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Biomedical subjects

G Blatter

Publications and source records attributed to G Blatter.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Stress on the femoropatellar joint in downhill walking--a biomechanical study].

Kinematic and kinetic data were collected of 6 male and 6 female healthy subjects. For downhill walking a dismountable slope of 6 m length and a grade of 19.3% was built. Planar net joint moments and mechanical power at the knee joint were calculated for the sagittal view using force platform records based on standard inverse dynamics procedures. On the basis of a two dimensional knee model the patello femoral joint compressive forces were calculated. While the maximal extension moment for level walking was only 1.2 +/- 0.5 Nm/kg bw at a knee flexion angle of 20 degrees it was 2.6 +/- 0.6 Nm/kg bw at an angle of 40 degrees for downhill walking. This increased moment and knee flexion angle yields a 3 to 4 times bigger femoropatellar joint compressive force for downhill walking compared to level walking. Due to a smaller moment arm of female subjects the patello femoral joint compressive forces were bigger for females compared to males (14 N/kg bw for male subjects, 18 N/kg for female subjects during level walking and 50 N/kg bw for male subjects, 70 N/kg for female subjects during downhill walking). The femoropatellar joint compressive force for downhill walking is comparable to running, squatting or downstairs walking. Based on this investigation downhill walking must be considered a strenuous task for the femoro patellar joint and explains well why patients with anterior knee pain or osteoarthritis have problems during downhill walking.

Adult↗
PubMed1993

Wave plate osteosynthesis as a salvage procedure.

The load axis of the curved-shaped proximal femur lies not inside, but outside the bone. Therefore high bending forces are acting, the medial cortex absorbing pressure, the lateral cortex absorbing tension. In a transverse fracture, a laterally applied plate will absorb the tensile stresses, the medial cortex the pressure forces. When medial butress due to bony defect is missing, the laterally applied plate is subjected to cycling bending and will undergo fatigue fracture. This dilemma is compensated by a wave-plate with bone graft: The compression forces are detoured to the lateral cortex and the plate is again subjected to tension. Furthermore since the plate is standing away from the bone, the plate does not disturb the blood supply at the fracture side and bone healing.

Adult↗
PubMed1991

[Is suture of the ruptured anterior cruciate ligament without augmentation sensible?].

The five- and ten-years review of 40 patients with primary suture of the anterior cruciate ligament without augmentation showed all patients to have a positive Lachman-Test. Five years postoperatively 14 patients had no complaints, after ten years, only two patients remained free of symptoms. Five years after suture nine patients were limited at work, while after ten years this number had risen to twelve. Ten years after the suture only eleven patients had the same sporting abilities as before the accident; only six patients retained their level of performance. Six patients needed a meniscus-operation between the first and second review (five and ten years postoperatively). Radiologically we found signs of gonarthrosis in 15% at five years and 30% at ten years. 75% of the patients with gonarthrosis had had partial meniscectomy. Our results confirm that instability caused by an insufficient anterior cruciate ligament leads to higher incidence of meniscal tears and osteoarthritis. A primary suture of the anterior cruciate ligament without augmentation almost always leads to functional instability. This surgical procedure therefore is not recommended.

Adolescent↗
PubMed1991

[Osteotomy of the first ray in the treatment of hallux valgus].

An osteotomy of the first row for the treatment of hallux valgus is indicated for younger patients with minor to moderate valgus deformation and only minor arthritic changes in the first metatarsophalangeal joint. The osteotomy has two prominent goals: Correction of the deformity and restoration of muscle function and muscular balance. Especially the later seems to be essential for preventing failures in the long term. Osteotomies can be carried out on os cuneiforme mediale, metatarsal bone (proximal, shaft, subcapital) and phalanx. The cuneiforme osteotomy isn't recommended because of alterations in the joint between the medial and intermedium cuneiforme. Osteotomies of the proximal metatarsal bone are rarely performed and mostly combined with an arthroplastic procedure of the metatarsophalangeal joint. The disadvantage of a shaft osteotomy (Ludloff's osteotomy) is the long time for healing of the osteotomy of diaphysis of the metatarsal bone. Subcapital osteotomies are most frequently performed. With a subcapital osteotomy you can correct more deformities than with the other osteotomies. The phalangeal osteotomy is indicated just in special cases. The combination of a subcapital and a phalangeal osteotomy is recommended by Magerl in order to reduce the failure rates.

