Biomedical subjects

H J Hesselschwerdt

Publications and source records attributed to H J Hesselschwerdt.

6 recordsLinked to original sources

PubMed1995

[Synovectomy of the knee joint in rheumatoid arthritis. Follow-up studies].

A total of 156 synovectomies were performed to treat recurrent swelling of the knee joints in 148 patients with rheumatic diseases. The late results observed in 112 patients (72%) re-examined after an average follow-up period of 6.2 years are discussed. The subjective and objective findings in patients undergoing early surgery proved to be superior to those seen after late synovectomy. Also in comparison with a group of patients submitted to synoviorthosis, surgical synovectomy, in particular when carried out at an early stage, showed more favorable results. For this reason, should conservative treatment fail, and recurrent swelling of the knee joints persist, early surgical intervention ist recommended.

Arthritis, Rheumatoid↗

PubMed1995

[Computer-assisted classification of ICD-9/10 and IKPM in compliance with the new federal health care regulation--practice-oriented solution for trauma surgery and orthopedics].

From the beginning of 1995, the German law on the health system structure prescribes that in all clinics the four-digit ICD code be supplied for each diagnosis and the ICPM code for each operation. This makes on-line access to diagnosis and therapy codes embedded in a clinic documentation system advisable. Since 1 February 1995, in one department of traumatologic surgery the ICD diagnosis and ICPM therapy coding is managed on-line by the doctors in the outpatient clinic and operation theatre, using the "do it" coding system in combination with the KAUZ system for clinic documentation. The user guidance supplied by a frequency-oriented menu and specialist traumatological terms makes it possible to determine the ICD and ICPM codes without any great expenditure of effort. Furthermore, the appropriate flat rates per case and special charges are displayed. Comparison of manual and computer-assisted coding of operations during 1 month (160 patients, 173 operations) showed that manual coding could be corrected or improved by the computerized system in 35% of cases. The ICD-10 system has already been integrated: it improves the recording of diagnoses and will simplify the change over to the coming new revision.

Electronic Data Processing↗

PubMed1990

[Metabolic diseases of bones. Catamnestic study of the incidence and kind of problems in surgical treatment].

By a catamnestic study at Orthopedic Department of Homburg/Saar University Clinic 156 courses of variant constitutional diseases of bone (1965-1986) were recorded. The frequencies of primary spontaneous fractures, fracture healing-disturbances, refractures and pseudarthroses after operative management of bone lesions or correction-osteotomies were of special interest. While there was no increased rate of traumatic or spontaneous lesions or prolongated healing-rate in case of Rickets and M. Ollier, those complications with need of osteosynthetic measures were more often due to M. Paget and M. Jaffé-Lichtenstein. As expected, osteogenesis imperfecta represented the highest rate of osseous lesions; an uneven situation was found among multiple/generalized epi- and metaphyseal dysplasias.

Adolescent↗

PubMedDate not supplied

[Mesomelic dysplasia: presentation of a case and literature of Werner's syndrome].

The extremely rare Werner syndrome (tibial hemimelia, foot polydactyly, triphalangeal thumbs) is represented by an own case: a 21 year old female has been treated since her birth in the orthopedic department of Homburg/Saar university clinic. First, during several operative sessions, there was the correction of the bilateral completely webbed fingers and the resection of the supernumerary toes. Because of tibial hypoplasia there was need of bilateral operative club-foot-correction, too. Presentation of the course over 20 years with clinical and roentgenological late results. In several publications we find different classifications of the collective name, tibial hemimelia'; the symptom-triade congenital tibia-defect/foot-polydactyly/triphalangeal thumb was of special interest.

Adolescent↗

PubMedDate not supplied

[Simple and valid ICD9-/10- and IKPM coding using an electronic data-assisted coding system "do it"--experiences after one years use].

UNLABELLED: Question by introducing "Fallpauschalen" and "Sonderentgelte" in German health system the coding of diagnoses and therapies gains a new momentum. Therefore, a new computer based coding-system for ICD- and ICPM- digits is presented. The physician gets enabled for simple and valid classification within his documentation routine. METHODS: Development of a hierarchic menue system, whose first part represents the anatomic region. The second part is reserved for the most common diagnosis rsp. therapies within its special anatomic region. By further sub-menues all other ICD numbers in the orthopedic and traumatologic field may be coded (selection related by frequency). This coding-system has been in clinical use since jan. 1st. 1995. RESULTS: Control of the efficiency of this coding-systems by 1316 patients with 1551 operations within one year. By using ICD-10, the representation of orthopedic-traumatologic diagnosis inhanced by factor 1.8 versus ICD-9. According to ICPM, 3560 therapies were coded, making it 2-3 actions per operation. "Fallpauschalen" were found in 21.9%, in 27.7% there were "Sonderentgelte". Within one year the coding error rate was reduced from 25% to 5%. CONCLUSIONS: Because of its easy handling the coding system "do it" represents a good alternative to conventional coding rsp. clear text analysis.

Data Collection↗

PubMedDate not supplied

[Endoprosthetic joint replacement in Morquio-Brailsford syndrome].

Morquio-Brailsford's disease belongs to the mucopolysaccharidoses, it shows growth-retarding with dysproportional dwarfism. Due to bone deformations and joint dysplasias very early severe arthritic changes arise with serious functional disabilities, especially in the loaded lower extremities; this may lead to early alloplastic joint replacement surgery. By means of two patients with respective bilateral THR and singular total knee replacement intraoperative complications and postoperative follow up (up to 12 years) are represented casuistically. Unfavourable anatomic properties (dysplasia, size of joints) were the main technical surgery problem; the use of individually manufactured implants might be recommended in some of these cases. The achieved subjective and objective functional results of our cases were-compared to the preoperative situation-altogether quite satisfactory.

Female↗