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Biomedical subjects

H Ecke

Publications and source records attributed to H Ecke.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Arthrolysis of the elbow joint].

Promising results can be achieved in arthrolysis of the elbow joint in case of a strictly observed indication and if the intervention is carried out by an experienced surgeon. The problems of motivation in case of an existing indication are described. Only a motivated patient will be capable to cooperate to such an extent as is necessary for the postoperative follow-up treatment. Good results are subject to three conditions: the performance of the surgeon, i.e. the intervention itself, cooperation, and follow-up under medical supervision. This last point is especially important for the therapy result, because at present several health insurances have formed the opinion that after the operation the patient shall be abmitted for example to a physiotherapeutic institute without constant medical control. This is just the way which produces deleterious results especially following to arthrolysis, but also after all other accident surgeries and in particular after joint operations.

Ankylosis↗
PubMed1986

[Autologous blood-antibiotic filling as effective therapy of chronic osteomyelitis].

A control of osteomyelitis by parenteral administration of antibiotic drugs is not possible due to sequestration, thrombosis of the peripheral vessels, and encapsulation of the osseous focuses. The autoblood-antibiotic plombage was indicated in 1951 by Winter. The principle used for this method is the concentration of one or more antibiotic drugs in an autogenic carrier releasing the drugs which then exert their effect directly at the site of the disease. In the experimentation on animals, the streptomycin level in the peripheral blood decreases only after 130 hours to the inhibiting threshold value of 0.008 g/ml. The autoblood-antibiotic filling becomes a connective tissue filling and, about seven weeks later, a bone filling. There are three conditions for a therapeutic success of the antibiotic plombage. 1. It must be only a limited, unilocalized, not too extended bone process. 2. large débridement and sequestrotomy, and 3. the bone must be provided with an own absolute stability. 74 out of 112 patients treated with an autoblood-antibiotic plombage were immediately free from symptoms. Two thirds of these patients showed a superficial recovery.

Administration, Topical↗
PubMed1986

[The Giessen model of a cement-free implantable total endoprosthesis for the hip joint].

Complete endoprostheses of the bitrochanteric type were implanted in Giessen in 111 patients the average age of whom was 74 years. Computer-assisted evaluation showed that more than 70% of these patients developed autonomous mobility. The rest had not been able to walk before surgery, but could be nursed or became able to sit after the operation or were still followed up. At the end of follow-up treatment, a rate of 90% of mobile patients with or without stick is to be expected. Initially, the implantation technique is certainly more difficult to learn with this model than with other allo-endoprostheses of the hip joint. This is due to the fact that the implants are an exact replica of the pertrochanteric region, thus permitting a broad contact face to the cortical substance instead of the punctiform contact of some other models. Once learned, the technique can be applied without considerable problems. At our Department it has proved to be successful.

Aged↗
PubMed1985

[Considerations on the time of surgery of femoral fractures].

As shown by a study elaborated in 1980 by the A.O. (Working Association for Osteosynthesis) which was based on the data of 1127 patients, the number of general complications occuring during the primary treatment of fractures of the femur had increased by 13%. However, this study also comprised a great number of polytraumatically injured persons possessing other indications for surgery than patients with monosseous fractures of the femur shaft. So all monosseous fractures of the shaft were compiled with the aid of the A.O. computer in Bern, and 1257 cases were received. It is clearly demonstrated by evaluating these cases that a primary treatment of fractures of the femur has a significantly better effect than a delayed treatment. The number of cardiac complications increases with the time interval passing between injury and treatment. The same effect was not statistically proved for pulmonary complications; on the contrary some pulmonary complications occured during primary treatment in young patients, i.e. in a group of patients where this is expected least of all. For the future, the circulatory parameters of these patients must be estimated with special accuracy. Fatalities only occurred in the group of the oldest patients; the number of deaths increased significantly with the time interval after the injury. The differences between the present study and the preceding. A.O. study of 1980 are explained by the relatively great number of polytraumatically injured persons with fractures of the femur included in the first study. However, no satisfactory explanation does exist for the deaths occurred in 1972 at our own hospital, mentioned at the beginning of this report.