Hallux Valgus↗
PubMed1990

[Fatigue fracture of the calcaneus].

Formerly, stress-fractures of the metatarsus were the most common stress fractures. But over the last years, tibial and calcaneal localizations have dominated. The diagnosis of a calcaneal stress fracture is usually easy, provided the possibility is remembered. The symptoms are indeed vague, and radiological alterations are often not seen during the first 2 months. Sclerosis (callus formation) is the first finding on roentgenograms. A periosteal reaction like on tabular bone is never seen. Signs of a stress fracture are first seen on bone-scan, but other nonstress-related bone abnormalities which have not manifested any radiographic changes such as early osteomyelitis, fibrous dysplasia, bone tumor, etc. have to be excluded. The treatment is simple. Vigorous activities are stopped for 6 weeks, soft heel pads are given, partial weight-bearing can be helpful for some days. Plaster is usually neither necessary nor useful.

Calcaneus↗
PubMed1990

[Posterior shoulder dislocation. An often overlooked injury].

Posterior dislocation of the shoulder is rare. Only 2% of dislocated shoulders are displaced posteriorly, and these are chiefly of the subacromial type. Over 60% of the cases are not diagnosed initially because the arm is held in the normal position of adduction and internal rotation. The most consistent findings on physical examination are: the fixed internal rotation of the arm and the characteristic movement of the scapula with abduction of the upper extremity. It is essential that appropriate radiographs are obtained to correctly diagnose the dislocation. While the routine anteroposterior shoulder film is often enough to diagnose various anterior dislocations, it is not sufficient to diagnose the subacromial type of posterior dislocation. We recommend an anteroposterior view and an axillary lateral or tangential scapula view.

Adult↗
PubMed1990

[Conservative treatment of classical radius fractures].

In Colles' fractures of the radius the distal fragment is slanted dorsally and radially, dislocated dorsally and radially and supinated. The radius is shortened. Furthermore a comminution-zone of the dorsal cortex is found. In closed reduction the fracture is unwedged and reduced by recreating the mechanism of trauma in neutral position, rather a light dorsiflection is maintained to check secondary dislocation of the distal fragment and shortening of the radius. The cast should push the carpus slightly palmwards and hold the hand in light ulnar-duction. Immobilization is retained for four to six weeks. Radiologic review is performed 4, 8, 12 and 16 days post reduction so that timely change to a different form of fixation is possible in case of secondary dislocation.

Casts, Surgical↗
PubMed1990

[Which distal radius fractures can be treated conservatively?].

Roughly 80% of distal radial fractures can be treated conservatively. To decide which fractures should be treated surgically and which can be treated conservatively we divide them into four categories; metaphyseal bending-fractures, epiphyseal buckle-fractures, avulsion-fractures of the articular rim and fractures of the growing skeleton. Metaphyseal bending-fractures with dorsal inclination of the distal fragment (Colles' fracture) can generally be treated conservatively, those with palmar slanting of the distal fragment (Smith's fracture) must be stabilized surgically. The intraarticular fractures (avulsion-fractures and epiphyseal buckle-fractures) must be reduced anatomically and stabilized by osteosynthesis. In the growing skeleton Aitken 0 and I respectively Salter I and II fractures can be treated conservatively.

Casts, Surgical↗
PubMed1990

Wave plate osteosynthesis as a salvage procedure.

The load axis of the curved proximal femur lies not inside but outside the bone. Therefore, high bending forces are acting, the medial cortex absorbing pressure and the lateral cortex absorbs tension. In a transverse fracture, a laterally applied plate will absorb the tensile stresses and the medial cortex, the pressure forces. When the medial buttress due to a bony defect is missing, the laterally applied plate is subjected to cyclic bending and will undergo fatigue fracture. This dilemma is compensated by a wave plate with bone graft: the compression forces are redirected to the lateral cortex, and the plate is again subjected to tension. Furthermore, since the plate stands away from the bone, it does not disturb the blood supply at the fracture site and thus bone healing.

Adult↗