Biomedical subjects

G Hehl

Publications and source records attributed to G Hehl.

21 records · Page 2Linked to original sources

PubMed1993

[Post-traumatic leg length inequality after conservative and surgical therapy of pediatric femoral shaft fractures].

Between 1986 and 1991, 120 femoral fractures were treated in 116 children. The treatment of choice was conservative in young patients (overhead traction in 1- to 3-year-old children. Weber traction in 3- to 8-year-old children). Operative treatment was indicated in older children: plate fixation was performed in children between 5 and 16 years of age, while external fixation was used in children aged 2-14 years. In a retrospective study 66 femoral fractures in 62 children were reviewed and limb length checked both clinically and by ultrasound measurement. For ultrasound evaluation a special device was constructed to provide standardized measuring conditions. In 27 cases we observed specific complications related to the method. In all cases fracture healing occurred, but in 7 cases it was necessary to change the method of treatment. Ultrasound measurement revealed mean limb lengthening of 5.5 mm after overhead traction (max. 11 mm) and of 7 mm (max. 25 mm) after Weber traction. The median difference in leg length after operative treatment was 5.5 mm (max. 15 mm) for plate fixation and 8.5 mm (max. 25 mm) for external fixation. Our results allow no definitive statement on the most suitable treatment for femoral fractures in children (conservative versus operative treatment), except that children under 3 years of age are best treated by overhead traction.

Adolescent↗

PubMedDate not supplied

[Isokinetic muscle training with high motion speeds in the rehabilitation following surgical treatment of fresh anterior cruciate rupture].

In the course of a prospective investigation 17 patients with operatively treated acute anterior cruciate ligament ruptures received an isokinetic muscle training with high motion velocities in addition to the common physiotherapy from the 7th to the 19th week after operation. The comparative group consisted of 17 patients with operatively treated acute anterior cruciate ligament ruptures who were receiving the common physiotherapy only. The aim of the study was to improve both the postoperative dysbalance between agonists and antagonists and the active muscular stabilisation of the knee. The isokinetic muscle training was done with 150 degrees/s and a motion limit for flexion/extension of 0-20-90 degrees. The postoperative muscular dysbalance was improved significantly in the isokinetic group after 6 weeks of training compared to the control group. The flexion/extension ratio of the operated leg at 60 degrees/s came to 100% in the training group compared to 135% in the control group. This difference was even more apparent at 180 degrees/s with 100% in the isokinetic group compared to 160% in the control group and at 240 degrees/s with 110% compared to 200% respectively. The average maximum torque was 10 to 15% better with the training group as with the control group though there was no training of maximum force done explicitly. There was no effect on the postoperative anterior stability of the knee.

Adult↗

PubMedDate not supplied

Primary repair for posterior cruciate ligament injuries. An eight-year followup of fifty-three patients.

We reviewed 53 of 58 patients who had primary repairs of posterior cruciate ligament injuries between 1981 and 1988. Sixteen patients had isolated posterior cruciate ligament ruptures, 16 had complex injuries with capsular and collateral ligament involvement, and 21 had additional anterior cruciate ligament ruptures. Forty-six patients were treated by transosseous multiple-loop sutures and seven with bony avulsions by screw osteosynthesis. The mean follow-up time was 7.5 years (range, 3 to 12). All patients were examined subjectively (questionnaire) and objectively (clinical examination, KT-1000 arthrometer, functional testing, radiographs, and Cybex II isokinetic strength analysis). The results were graded according to the International Knee Documentation Committee evaluation form and the Lysholm score. The average Lysholm score was 82.4 (range, 40 to 100). Thirty-eight patients returned to their preinjury activities at the same intensity level. The patients' subjective assessments were normal or nearly normal in 35 patients. The posterior drawer test was negative or 1+ in 46 patients. Cybex isokinetic strength analysis revealed a decrease in quadriceps muscle strength of the involved limb by 10.5% (P < 0.01). Our data suggest that primary repair of posterior cruciate ligament ruptures provides good results after 8 years in approximately two thirds of the patients. Distal ligamentous ruptures, lack of athletic activity, and temporary olecranization correlated with poor results. Bony avulsions, midsubstance or proximal ruptures, and athletic activity correlated with good results.

Adolescent↗