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Biomedical subjects

H Reilmann

Publications and source records attributed to H Reilmann.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Para-basal metatarsal V fracture: conservative functional treatment].

Fractures of the fifth metatarsal bone, mostly avulsion fractures that result from forced inversion of the plantar foot, are relatively common. There are two distinct types of fracture that involve the proximal portion of the fifth metatarsal bone. The first type is the proximal diaphyseal fracture, the so-called Jones fracture, and the second type involves the area of the metatarsal tuberosity. They are usually not displaced or only slightly displaced. The standard treatment is a below-the-knee walking cast Osteosynthesis for fractures of the fifth metatarsal bone is indicated only in cases where significant displacement cannot be corrected by closed reduction. At the Department of Traumatology in the Städtische Klinikum Braunschweig. 51 patients (32 male, 19 female) with an avulsion fracture of the proximal diaphyseal portion or a Jones fracture of the fifth metatarsal bone were treated functionally with a brace (Caligamed II). The average displacement was 1.4 mm (range 0.8-4.0 mm). In each case the fracture was treated for 2-3 days in a short leg cast and additional antiphlogistic medication was applied. After edema had been reduced, every patient was fitted with a carefully adapted Caligamed II brace, and this was followed by intense mobilization and walking therapy. The average follow-up in this study was 14.2 +/- 1.8 month. In this protocol the patients were examined at our clinic during the first week after trauma in order to check the brace again, again after 5-6 weeks for X-rays and to remove the brace, and for a final check-up after 12 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

[Prevention of thrombosis in ambulatory patients].

In surgical outpatients who required immobilization with a plaster cast because of injury to the lower limb a deep vein thrombosis occurred in 14%. General thromboprophylaxis seems advisable for surgical outpatients and depends on the severity of trauma and thrombosis risk factors. In a study of 97 patients who received a daily subcutaneous injection of heparin fragment calcium throughout their cast period, only one patient with a deep vein thrombosis was seen.

Adult↗
PubMed1992

[The Pelvic Professional Section of the German Society of Accident Surgery and the German Section of AO-International].

On the occasion of the 1990 Conference of the German Society for Accident Surgery (DGU) in Berlin, a working group "Pelvis" of the DGU and the AO International was established on the initiative of H. Tscherne. It is the objective of this working group to formulate guidelines for the diagnosis and treatment of pelvic girdle fractures, within the framework of a prospective multicentre study based on comparable results. In the annual report for 1991, a total of 460 pelvic fractures were documented. Classification shows that 9.5% belong to group A, 46.3% to group B, and 44.2% to group C. One hundred and eighty-two patients (39.6%) had an isolated pelvic injury, while 278 (60.4%) sustained multiple injuries. The average polytrauma score for all 460 subjects was 23.2 points. The surgical management was shown to depend on the severity of the fracture.

Adolescent↗
PubMed1992

[Long-term results of treatment of supra-condylar humerus fractures in children].

From 1982 to 1986, a total of 106 children with supracondylar fractures of the humerus were treated at the trauma surgery clinic in Braunschweig. Undisplaced or slightly displaced fractures were treated with plaster casts. More severely displaced fractures were initially treated by closed reduction under general anesthesia and percutaneous Kirschner wiring. In 72 cases (= 85.7%) a follow-up examination revealed a very good or good result. In 9 cases (= 10.7%) satisfactory results were found and in 3 cases (= 3.6%) unsatisfactory results. The most common complication prejudicing the result was cubitus varus. It was found in 27 cases (= 32.1%), most often with a varus under 10 degrees (19 of the 27 cases). A retrospective study of the 12 cases in which the results were classified as satisfactory or unsatisfactory showed 8 insufficient reductions in fractures with severe instability.

Adolescent↗
PubMed1989

[Pathologic fractures in dialysis-associated amyloidosis].

A correlation could be demonstrated between four pathological femoral neck fractures in patients who regularly underwent hemodialysis; cystic bone deposits of beta-2-microglobulin amyloid were also found. The characteristic symptom complex includes painful arthralgia of the shoulder, carpal tunnel syndrome, pain in the hip and recurrent knee effusions. The first step in the diagnostic procedure is to demonstrate cystic defects in skeletal radiographs. Then a biopsy of the cystic bone lesion is needed for histological verification of beta-2-microglobulin. The surgical treatment is total joint replacement or augmented composite osteosynthesis due to poor regeneration capacity in the amyloid bone lesion.

Aged↗
PubMed1988

[Risk of lung embolism following preventive intravenous use of heparin in polytraumatized patients].

