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Biomedical subjects

G Hierholzer

Publications and source records attributed to G Hierholzer.

At least 19 recordsLinked to original sources

[Treatment of closed dislocations of the knee joint].

Nineteen knee dislocations in 18 patients (one bilateral) occurred over a period of twelve years. The age range was 17 to 70 years with an average age of 33 years. There was no injury of the popliteal artery and five peroneal nerve injuries in the group. One compartment syndrome occurred after reduction. The follow-up study including examination showed good and satisfactory results for early surgical repair. After delayed surgical repair there were more signs of instability, pain and restrictive range of flexion movement. Early operative repair followed by cast bracing for six weeks and an intensive mobilisation therapy after cast bracing are the method of choice. An immobilisation period of three to four weeks is possible.

Adolescent

[Three-dimensional computerized tomography in trauma surgery. A case presentation].

Three-dimensional images of bone structures can easily be reconstructed from computed tomography data. The technique and the advantages of contemplating reconstructions of bone defects in different directions are described. A special software programme allows to combine all data which are given by the standard CT. The slice diameter is two millimetres. The reconstruction shows bone surfaces in all required views. In traumatic and orthopaedic surgery 3-D-CT is useful in the analysis, detection and preoperative planning of comminuted bone injuries of the spine, pelvis, knee, shoulder and the calcaneus. With this technique it is possible to see the bone in its topographic constellation, to observe fractures in unusual directions and to identify fragments from each other. The surgeon gets a lot of additional information which is helpful to decide on the incision, the reduction and the fixation of fragments. Undesirable effects during operation are reduced, which leads to a more accurate treatment and subsequent better results.

Accidents

[Indications, choice of procedure and results of conservative therapy of spinal injuries].

For conservative treatment of injuries of the cervical spine, two different methods are available: The HALO fixator and the collar. The choice depends on the kind and extension of the injury. Stable thoracic and lumbar vertebral fractures are treated in a conservative functional way in order to strengthen the muscular apparatus. Three-point-fixation with a brace is not necessary. Functional therapeutic methods can also be applied in the case of instable fractures if they are not operable. During a rigid confinement to bed, the postural reduction by increasing lordosis has turned out to be the treatment of choice. As an essential measure the patient has to take part in a "backschool" with postural exercises for the daily life.

Braces

Back school for patients with vertebral fractures.

Back school is behavior training for the prevention and treatment of back problems arising from faulty body posture and muscular dysfunction. This paper describes the conception and evaluation of a back school program for patients with vertebral fractures. The curriculum includes the provision of detailed information as well as physiotherapy, training in the right way to perform activities of everyday life, counseling, relaxation training, and self-monitoring. From October 1987 to June 1990 214 patients with vertebral fractures completed the back school program. The effectiveness of the program was measured by a knowledge test and a behavior test. The results suggest that this back school is an effective addition to conventional concept using physiotherapy exclusively.

Adolescent

[Analysis of the collective term "periarthritis humeroscapularis"].

The functional and anatomical consideration of the shoulder joint in relation to the clinical aspects can differentiate the general term of "scapulohumeral periarthritis". The most frequently pathological findings are seen in the rotary cuff and the long head of the biceps muscle. Significant causes are further arthrosis of the acromioclavicular joint, the instability of the shoulder joint and the frozen shoulder. The exact diagnosis of the disease makes on operative therapy possible.

Acromioclavicular Joint

[Indications for a bridging plate osteosynthesis of compound femoral shaft fractures].

We performed the clinical and radiological follow-up of 29 comminuted fractures of the femoral shaft treated by bridging plate osteosynthesis. Complete bone healing in 6 open fractures took place within 33 weeks, in 15 closed fractures within 22 weeks. We had to meet 5 postoperative complications: 2 cases of osteomyelitis following open fractures, 1 early wound infection and 2 haematomas. Primary cancellous bone grafting we found unnecessary in all of the 29 fractures. We recommend the technique of bridging plate osteosynthesis for the stabilization of comminuted fractures of the femur especially under the clinical circumstances as follows: 1. Polytrauma, 2. Metaphyseal or condylar fracture, 3. Open fracture, 4. Redisplacement, 5. Fracture in children.

Adolescent

[Incidence and causes of typical injuries in popular sports].

The increasing participation in extensive athletics and leisure time activities correlates with increasing sport injuries. The surgeons tasks include being involved in preventing sport injuries and ensuring a correct diagnosis, as well as providing adequate surgical therapy. After sport injuries, the true diagnosis can be obscured by functional compensation. Therefore the case history and analysis of the trauma mechanism are important for an adequate surgical therapy.

Adolescent

[Fractures of the femoral neck in old aged people (author's transl)].

Old aged people are more prone to accidents. This morbidity is caused by senile osteoporosis, preexisting diseases and other factors traumata. In most cases therapeutical problems of femoral neck fractures do not arise from surgery, but from general postoperative complications.

Adolescent

External fixation. Classification and indications.

The conclusion from the above clinical and experimental presentation is that stabilization by using external fixation in problematic cases is the method of choice because the risk of infection is better than by using the standard methods of plating and nailing. Using external fixation based on the tubular system of ASIF we can achieve rigid stability. Correct application allows early mobilization ensuring alignment even in bone defects. This method of treatment also facilitates the care of wounds. Our experimental and clinical information provides us with the opportunity to offer a systematic classification of each individual type of external fixation and its merits, as described above in types I, II, and III and its application in different situations. Our clinical experience also shows that external fixation has greatly reduced the risk of amputation in these problematic cases, but it has not solved all the problems associated with the primary injury. The advantage of the three-dimensional external fixation type III can also be seen in the case of arthrodesis of the knee joint. Here there is a better neutralization of the bending moment, than by using type II. Finally we would like to emphasize that the external fixation is not the panacea for every problematic case and each surgeon should be well aware of its methodical and correct application, as abuse of external fixation may lead to secondary complications.

Biomechanical Phenomena