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Biomedical subjects

G Hierholzer

Publications and source records attributed to G Hierholzer.

At least 55 records · Page 3Linked to original sources
PubMed1988

Corrective osteotomy of the distal radius after fracture to restore the function of wrist joint, forearm, and hand.

Eighty-two patients suffering from a severe deformity of the distal radius were operated on in the course of the past 7 years. The corrective osteotomy was done by implanting a corticocancellous bone graft to restore the correct angle of the joint surface and the correct length of the radius. In addition to this, a buttress T-plate was used, which could be removed 6 months later. In 80% of the cases the results with regard to the function of the patients' hands were good. The operative technique is standardized. It is possible to perform this kind of operation on patients of any age, and the procedure can check Sudeck's atrophy. When the obvious disability of the forearm is corrected the mobility of the wrist joint is simultaneously improved.

Adolescent↗
PubMed1988

Standard method for the investigation of bone transplants, ceramics, or other material in a human bony layer.

A new model for the investigation of human bone regeneration is introduced. We use the iliac crest as a bony layer for implants, which are the object of research. For therapy in cases of delayed bone healing the cancellous bone is removed. The empty iliac crest is then filled with the material we want to investigate. During a further operation necessitated by therapy of the bone disease, we obtain a probe of bone and material by drilling a hole through the iliac crest. This bony cylinder can be examined by histological techniques. We have used this procedure in 69 patients to date. No specific complications were caused by the implants. Fifteen biopsies could be taken and are now under examination. In the future it may be possible to breed new bone in this layer for further therapy and to fill the gaps at donor sites.

Bone Diseases↗
PubMed1988

[Clinical problems in fracture of the scaphoid bone].

UNLABELLED: The following specific characteristics of injury cause the problems that occur in scaphoid bone fractures: 1. Mechanisms of accident: There are only a few typical circumstances that cause the injury: as there are false winding of a shrankshaft handle or a fall on the extended hand. In all the other cases the accident is neither realized by the injured person himself or by the physician. As a consequence the possibility of injury of the scaphoid bone is not taken into consideration. 2. SYMPTOMS: In a stable fracture the symptoms do not appear directly but may be clearly delayed or they may disappear very quickly after a short period of intensity, so that the accident is no longer taken any notice of. 3. Radiodiagnostics: Because of the anatomic position of the scaphoid bone any X-raying from a lateral view is difficult because the scaphoid is covered by other carpal bones. In case of an undisplaced fracture you often only see very fine fracture lines, which are only to be seen from a direct orthograde view. It is necessary to X-ray the carpus in different positions. 4. THERAPY: If there is the slightest chance of a scaphoid bone fracture an intensive therapy must be directly started. An immobilisation for a too short period may lead to a delayed union and end in a pseudarthrosis. This is also the case if you start the therapy too late. Then the fracture line is already filled up by fibrous tissue. The latest period of time to begin a conservative treatment is six to eight weeks after the day of the accident.(ABSTRACT TRUNCATED AT 250 WORDS)

Carpal Bones↗
PubMed1988

[Dislocations of the elbow joint].

In a collective follow-up study the results of conservative and operative treatment of luxations of the elbow joint were assessed. In all, 433 patients were followed-up; 315 of them had a ligamentous injury, 225 flake fractures. Because of the amount of soft and bone tissue damage, 241 patients were treated operatively. The functional results of these operations were good in 90% and comparable to those in patients receiving conservative treatment. This confirms that operative treatment of elbow luxations has to be recommended in cases with considerable ligamentous and bone damage.

Adult↗
PubMed1988

[Significance of primary diagnosis in dislocations of the carpal bones].

In order to diagnose dislocation of carpal bones it is important to interpret the X-ray film correctly. In most cases of primary dislocations, closed anatomical reduction can be achieved. The resulting stability after primary reduction must be checked in moving the wrist under X-ray intensifier control. If there is reluxation or any persisting instability, operative treatment is indicated. By clinical examples it is shown that very good functional results are obtained after primary diagnosis and correct treatment. Regarding overlooked dislocation of carpal bones, therapeutic management is difficult and the clinical result is often unsatisfactory.

Carpal Bones↗
PubMed1987

The importance of trochanteric lag screws to achieve primary stability in cementless fixation of the RM hip prosthesis.

To allow the bony incorporation of a cementless prosthesis it is important to achieve stability at the time of operation. To neutralize tension and torsional stresses the RM-shaft prosthesis is fixed with two lag screws in the trochanteric part of the femur. By measuring the applied torque intraoperatively we could demonstrate that the threads of the screws found a better grip when inserted from the bone to the prosthesis. Thus, the stronger fixation of the screws enhanced the primary stability of the cementless prosthesis.

Bone Cements↗
PubMed1987

Severely comminuted femoral shaft fractures: treatment by bridging-plate osteosynthesis.