The risk of thrombo-embolic complications in multiple injured patients is increased due to several pathophysiological factors. The purpose of this study was to analyse the effect of a continuous IV heparin prophylaxis (10000IE/24h) in polytraumatized patients. A post-mortem evaluation of 72 decreased patients out of 373 multiple trauma patients treated during 1984-1985 was performed. In one patient multiple major pulmonary emboli were found to contribute to his death. No deep vein thrombosis as well as no fulminant pulmonary embolism were found in any case.

Adolescent↗
PubMed1988

[Prevention of thromboembolism in surgery].

Thromboembolic complications are one of the most common complications in patients undergoing major surgery or conservative treatment in cast. The incidence of thromboembolic complications is the highest in orthopedic and trauma surgery. Stasis in the deep veins of the lower extremity, intimal damage and disorders in blood coagulation are important factors in the pathogenesis of deep vein thrombosis. The most important predisposing risk factors are age, previous thrombosis, varices and the combination of oral contraceptives and smoking. 50% of thrombosis begins intraoperatively and 80-90% in the first 3-4 days after operation. The incidence of thromboembolic complications was significantly reduced after introduction of low-dose heparin and heparin with dihydroergotamine in the perioperative regimen. Recently various investigations demonstrated that low-molecular-weight heparin (LMWH) is equally as effective as a low-dose heparin regimen in preventing postoperative thromboembolic complications. Our own management of prophylaxis of thromboembolic complications is presented. In a prospective pilot study 100 trauma patients were evaluated. 84 patients received LMWH plus dihydroergotamine (DHE), 12 patients heparin alone because of contraindications for DHE and 4 patients received a low dose continuous intravenous heparin prophylaxis because of high risk. Two deep vein thrombosis occurred, one in a patient with high risk prophylaxis and one in a patient with a subcutaneously heparin prophylaxis. No thromboembolic complications occurred in patients with LMWH + DHE prophylaxis.

Heparin, Low-Molecular-Weight↗
PubMed1984

False aneurysm of the femoral artery due to an osteochondroma.

Two cases of primary misdiagnosis of a posttraumatic false aneurysm are reported. In the first case a twenty-year-old patient was hospitalized under the diagnosis of a malignant soft tissue tumor five weeks after a kick against the right distal thigh. Diagnostic procedures performed in our clinic, however, led to the expectation of a false aneurysm of the femoral artery, caused by perforation of the wall of the vessel by an osteochondroma. Intraoperative findings confirmed this and led to the supposition of a connection with the mechanical trauma. The postoperative course was uneventful. The second case had a similar history. Prophylactic excision of osteochondromas in areas with increased risk of perforation, as in the region of the femoropopliteal junction, is recommended.

Adult↗
PubMed1983

Frequencies of segmental perfusion and ventilation abnormalities in lung scintigraphy.

The segmental ventilation-perfusion mismatch is almost invariably a sign of pulmonary embolism (PE). As ventilation scintigraphy is an expensive and time-consuming procedure, it is rarely performed in patients presenting as emergencies. In such patients PE is diagnosed by the presence of a segmental perfusion defect (SPD) in combination with a normal chest X-ray. However, little is known about SPD frequencies in different groups of patients or its value in predicting a mismatch. To determine this frequency, as well as its predictive value for a mismatch (PVM), we examined 764 patients with suspected Pe (PE? group), 359 patients at low risk for PE (low risk group), and 234 patients without suspected PE but at high risk for PE (high risk group), all by perfusion and ventilation scintigraphy. Frequencies of SPD were determined in each group as a function of age. PVM was calculated for each age subgroup using Bayes' theorem. In the low risk group the frequency of segmental mismatches (SM) was about 4%, while one-third of patients at high risk had a SM. This was not age dependent in contrast to the PE? group, where the frequency decreased with age. In the youngest subgroups the PVM for a SPD was higher than 0.9 as well as in a subgroup of the PE? group with a known thrombo-embolic disease. In these subgroups a ventilation scintigraphy is not required for the scintigraphic diagnosis of PE; in all other patients an additional ventilation study is necessary.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Regeneration and function of autologous splenic grafts in pigs.

The growth kinetics, perfusion and immune response of autotransplanted splenic tissue were studied in pigs. Splenic fragments were transplanted subfascially or in the greater omentum and regenerated to small splenules with a normal histologic structure 6 months later. The grafts showed a normal function of the white pulp after antigenic stimulation, and of the red pulp as demonstrated scintigraphically. The blood flow was reduced. The growth kinetic was less rapid than in rodents and resulted in a relatively lower mass of splenic tissue, but these results are closer to findings in human splenosis.

Animals↗