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Biomedical subjects

F U Niethard

Publications and source records attributed to F U Niethard.

At least 91 records · Page 5Linked to original sources
PubMed1977

[The intraarticular fracture of the distal end of the tibia as a prognostic criterion (author's transl)].

Ankle fractures with injuries of the distal articular surface of the tibia have particularly unfavourable results. A follow-up of 103 cases shows, that even small marginal fragments of the lip of tibia produce posttraumatic athrosis. Results become statistically worse when the fragment is about 1/5 of the joint surface. Further there is a clear relationship between the number of the single injuries and the incidence of posttraumatic arthrosis. Thus the prognosis of ankle fractures is better described by the genetic classification of Lauge-Hansen than by the classification of Weber,

Ankle Injuries↗
PubMed1977

[Dysostotic changes and the prognosis of Perthes' disease after operation (author's transl)].

Goff and Mau for the first time demonstrated dysostotic changes in children with Perthes' disease. Their effect on the course of the disease has not so far been determined. It was examined on 41 patients following varus-osteotomy. Follow-up after 2--6 years showed late radiologic results, measured against the total quotient (Heyman and Herndon) depended essentially on this dysostotic component. The worst results are seen in children with high-grade skeletal retardation. Final results are further influenced by age, stage of the disease at the time of surgery and pre-operative status. Age plays a part in that results are better the younger the child. There are obvious parallels between results of radiologic and histologic examination at the time of operation and the weightbearing capacity. Dysostotic changes prolong the course of Perthers's disease and cause long-term lack of firmness of the femoral head. The influence of these facts on the still controversial indication for surgery is discussed. Our findings suggest that protection against weightbearing should be prolonged after operation according to the dysostotic changes.

Age Determination by Skeleton↗
PubMed1976

[Roentgenologic and morphologic studies of experimental tibial-plateau fractures (author's transl)].

Experimental tibial-plateau fractures had been produced to a series of 12 knee joints of corpses. The knee-joints had been exposed to vertical pressure in an extended position. The exerted pressure and the achieved deformation had been noted down in a diagram. The following radiological and morphological examination of the specimen showed that clear impressed fractured had arrived in case of a small deformation, whereas stronger compression had always caused combinated impression and split fractures. Impressions up to a depth of 3 to 5 mm cannot be proved radiologically. A certain unknown figure must be reckoned with in cases of distorsions of the knee-joint without a striking radiological finding. This will, however, hardly involve therapeutic consequences, because the carrying capacity of the tibial condyle will not be considerably reduced by such small impressions, and there is no fear of a further impression under load.

Biomechanical Phenomena↗
PubMed1976

[Experimental investigations regarding the limations of radiological demonstration of fractures of the head of the tibia (author's transl)].

The discrepancy between the radiological and the morphological finding, which we know from the clinic, could be confirmed in examinations of experimentally produced fractured of the lateral tibial condyle. The depth of the impressions of the tibial plateau and the width of the gap of the fracture can only be shown on additional tomographs and oblique radiographs of the knee-joint. Pure impressions of the tibial plateau up to a depth of 3 mm are totally beyond the radiological methods known for the present.

Biomechanical Phenomena↗
PubMedDate not supplied

[Pulsating electromagnetic fields in treatment of injuries and illnesses of the locomotor system--an overview and meta-analysis].

AIM: Recently, pulsating electromagnetic fields have gained wide attraction in the treatment of various orthopaedic diseases. The purpose of this study is to evaluate the scientific evidence for the effectiveness of this therapeutic tool. METHOD: All clinical studies which deal with pulsating electromagnetic fields in the treatment of orthopaedic conditions are reviewed. To elucidate the physiological basis of the method, important experimental studies are considered. RESULTS: 37 clinical studies with 3379 patients are evaluated, of which only a minority were performed as prospective studies with control groups. The results of the studies, performed on patients with various orthopaedic conditions, are not unequivocal and partly inconsistent. In view of the physiological basis many questions remain unanswered. CONCLUSIONS: At present the use of pulsating electromagnetic fields in the treatment of orthopaedic diseases is not scientifically proven.

Clinical Trials as Topic↗
PubMedDate not supplied

[Degenerative changes of the lumbosacral transition after Risser and Harrington spondylodesis].

INTRODUCTION: The long-term results of two operation techniques according to Risser and Harrington were of special interest. As part of this study, secondary changes of the lumbar spine, as well as the lumbosacral junction, were evaluated over time. MATERIAL AND METHODS: Two groups of 20 patients, who underwent one of the above-mentioned operative procedures for idiopathic scoliosis were analyzed (group A: Risser procedure, average age 15 years; group B: Harrington procedure, 17 years of age). The preoperative deformity ranged between 34 degrees and 108 degrees Cobb angle. The patients were evaluated at three different points in time: 1) preoperatively; 2) upon the conclusion of outpatient treatment following the surgery; and 3) between 13 and 15 years postoperatively. RESULTS: Degenerative changes, especially spondylarthrosis of the lumbosacral region, were seen more frequently in the Harrington group due to the higher rigidity of the implant and the ensuing increased loading of the adjacent spinal segments. The comparison of the two procedures revealed that a better primary correction of the deformity was achieved with the Harrington operation. Moreover, the Risser group showed a higher rate of pseudarthrosis and secondary loss of correction. In the Harrington group we found a higher rate of degenerative arthritis. CLINICAL RELEVANCE: A better primary correction of the scoliosis leads to a higher strain of the lumbosacral junction. The resultant secondary changes (spondylarthrosis) in this period of observation were rarely of clinical relevance. Nevertheless, whenever possible presacral segments should remain free in the range of a spondylodesis to reduce the loading of the lumbosacral junction.

Adolescent↗
PubMedDate not supplied

[Measuring isokinetic force in patients with gonarthrosis before and after hyaluronic acid therapy].

AIM: In the study we evaluated the effectiveness of intraarticular injected hyaluronic acid (Hyalart) with regard to the changes in the parameters maximal isokinetic muscle strength, total work, pain at rest, and pain under toad. METHOD: We examined 43 patients with osteoarthritis in both knee joints (Kellgren II or II according to X-ray) in right/left comparison. We used the isokinetic system Cybex 600 for measuring the maximal isokinetic muscle strength and the total work. We used the visual analog scale for the pain. The evaluated parameters were measured before and after a 5-week treatment phase with 5 intraarticular injections (one injection per week with 20 mg hyaluronic acid). RESULTS: In knees treated with hyaluronic acid the mean peak torque of the knee extensor was 57 +/- 26.15/32 +/- 19.63 Nm vs. 77.17 +/- 32.54/47.83 +/- 21.43 Nm after (p < 0.01), the mean peak torque of the knee flexor was 40.44 +/- 21.58/22.89 +/- 16.64 Nm vs. 53.55 +/- 24.26/34.05 +/- 17.37 Nm after treatment (p < 0.01) at the angular velocities of 60 degrees/s and 180 degrees/s. Significant differences (p > 0.01) between treated and untreated knee were found for total work of the extensor and flexor of the knee. The pain at rest decreased from 3.83 +/- 1.72 cm to 1.36 +/- 1.42 cm and the pain under load decreased from 7.57 +/- 1.34 cm to 3.75 +/- 1.32 cm in the treated knee group (p < 0.01). CONCLUSION: The intraarticular injection of hyaluronic acid is effective and safe in the treatment of patients with gonarthrosis. The treatment resulted in a functional improvement of the knee joint and had a good pain lowering effect in patients suffering from gonarthrosis.

Aged↗