[Differential diagnosis and therapeutic possibilities in radiating vertebrogenic disorders].
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Bone Diseases↗
Biomedical subjects
G Dahmen
Publications and source records attributed to G Dahmen.
Pharmacokinetics of ampicillin, sulbactam and cefotiam in patients undergoing orthopedic surgery.
As perioperative prophylaxis for major orthopedic operations 81 patients were given the fixed combination of ampicillin (1 g)/sulbactam (0.5 g) or cefotiam (2 g) as short infusions. The three beta-lactams were rapidly distributed into the different tissues and their pharmacokinetic profiles were found to be very similar. It was noteworthy that ampicillin, sulbactam and cefotiam penetrated within minutes, not only into skin, fat and muscles, but also into bone. Thus 0.25 h after starting the infusion the following mean concentrations were measured in bone: 21.8 +/- 10.5 mg/kg ampicillin, 4.9 +/- 2.2 mg/kg sulbactam and 19.4 +/- 10.6 mg/kg cefotiam. For a period of at least 2 h the concentrations measured in serum and in the different tissues affected by the operation (skin, fat, muscle, bone) were above the MICs for pathogens which are involved in postoperative wound infections. On the basis of pharmacokinetic data, ampicillin/sulbactam and cefotiam seem about equally suitable for perioperative prophylaxis in major orthopedic operations.
Adult↗
[Paraplegia in manual therapy. A case report].
A case of complete paraplegia due to a giant cell tumor of the dorsal spine following manual therapy without previous x-ray examination is reported. In a malpractice trial the question whether manual therapy is indicated or not had strictly to be denied. The question whether paraplegia due to a giant cell tumor could have been avoided when the tumor would have been detected radiologically was impossible to answer retrospectively. But, it is likely that with immediate surgical therapy after radiological detection of this lesions complete paraplegia should have been avoidable.
Female↗
[Medium-term results in cement-free endoprosthetics: the Lord prosthesis].
In a clinical and radiological follow up 64 Lord-endoprostheses could be controlled after a meantime of 8.5 years. The positive judgement of the patients, which is caused by the reduction of pain, is in contrast to the poor improvement of gait and mobility. Radiological findings are suspicious for a higher rate of loosening of the cup and fractures of the shaft.
Activities of Daily Living↗
[Fungus-induced spondylitis].
Candida caused osteomyelitis of the spine is a rare entity. In the literature are only 15 cases reported. An own case of Candida-osteomyelitis of the spine is demonstrated and a overview of the literature is given.
Bone Transplantation↗
[Perthes disease--choice of therapy with reference to psychosocial aspects].
Within the scape of a comparative long-term study between conservative and operative therapy of Perthes'-disease the effort was made to estimate the dimension of the psychic and social detraction in addiction to the method of treatment by a detailed inquiry of 116 patients as well as of their accompanying parents. This happened because of the opinion, that not only the formal result should decide on the choice of therapy, but also in a justifiable dimension the way of treatment should be orientated on patients. The analysis of the anamnestic particulars showed, that also under psycho-social aspects the immediate surgical procedure has the advantage over conservative methods of treatment at Perthes' disease.
Adolescent↗
[Pathogen changes in bacterial bone and joint infections (osteomyelitis, spondylitis, arthritis)].
With regard to germ mutation in osteomyelitis, spondylitis, and arthritis it has been established that the frequency of Mycobacterium tuberculosis and the gram-positive pathogens (S. albus, Streptococci) has decreased in the last 20 years. To varying degrees, S. aureus and the gram-negative, aerobic organisms are the most important pathogens of bone and joint infections. Overall, there has been an increase in the frequency of infections with gram-negative, aerobic organisms. In the majority of cases the bone and joint inflammations were caused by exogenous factors, their course was chonic, and the typical localization was the lower extremity. There was a positive trend toward shorter periods of hospitalization and a shorter duration of illness.
Arthritis, Infectious↗
[Roentgenologic stages of Perthes disease].
Not only for giving the diagnosis "Perthes' disease" but also with regard to prognostic statements the knowledge of the radiological stages of Perthes' disease is essential. The present treatise demonstrates the radiological course of Perthes' disease, how it results from the evaluation of the courses of illness of 116 patients, which were treated in the period from 1965 to 1980 at the Orthopedic University Hospital Hamburg-Eppendorf because of a genuine Perthes' disease. The following schema turned out to be appropriate to the assessment: I. Initial stage, I a Early period, I b Late period. II. Florid stage, II a Sclerosing period, II b Fragmental period, II c Osteolytic period. III. Stage of regeneration. IV. Final stage.
Bone Regeneration↗
[Effect of various criteria on the course and therapy result in Perthes disease].
