S. Suzuki et al.: Ultrasound diagnosis of pathology of the anterior and posterior cruciate ligaments of the knee joint.
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Anterior Cruciate Ligament↗
Biomedical subjects
H Gerngross
Publications and source records attributed to H Gerngross.
Ultrasound scanning for the diagnosis of meniscal lesions of the knee joint.
We report on the efficacy of ultrasound scanning as a noninvasive method of the preoperative diagnosis of meniscal lesions of the knee joint, using the 7.5-Hz head of a real-time scanner. In studies on cadaveric knee joints we found a high efficacy in diagnosing meniscal lesions using ultrasound. Comparative clinical studies on 51 patients who had undergone preoperative ultrasound scanning showed a strong correlation of ultrasound diagnosis with intraoperative findings. Arthrography was performed in 24 of the 51 patients, yet ultrasound studies proved to be more effective than arthrography in diagnosing meniscal lesions. Consequently, we believe that ultrasonic scanning as a noninvasive method of diagnosis is more helpful in identifying meniscal lesions of the knee joint.
Arthrography↗
[Experimental and clinical studies of the use of thin-lumen polyurethane gravity drainage in accident surgery].
A clinical randomized study was conducted to compare 28 closed polyurethane (PU) drainage systems and 28 open polyvinylchloride (PVC) (Redon) drainage systems. The aim was to find whether the Redon drains could be replaced by PU drains without suction in the field of joint and soft tissue surgery. In another study, 27 PU gravity-drainage systems were implanted for surface electron microscopy. There was no difference in the volume of fluid drained. The tendency to diversion of the secretion induced by a thrombus in the drain was significantly lower in the PU drainage group than in the PVC-Redon group. Extraction of the drain was significantly less painful in the PU group than in the group with Redon drains. No complications occurred in either group. The surface electron-microscope study revealed slight adherence of thrombotic material to the inner wall of the drain in the PU group only. The thrombi were mobile and had a smooth surface, so that they could not block the drainage of secretions. In our opinion, PU gravity-drainage systems could be substituted for PVC-Redon drainage systems in the field of traumatology. This would exclude the potential toxic effects of PVC.
Drainage↗
[What suction drainage is optimal for drainage of wound secretion? A clinico-experimental study exemplified by the knee joint].
In a randomized clinical study on 40 intraarticular knee joint drainages the effect of a high vacuum, middle vacuum, low vacuum and suction free drainages were examined. The maximum of the volume that was drained had been in the group of the suction free drainages. Drains with a long period of suction had a minimum of evaluated ultrasonographic effusion in the knee joint. The group with high vacuum was obviously not as long as open as in the other groups. Thrombi in the drainages could be found in every group. This refers to the observation that the finding of adherent thrombi is related to the material the drain is made of. Adherent thrombi decrease the possibility of secretion, not adherent thrombi do not decrease suction volume. Referring to these results it is obvious that not the high-vacuum drainage is the matter of choice for intraarticular drains. The suction-free drainages or drains with reduced vacuum have more advantages in respect to simple, secure and fast implantation and handling.
Equipment Design↗
[Invasive measurement of compartment pressure based on piezo-resistance principles].
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Compartment Syndromes↗
[The use of bioresorbable implants (Biofix) in surgery. The indications, technic and initial clinical results].
Carrying out osteosyntheses with absorbable implants is a dream cherished by traumatologists for a long time. The absorbable rods available on the medical market comply within narrow ranges with the necessary conditions with regard to stability, absorption time and biocompatibility. In our clinical department 38 osteosyntheses with Biofix rods were performed. The complication rate amounted to 13%-5 abacterial disturbances of wound healing and secretions. The indications assured so far are limited to refixation of chondral and osteochondral fragments as well as the fixation of cortical-cancellous bone grafts.
Absorption↗
Total "internal" hemipelvectomy.
Several authors have described resections of tumorbearing parts of the pelvis including reconstructive plastic surgery. With extensive tumor growth present mutilating hemipelvectomies often have been the last resort. Even the most sophisticated prostheses hardly ever enabled the patients to walk again. We have therefore performed total "internal" hemipelvectomies in three cases. The necessary substitute consisted of half a pelvis made of polyacetal resin produced from a given model. The model's measures and shape was established by computer tomograms thus resulting in an individually shaped pelvis half. The operative procedure aims at the maintenance of osseous muscular insertions and origins and their reconstruction. Utmost care has to be taken in avoiding damage to nerves and vessels. Fixation of the implant is performed by screws aiming through the sacroiliac joint into ala and corpus of the sacrum and corticocancellous grafts incorporated in the implant. The symphyses are united by means of plate fixation. The hip joint is substituted by a total prosthesis. With the procedure described we have managed three cases of extensive malignant tumors of the pelvis. One patient suffered a nerve lesion and skin necrosis with infection. The two remaining patients are capable of weight-bearing and standing on the inflicted leg alone.
Adolescent↗