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Biomedical subjects

H J Refior

Publications and source records attributed to H J Refior.

At least 127 records · Page 7Linked to original sources
PubMed1976

[The indication for intertrochanteric osteotomy of the femur based on late results (author's transl)].

57 intertrochanteric osteotomies of the femur were performed in 43 patients during childhood. A statement about late radiographic results is made, based upon follow-up examination after cessation of growth of the upper end of the femur. Attention was given to the development of the CCD-angle, the AC-angle, the CE-angle as well as the development of antetorsion. Further-more the evaluation included the development of the caput-epiphyseal angle as well as the development deformities of the caput femoris. The data presented show that satisfactory results can be obtained through Bernbeck's method and also through the presently used derotation-varisation-osteotomy involving wedge removal. However, the results show that the correction of CCD-angle and antetorsion alone frequently is not sufficient. Thus the acetabulum deserve greater consideration is discussing intertrochanteric osteotomy in childhood.

Adolescent↗
PubMed1976

[Plastic substitutes for old cruciate ligament ruptures. I. Material, methods, and indications (author's transl)].

A report was made of 101 old cruciate ligament ruptures which were reconstructed at the Orthopedic Hospital in Munich between 1963 and 1975. On the basis of this material, it was confirmed that the anterior ligament is predominantly affected. Injuries of the knee ligaments and, therefore, the cruciate ligaments were acquired by 67 of the 101 patients during the course of sport activity. Football had a particularly high injury quota. Single, isolated cruciate ligament injury was found in 17 cases. Combination injuries with stress on the medial structures of the knee joint were found in 84 cases. 39 cases came to surgery more than 2 years after the accident. In 29 cases, some type of surgery had been carried out previously. The measures used to restore function of the cruciate ligament in addition to tightening the anterior cruciate ligament were Brückner-plasty using the distally flapped medial third of the ligamentum patellae, the free ligamentum-patellae transplant, Augustine-plasty, distally flapped tendoplasty from the pes-anserinus group, Hey-Groves fasciaplasty as well as anterior cruciate ligament-plasty using the ventrally flapped internal meniscus. The necessity of reconstructing additional ligamentous lesions to eliminate complex instabilities was stressed. A plaster fixation is always carried out postoperatively in the lying cast on the thigh. This plaster fixation is completed by restorative measures at the collateral ligaments through a pelvic girdle. Remobilization should begin 6 weeks after the operation. Its length as well as the final result is determined by the condition of the joint before treatment, the technique applied and the postoperative complications.

Adolescent↗
PubMed1976

[The plastic replacement of old ruptured cruciate ligaments. II. Late results (author's transl)].

We discuss the results of postoperative examinations of 66 patients, who were treated at the Orthopaedic Hospital of the University of Munich by different methods of ligament grafts for old ruptures of the cruciate ligaments. Distally attached tendons of the pes anserinus group as replacement material show better results than distally attached medial thirds of the patella tendon. Biomechanical reasons are discussed, which have led to the changing of this method by using the medial one third of the patella ligament as a free graft. Advantages and disadvantages of fascia lata and the meniscus as a cruciate graft are discussed, a final judgement of the long term results is impossible with their small number of cases. In total an agreable subjective result was achieved in two thirds of the cases (60.6 per cent), an objective result from "very good" to "agreable" in more than three quarters of all cases (86.4 percent) be reparative procedures at the crucitate ligaments. Tightening or grafting of the collateral ligaments are discussed for its influence on the result of the cruciate graft. It is found, that with insufficient lateral stabilisation of the joint an eventually remaining anterior-posterior instability is increased as a rotatory instability. Finally it can be said, that only the repair of the loose posterior capsule in all ligament grafting procedures can lead to a final stabilisation of the knee joint.

Adult↗
PubMed1975

[Ruptures of the extensor mechanism of the knee joint (author's transl)].

Ruptures of the quadriceps tendon and patellar ligament are rare among injuries of the extensor mechanism of the knee when compared to fractures of the patella. 39 cases of which 31 were re-examined are being discussed with regard to therapy and results. According to our findings, ruptures of the extensor mechanism are not exclusively an injury of higher age groups. Predisposing factors for ruptures of the quadriceps tendon and patellar ligament are preexisting disease or posttraumatic sequelae. Fresh or old injuries require different operative technics. Usually, fresh ruptures can be repaired by end-to-end sutures. Old injuries require plastic procedures. Different technics are being described. Postoperatively, cast fixation is mandatory. The post-operative period of remobilisation is largely depend upon preexisting degenerative joint changes as are the post-operative results. A significant increase in post-operative osteoarthritis did not occur. Early degenerative changes in the femoro-patellar joint as seen on tangential views by the Settegast technic lead to the conclusion that the operative reconstruction does not always take into consideration the biomechanics of the femoro-patellar articulation. Immediate operative reconstruction of the ruptured extensor mechanism of the knee joint seems mandatory.

Adolescent↗
PubMed1975

[Microstructural examinations of the behavior of human cortical bone after compression osteosynthesis].

20 samples of human cortical bone removed from the subtrochanteric region after introchanteric femoral osteotomies with subsequent fixation by a blade plate were examined for studies of the phenomenon of cancellous transformation. Previous experiments with animals can be confirmed. A dilatation of Haver's canals in the direction from endosteum peripherally becomes apparent. This quantitative loss of cortical density is associated with a loss of mineral density. Under polarisation and scanning microscopy a derangement of collagen fibrils usually arranged in an oriented fashion can be shown. The loss of mechanical properties is discussed in connection with the derangement of orientation of collagen fibrils.

Animals↗