We report on 71 severely comminuted femoral shaft fractures that were operated on between 1980 and 1984 at the Berufsgenossenschaftliche Unfallklinik Duisburg-Buchholz. The method of operative stabilization was plate osteosynthesis in two variations: In one group 39 fractures (ten open) were stabilized by plate osteosynthesis after anatomical reduction of the fractured area. The other group comprised 32 fractures (six open) fixed with a bridging-plate osteosynthesis, without preparation of the fracture zone. The rate of postoperative complications was strikingly diminished after bridging-plate osteosynthesis. Fracture healing occurred within 23 (16-32) weeks after bridging-plate osteosynthesis and within 36 (32-40) weeks after anatomical reduction. No special instrumentation or equipment is necessary to perform a bridging-plate osteosynthesis. The patient rests in a supine position. There is no need for intraoperative image-intensifier control. For operative treatment of severely comminuted femoral fractures we consider the technique of bridging-plate osteosynthesis advantageous, especially in multiply injured patients.

Adult↗
PubMed1987

[Surgical hip joint replacement with a cement-free fixation technic--indications, technic and results].

There is reason to doubt the reliability of bone cement in joint replacements. In this paper we report about our indication for the cementless RM-Prosthesis and the follow-up examination of a group of 98 patients four and five years after total hip implantation. The rate of cup-loosening is lower than 1%, in five cases we had to observe stem-loosening. The artificial cup consists of high density polyethylene and has to be inserted with preload. The stem consists of polyacetal with a central metal reinforcement. A snap-fit 32 mm steel-head articulates with the acetabulum. From our experiments we know the importance of neutralisation of sharing and tension forces at the area of the greater trochanter.

Bone Cements↗
PubMed1986

The operative treatment of fresh ruptures of the acromioclavicular joint (Tossy III).

We give a preliminary report of ten patients with fresh dislocations of the acromioclavicular joint (Tossy III). All ten were operated with suture of the torn ligaments and indirect fixation of the acromioclavicular joint with a monocerclage wire passed around the coracoid process and the clavicle. Removal of metal was done 8 weeks later. None of the wires broke, and there were no problems with wound healing. Control X-rays under stress revealed stable acromioclavicular joints in all cases.

Acromioclavicular Joint↗
PubMed1986

[Peri- and postoperative preventive use of antibiotics in accident surgery].

To systematize the application of prophylactic antibiotics the classification of wounds into 4 groups is recommended corresponding to the risk of infection. Wounds without bacterial contamination, type 1: Prophylactic antibiotics are not indicated. Wounds type 2: Surgical and chemical decontamination have priority over antibiotics. Wounds type 3: Early antibiotic treatment is indicated if a sufficient débridement is not possible because of anatomical or cosmetical reasons. Wounds type 4: Delayed treatment of open fractures, treatment of infected fractures and fractures with faecal contamination require antibiotic therapy.

Anti-Bacterial Agents↗
PubMed1986

[Conservative or operative fracture treatment--alternative information in relative indications].

The aim of every treatment of bone fractures is the recovery of function. The treatment - conservative or operative - assumes the consent of the patient. This consent is only effective, if the patient is well informed about course and risks of the treatment. In case of alternative indication the information has to be alternative in reference to the typical risks. The information of the patient before immediate operative treatment and alternative indication might be problematic. It is possible to renounce any information but renunciation of information assumes a basic knowledge of both possible kinds of treatment.

Fracture Fixation, Internal↗
PubMed1986

[Anatomy of the ligaments of the upper ankle joint].

The ankle joint is stabilized by a specialized system of ligaments. These are the medial and lateral collateral ligaments and the anterior and posterior syndesmoses, the arrangement and orientation of which can only be understood in terms of function. In the vast majority of cases, injury involves the fibular capsuloligamentous apparatus which, according to anatomical and intra-operative findings, exhibits considerable anatomical variability, recognition of which is a prerequisite for the correct diagnosis and therapy of such lesions.

Ankle Joint↗
PubMed1985

[Polyvinylpyrrolidone iodine in accident surgery].

Indications and contraindications of local application of PVP-iodine in accident surgery were obtained on account of own investigations and the study of literature. For disinfection aqueous solutions of PVP-iodine do not have a complete antimicrobial spectrum. Only alcoholic PVP-iodine-solutions have complete spectra. Using alcoholic PVP-iodine-solutions to disinfect usually hands for surgery or hygiene the resorption of iodine is evident. This may cause disturbances of the thyroid gland. Disinfecting the area of surgery in one patient the resorption of iodine is tolerable. In contrary PVP-iodine today is needed for antisepsis especially in purulent situations. Additionally PVP-iodine is still the antiseptic of choice in the treatment of burn injuries. But because of the resorption of iodine the danger of hyperthyroidism in the group of patients with high risk must be kept in mind. Contraindications for the antiseptic therapy with PVP-iodine result from the investigations concerning the cytotoxicity and resorption of iodine. The application of PVP-iodine to rinsing fluids during aseptic operations, in the treatment of peritonitis or in suction drainages are not recommended any more.

Administration, Topical↗