Adult↗
PubMed1985

[Continuity resections of long tubular bones and subsequent bone reconstruction].

The osseous restitution of extended deficiency pseudarthroses is possible by means of modern osteosynthesis methods which exactly immobilize the bone. However, numerous operations are required in order to prevent infections and to reconstruct the osseous stability by subsequent bone chip grafts. The treatment may take three to five years, and relapse and even failure will occur frequently. This aspects have to be discussed with the patient before beginning such a treatment, and there must not be any doubt that the patient really desires to be treated in this way.

Adolescent↗
PubMed1984

[Surgical indications and choice of procedure in distal radius fractures--wire, plates, external fixation].

The treatment of the typical fracture of the radius is predominantly conservative. Unstable fractures, bending fractures and open fractures will receive operative treatment. Hereby Kirschner wires, blade plates and screws are applied for osteosynthesis. Heavy comminuted fractures were stabilized, besides by minimal osteosynthesis, by a mini-external fixation unit. The results of operative treatment in the Unfallchirurgische Klinik Giessen were in 50% excellent and good, in 38% satisfactory and in 12% bad. The main complications were disturbances of sensibility in the area of the superficial branch of the radial nerve.

Adult↗
PubMed1983

[Osteosynthesis procedure in replantation surgery].

A number of methods of bone fixation are recommended in microreplantation, none of which fully meets the requirements. The individual procedures are shown and their suitability for stabilisation of the long bones of the hand is discussed. The oblique Kirschner wire with either transosseous wire or a parallel bore wire emerges as the method of choice. Until an alternative method, such as a resorbable bone-peg, is developed, which might possibly satisfy the requirements completely, this procedure must be preferred.

Amputation, Traumatic↗
PubMed1982

[Results of surgical treatment of recent capsular ligament lesions of the knee joint (author's transl)].

During the period from 1971 to spring 1981, 85 patients with recent ruptures of the knee ligament were operated at the Hospital of Accident Surgery of Giessen. After 38.3 months on an average, 55 patients could be submitted to a follow-up examination. This examination comprised subjective troubles, clinical and X-ray examination of the injured knee joints. Above all, the full loading capacity of the operated extremity with a good mobility of the joint was evaluated. A good result was achieved in more than half of all cases. Only five patients showed an unsatisfactory results. A good result can only be achieved by an exact reconstruction of all injured structures carried out during the first few days following the accident. A later treatment of capsular ligament lesions will bring worse results.

Adolescent↗
PubMed1981

[The polytrauma, a task for different fields (author's transl)].

Different fields and specialities have been developed within surgery. This has yielded basic knowledge and good therapeutic results. Today even in patients with multiple injuries a satisfactory rehabilitation can be achieved. The treating surgeon has to coordinate the different fields. As coordinator the traumatologist is the most suitable person, as he is trained in various fields of surgery. One-sided thinking would jeopardize the presently available as well as the obtainable results in the treatment of polytraumatized patients. The best results can be achieved only through a synthesis of the various fields.

Accidents, Traffic↗
PubMed1980

[Analysis of the therapeutic results in 1127 patients with fractures of the femur in the Federal Republic of Germany and in Switzerland (author's transl)].

Under the aspect of quality control of the surgical treatment the results of femur-fractures of 1127 patients were scrutinized. These patients were treated in 16 German and in 21 Swiss AO-hospitals. Different complications are discussed. The study shows that not so much the chosen method of osteosynthesis is of paramount importance, but the way it is performed, especially if the surgical technic is done according to standardized principles and biomechanical rules. As the injuries are in many cases very severe and as in many patients the fracture of the femur is only part of the polytrauma, the results are satisfying.

Adult↗