The present treatise gives an account of the courses of illness as well as of the results of a follow-up examination of 116 patients, which have been treated in the period from 1965 to 1980 at the Orthopedic University Hospital Hamburg-Eppendorf because of a genuine Perthes' disease. Sufficient documented courses are going back to the year 1952. In the centre of interest is the question about the influence of the method of treatment, of the patients' age at the time of giving the diagnosis as well as of the radiological stage of illness at the moment of giving the diagnosis on the course and on the therapeutic result of Perthes' disease. Clinical parameters have been subdivided in the classifications of Renckhoff (1975) as well as of Howorth and Ferguson (1934). The assessment of the radiological results took place according to the classifications of Sundt (1949) as well as of Bauer und Jünger (1977). 4 therapeutic groups, 7 stage of disease and 5 age groups have been differentiated. According to the results of this long-term study at the moment the immediate intertrochanteric varus osteotomy, independent of the radiological stage of disease and of the patient's age, is being looked upon as the best method of treatment for Perthes' disease.
Bone Regeneration↗
[Experience with a laterally-reinforced ankle sock].
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Ankle Injuries↗
[Partial replacement of the pelvis with the hip joint and proximal femur. A possibility in tumor treatment].
In cases of extensive destructive osteolytic processes in the pelvis and hip region, alloplastic replacement of a part of the pelvis with a total hip replacement and, if necessary, partial replacement of the femur, can represent a therapeutic alternative to hemipelvectomy for preserving the limb in the presence of malignancies; it offers the same degree of radicality in removing the affected bone and soft tissue while preserving the bone. This applies with regard both to primary malignant growths as well as extensive isolated metastases and aseptic osteolysis following multiple total replacement procedures. The partial pelvic prostheses, produced individually on the basis of roentgenograms, are adapted to a great degree intraoperatively and fixed with screws, locknuts, and Palacos, and if possible lined with autogenous bone. Where the defects are extensive the pubic bone of the unaffected side is incorporated in the stabilization. Experience gathered so far and follow-up examinations show that all patients regain full mobility and weight-bearing ability, with almost complete lack of complaints and adequate to good motility. This is demonstrated by examples.
Adult↗
[Results of rotation osteotomy using the Weber method in the treatment of habitual shoulder dislocation].
Weber's rotational osteotomy is a surgical treatment of recurrent shoulder dislocation. While eliminating recurrence of the complaint, it attempts to regain full range of movement in the joint. Of the 39 operated patients it was possible to follow up 34 cases. The percentage of recurrent dislocation was 5.7%. The range of movement was reduced in some patients; in one by 10 degrees - 20 degrees. Otherwise there were no significant complications or post-operative complaints. The operative technique, the X-ray procedure and the pathogenesis of the original dislocation are described. Typical accompanying injuries require a particular operative method. The most common accompanying damage was normally the typical defect of the humeral head (incidence 91%). The regular overstretching of the subscapular muscle and the defect of the humeral head are considered by the operational technique introduced by Weber.
Adolescent↗
[Orthopedic diseases in children and adolescents--indications for prohibiting sports participation].
School sports is not only a compensation for inactivity but also training and basic experience in many kinds of sports. The stress exercised by school sports is similar to that of hobby sports. The dimension of errors in respect of excessive stress in orthopaedic diseases and the biological development--acceleration/retardation--is important for prohibiting school sports in some diseases. The indication for prohibiting school sports either completely or incompletely in the most important orthopaedic diseases in childhood, is discussed. The special importance of part prohibition or participation without any giving marks, is emphasised.
Adolescent↗
[Early experiences with the total mini hip-joint endoprosthesis (St. George Mini model) in dysplasia coxarthrosis].
The results of 106 patients with osteoarthritis secondary to severe congenital hip dysplasia and dislocations of the hip operated at the Endo-Klinik were evaluated after an average follow up of 21 months. 142 "St. Georg-Mini" total hips were implanted employing Refobacin-Palacos R. The clinical results were graded as "combined performance" which considered hip pain, walking distance, hip mobility and walking aids. In 93% of the cases "combined performance" was improved at follow up and 91.7% of the patients were satisfied with the result. The early (during hospitalization) and late (after discharge from hospital) complication rate which had an influence on the result at follow up was 2.1% (n = 3) and 3.5% (n = 4) respectively. There were no deep infections. An extended indication for total hip arthroplasty also for younger patients with severe osteoarthritis secondary to hip dysplasia is discussed and can be advocated.
Adult↗
[Influence of axial deformities on the LDH isoenzyme of cartilage and synovial membrane in gonarthrosis].
Varus or valgus deformities and metabolic alterations of the articular cartilage and synovialis of patients with gonarthrosis (n = 67) had been analysed. The increase of axial deviation went together with a significant change of the LDH-activity of the cartilage. The increasing activity of the LDHH-subunits depending on the axial deviation corresponded exactly with the maximum stress on the articular surface calculated by Maquet. On the other hand alterations of the LDH isoenzyme distribution of the synovialis could be found with increasing activity of the LDHM subunits. A close correlation of the whole joint metabolism and the hypercompression of the cartilage is obvious.
Aged↗