Search PubMed⌕ Search

Biomedical subjects

G Blatter

Publications and source records attributed to G Blatter.

85 records · Page 5Linked to original sources
PubMed1990

[Augmentation of the coraco-clavicular ligament suture. Comparison between wire cerclage, vicryl tape and PDS cord].

A total of 71 patients (average age 32 years) with acute grade III acromio-clavicular dislocation were all treated with the same surgical procedure: open reduction, transfixation of the acromio-clavicular joint with a Kirschner wire and suture of the coraco-clavicular ligaments with augmentation. The augmentation was done with a 1.2-mm wire cerclage in the first group (22 patients), a 3-mm wide Vicryl tape in the second group (30 patients) and a 1.5-mm PDS cord in the third group (19 patients). At follow-up (average time 4.4 years) the patients were questioned as well as being examined radiologically and clinically. Only two patients were not satisfied with the outcome of surgery. On clinical evaluation after wire cerclage augmentation of the suture, the distal end of the clavicle was found to be dislocated in 23% of cases. The incidence was 20% after Vicryl taping and 58% after PDS cord augmentation. At X-ray examination with 8 kg suspended from the wrist acromio-clavicular dislocation was found in 45% after wire cerclage, 23% after Vicryl taping and 58% after PDS cord augmentation of the suture. The results show that dislocation is more likely to persist after augmentation of the suture of the coraco-clavicular ligaments with wire cerclage or PDS cord than when the suture is augmented with a Vicryl tape. We conclude that a resorbable material is suitable for augmenting the suture of the coraco-clavicular ligaments, but that a filiform augmentation is less appropriate than a band.

Acromioclavicular Joint↗
PubMed1989

[Peri-prosthesis fractures in total hip endoprostheses].

Periprosthetic fractures after total hip arthroplasty (THA) were found in 0.77% (33 fractures in 4280 THA). At the time of fracture the prosthesis was loose in about one-third of the cases. In most cases (63%), the fracture was located at the distal end of the prosthesis. Fractures at this location were transverse or short oblique; those situated more distally were spiral. Whereas those located along the prosthesis shaft were long oblique. Open reduction internal fixation was performed immediately for all fractures. Thirty patients were followed an average of 2.7 years (1 year-11 years) after fracture. In 28 cases stabilization was obtained using a plate. In 2 cases the prosthesis was changed at the same time as plate stabilization. 1 case the lossened prosthesis was converted to a Girdlestone. A primary change in the prosthesis without osteosynthesis was performed in 2 cases. One year after operation all fractures were healed. We recommend a large DC plate for fractures distal to the tip of the prosthesis (spiral fractures). In cases of stable THA, we stabilized the fracture at the level of the tip of the prosthesis or along the shaft of the prosthesis itself, using a wave plate with corticocancellous bone graft. Fractures along the loosened prosthesis but with good bone stock are treated by implantation of a long-stem prosthesis. If bone stock is poor, we recommend the fracture be stabilized using a plate. Only after the fracture is healed do we revise the prosthesis.

Aged↗
PubMed1987

[Patellectomy as a salvage operation].

One hundred seven patients were examined who had undergone patellectomies between 1965 and 1983 (113 patellectomies). The mean follow-up time was 10.5 years (3-17.5 years) and the average age of the patients 42.6 years. There were three distinct groups of operative techniques: (1) the purse-string technique in 40 patellectomies; (2) the vastus medialis technique in 24 patellectomies; (3) other techniques in 49 patellectomies. The indications for patellectomy were: chondromalacia, 56 cases; comminuted patellar fractures, 32 cases; arthritis, 17 cases; recurrent patellar dislocations, 8 cases. The patients were examined for pain, rage of motion, giving way, swelling, quadriceps strength, activity and cosmetic results (interview, physical examination, Cybex and radiographic study). In the purse-string technique group, 81% of the cases ended up with good or excellent results; in the vastus medialis group there were 79% and in the third group only 73% good or excellent results. Among the patellectomies for comminuted fractures, 75% had excellent results. The clinical outcome of patelletomy for arthritis is fair, for recurrent dislocation favorable, and for chondromalacia variable and not predictable.

Adolescent↗
PubMed1979

[Progress and developments in insulin therapy].

BANTING and BEST revolutionized diabetes therapy with the discovery of insulin 57 years ago. Since then, progress in this area has been slow despite tremendous reseach efforts. The subcutaneous injection of a depot insulin does not provide optimal control of blood sugar. True progress has been brought about by intravenous insulin administration for the management of diabetic coma. The authors do not recommend ultra low dose therapy. The prognosis of diabetic coma is much better than 20 years ago, in particular because of much improved and continuous supervision of the circulation (CVP, ECG, K+ etc.). Pancreas and islet transplantation fail in man due to immunological rejection. The "artificial pancreas" with a glucose sensor is useful for research purposes, and for controlling blood sugar for a few days at most. The implantable glucose sensor is not yet in sight. The authors have treated diabetics successfully with a programmable flexible open loop infusion program. The basal insulin infusion rate can be varied from 0.25 to 2 U/h, and rectangular one hour extra insulin infusions between 2 and 10 U/h are superimposed by pushing a button on the steering unit. The pump automatically switches back to the basal rate after one hour. No hypoglycemic reactions have been observed in patients on ths program on the ward or at home. At present, technical problems with the catheter remain to be solved before this simple therapeutic approach can be applied routinely.

Adolescent↗
PubMed1979

Optimal blood sugar control in labile diabetics using a portable open-loop insulin infusion system with a flexible program.

11 labile diabetics were well controlled after 2 days of an i.v., open-loop insulin infusion program consisting of constant, empirically determined, basal infusion rates (mean: 1.1 U/h) and superimposed rectangular one-hour insulin infusions between 2 and 8 U/h during the main meals. The steering unit switches automatically back to the basal infusion rate after one hour. An almost optimal blood sugar profile was already obtained on the third day of the infusion program. We believe that such a flexible, open-loop insulin infusion program would render long-term optimal blood sugar control in "labile" diabetics possible if the technological development ever allows implantation of the infusion pumps.

Adolescent↗
PubMed1978

[Adjustment of unstable diabetics with a simple insulin infusion program].

In view of the importance of knowing exactly how much insulin is required by diabetics who are difficult to control with subcutaneous insulin, an insulin infusion program has been tried in such patients. The apparatus, which was produced by Siemens as a prototype, works according to the following simple and flexible principle: During the day a basal rate of insulin is continuously infused. During the three main meals an additional rectangular insulin infusion is initiated by turning a knob. After an hour the apparatus switches automatically back to the basal ratio. We have used this machine in 13 patients who are fully mobile. 11 of them showed an almost ideal blood sugar profile after 4 days. After switching back to subcutaneous insulin 8 of these 11 patients did better than before but not as well as on the insulin infusion program.

Blood Glucose↗