 days after primary but 28 days after secondary surgery.
Adolescent↗
[Macroscopic and microscopic anatomy of the shoulder joint and the limbus glenoidalis].
Macroscopical and histological examinations were carried out in order to investigate the anatomy of the limbus glenoidalis, with respect to its surrounding structures such as tendons and ligaments. Basically the crosscut limbus glenoidalis has a triangular shape, however, especially in its anterior part, it has a meniscoid or labiate form. Histologically the limbus glenoidalis consists exclusively of connective tissue, rich in cells and fibers. It originates from the fibrocartilaginous rim of the glenoid surface, which merges into the hyalin cartilage. The bundles of fibers have a circular arrangement with radially and reticularly interwoven structures near the tendons of the biceps and triceps muscle.
Cartilage, Articular↗
[Stress to the lateral ankle joint ligament complex in confined imaging with an a.-p. radiation path].
Physical definition and laws of rotating systems will be stated. The application for supination in ankle joint shows, that lever action increases the force applied up to four times in case of stress X-rays in the a.-p. view. As quoted in literature, the test power of up to 25 kp means a loading of the lateral collaterals up to 100 kp. An additional iatrogenic rupture of already traumatically partially sprained structures seems possible. The critical judgement of five different methods producing stress X-rays of the ankle joint shows the weak points of this test system. Beck's method seems sufficient for precise statements and judgement of the stress X-ray tests without endangering ligaments so far unsprained.
Ankle Injuries↗
[Anatomical separation and clinical importance of two different parts of the vastus medialis muscle].
In 32 corpses, either fresh or fixed, the deviations of the two heads (musculus vastus medialis longus and musculus vastus medialis obliquus) of the vastus medialis muscle from the long axis of the femur were measured. The deviations were between 15 and 18 degrees medially for the m. vastus medialis longus and between 46 and 52 degrees medially for the m. vastus medialis obliquus. Anatomical dissections of the vastus medialis muscle in 115 fixed thigh specimens could always demonstrate a clear separation between a long head of the muscle that inserts at the base (m. vastus medialis longus) and a short head (m. vastus medialis obliquus) that inserts at the medial margin of the patella. The plane of separation could be identified by a femoral nerve's branch in every case. In 17 instances the nerve's localization was superficial, in 57 in an areolar fascial plane, and in the depth between the muscles in 41 instances. The ramification of the femoral nerve's branch that runs along the separation plane showed four types of variation. With these investigations it was possible to distinguish between two individual heads of the vastus medialis muscle not only with regard to its function, but also to its anatomy.
Femoral Nerve↗
[Treatment guidelines and results in severe open tibial fractures].
27 patients with compound fractures of the lower leg were treated according to the following scheme: Exact excision and surgical cleaning of the wound, reduction of the fragments without further exposure of the bone by additional incision, minimal osteosynthesis, stabilization by means of external fixation device and secondary closure of the accidental wound. During the last year we preferred the V-shaped arrangement in contrast to the tent shaped arrangement of the external fixation device as this minimizes the trauma to the extensor muscles of the foot. After external fixation combined with minimal osteosynthesis (n = 10) the patients had to stay in hospital for 6 weeks only. There was no infection at the incision of neither Steinmann-pins nor Schanz-screws and posttraumatic ostitis only in 1 case was seen. On an average only one secondary operation was necessary, a spongious bonegraft only at 3 patients. On an average the patients had the external fixation device for 5 months, bony union of the fracture was observed after 9 months. In case of external fixation without minimal osteosynthesis (n = 17) the patients had to stay in hospital for 16 weeks, 9 of them had infections at the incision of the Steinmann-pins, 9 of them developed posttraumatic ostitis with fistulae. On an average 4 secondary operations were necessary per patient and 9 patients needed a spongious bonegraft to get bony union of the fracture, which was reached on an average of 17 months.
Adolescent↗
[Treatment of infected tibial fractures and pseudarthrosis using an external fixator].
The clinical course and the results of our treatment of 18 patients with External Fixator after infection or pseudarthrosis are demonstrated. On an average of 6.1 months the patients wore the external fixator, the time of consolidation of the fracture was 17.2 months from the accident. At the date of examination - 16 months to 10 years after removal the external fixator all fractures and pseudarthroses were united. Two patients still had a fistula three years after removal of the external fixator. Three patients had slight pain in the area of the former fracture or the complication-wound; disturbance of sensibility in the area of the scar and the meshgrafts were found at 11 patients. The mobility of the knee joint was nearly free in all patients, the mobility of the ankle joint was impaired in most of them.
Adolescent↗
[Use of an external minifixator in severe open injuries of the hand].
Since January 1979 we have treated 14 patients at the 1st University Clinic of Traumatology in Vienna with the MFE described by Jaquet. The MFE was used mainly in severe open fractures of fingers and metacarpal bones. All 14 patients were examined for follow-up after a mean interval of 20 months. This method of treatment warrants minimal strain on the soft tissues while it ensures stability and optimal care of the wounds. Osseous consolidation was achieved in 13 of 14 patients; although one patient developed pseudarthrosis, he was, like 12 other patients, perfectly satisfied with the result of surgery. Only one patient was less satisfied by the result, as there was a rotational and axial deviation of 30 degrees between the fragments. However she refused operative correction, as the deviation does not interfere with her profession.
Adult↗
[Treatment of a tibial fracture in recessive epidermolysis bullosa herditaria dystrophica].
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Adult↗
Serial magnetic resonance imaging evaluation of a bioabsorbable interference screw and the adjacent bone.
The purpose of this prospective study was to review, using expanded clinical assessment tools, the initial use of a bioabsorbable interference screw (copolymer 85/15 D, L lactide/glycolide) in anterior cruciate ligament (ACL) reconstruction at the Wels Hospital, Austria. The study enlisted 32 patients of whom 28 were available for follow-up at minimum of 2.5 years. Since the implant material was new and the screw would not show on plain film radiographs, the clinical assessment was expanded beyond the usual historical and physical findings. The evaluation included opportunistic knee joint aspiration and repeat magnetic resonance imaging (MRI) studies to investigate the longevity of the implant and potential adverse effects of this new bioabsorbable material. The knee joint aspirations showed no infection. Serial MRIs showed the physical presence of the screw to remain intact for 4 months and disappear in 6 months. The MRIs showed minimal collection of edema around the bone tunnels that resolved by 12 months. There were no symptoms or adverse clinical result correlated with the MRI evidence of edema. There was temporary bone tunnel expansion. The clinical results were good. The OAK-score (Orthopädische Arbeitsgruppe Knie) showed 89.5% excellent and good results, 7% fair results and 3.5% poor results. The average score was 90.7 points (range, 63 to 100 points). The knee joint stability measured with the KT-1000 arthrometer showed 93% to have a 3-mm or less difference compared with the unoperated knee. This bioabsorbable interference screw appeared safe and effective for fixation of bone blocks during ACL reconstruction while producing no occult infection or adverse clinical response during the degradation process.
Absorbable Implants↗