Search PubMed⌕ Search

Biomedical subjects

H Resch

Publications and source records attributed to H Resch.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Rotational deformities following pediatric femoral shaft fracture].

At the beginning of 1983 65 children who had been treated at our hospital for fractures of the femoral shaft could be followed-up both clinically and radiologically at an average of 29 months after the injury. The radiological examination was performed with special regard to the rotational deformity; the torsion was measured using Rippstein's method. Out of 65 patients, 19 patients showed a difference between the angles of antetorsion of more than 10 degrees (29.2%) which we considered to be "rotational malpositions" (8 patients with endorotational and 11 patients with exorotational deformities). 40% of all fractures localized in the proximal third of the femur were accompanied by a rotational deformity of more than 10 degrees as compared to the other side. Exactly 4 years later a second examination of antetorsion was made using the same methodical procedure. 18 out of the 19 patients with rotational malpositions and 2 patients with a difference between the AT-angles of exactly 10 degrees could be re-examined. The average correction in the overall population was 3.4 degrees (-10 degrees to +5 degrees). In 15 cases we found a decrease in the difference between the angles of antetorsion by 5.8 degrees on an average, 1 patient showed no change in the difference, and in 4 patients the difference had increased by 3 degrees on an average. In 7 of the 20 patients (35%) the difference between the angles of antetorsion was less than 10 degrees, whereas the rotational malposition persisted in 13 cases. The extent of correction was much larger in patients with exorotational deformities than in those with endorotational deformities. A very close relation could be seen between the age of the children and the extent of correction. Furthermore, rotational deformities caused by fractures of the proximal third of the femoral shaft showed significantly less tendency towards correction than fractures with a more distal location.

Adolescent↗
PubMed1989

[The technic of the Bankart operation. A modified reinsertion technic].

A modified technique of reinsertion of the capsule to the bony rim of the glenoid was developed and performed in 57 patients with recurrent anterior dislocation of the shoulder joint. The technique is described in detail. The principal idea of this modified technique is to suture the lateral flap of the capsule into a small sulcus, which is chiselled into the transition zone between the cartilage of the joint and the bony rim of the glenoid. From the bottom of the sulcus four holes are drilled just below the corticalis of the glenoid rim with a dental drill. The capsule is fixed by two U-sutures transosseously. The advantages of this technique are: (1) stable capsular barrier along the rim of the glenoid reinserted by two strong U-sutures; (2) no step between the cartilage of the joint and the reinserted capsule (a Hill-Sachs lesion cannot hook in at the Bankart lesion); (3) the sutures are extra-articular; (4) the lateral flap of the capsule must not be shortened, and therefore full shoulder motion can be obtained; (5) the tendon of the subscapularis muscle is restored to its original position on the lesser tuberosity; (6) a short period of postoperative immobilization. In accordance with the standard rating scale of Rowe, 31 patients were graded as having excellent results, 8 good, none fair, and none poor.

Adolescent↗
PubMed1989

[Shoulder dislocation and -subluxation].

The diagnosis and treatment of shoulder instability require basic differentiation between unidirectional, multidirectional, and voluntary dislocation. Within unidirectional instability primary dislocation, recurrent dislocation, and recurrent subluxation need to be considered separately.--Primary dislocation: In 160 patients with primary dislocation a follow-up was done by questionnaire. In the case of atraumatic primary dislocation the redislocation rate was 100%. Predisposing factors inherent in the bony, cartilaginous, and capsular components of the joint favoured the tendency of primary dislocation. In the case of traumatic primary dislocation the redislocation rate was lower after immobilisation of the joint than without when it had not been immobilised.--Recurrent subluxation: In 52 patients with a clinical diagnosis of recurrent subluxation a tear of the glenoid labrum was found by arthroscopy. In 21 cases the detached labrum was refixed arthroscopically and in 18 cases the repair was done by an open Bankart procedure. Seventy-two percent of the patients who underwent arthroscopic repair showed good to excellent results. In all cases but one in which the Bankart procedure was applied the results were excellent.--Recurrent dislocation: Since 1984 a total of 183 patients were operated on for recurrent shoulder dislocation. All these patients were examined preoperatively by CT scan. The CT findings were used in selection of the appropriate procedure. In 114 patients the Bankart procedure was applied and in 39 cases, a bone-block method. The remaining patients were subjected to various other procedures. Not one of the patients showed postoperative redislocation. (ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Value of ultrasonography in preoperative diagnosis of rotator cuff tears and postoperative follow-up.

Four hundred and six patients presenting with shoulder pain underwent bilateral shoulder ultrasonography. Rotator cuff lesions were diagnosed in 197 patients. In 155 of the 308 patients who had additional arthrographic examinations, the arthrogram documented rotator cuff tears. Sixty-eight patients underwent surgery. There was good correlation between the ultrasonographic and arthrographic findings as well as the surgical results, with a sensitivity of 91% for each examination technique. Thirty-six postoperative patients were studied ultrasonographically; a minor to marked increase in rotator cuff echogenicity was demonstrated in them all. Its high predictive value makes ultrasonography the method of choice in diagnosing rotator cuff tears. Based on the evaluation of particular criteria, rotator cuff tears (greater than 1 cm) are commonly documented by ultrasonography. Only in patients with indeterminate or negative ultrasonograms in whom there is a high index of clinical suspicion, should arthrography be performed as a complementary imaging test. In postoperative follow-up the degree of scar formation at the reinsertion of the tendon is adequately documented by ultrasonography.

Adult↗
PubMed1988

Double-contrast computed tomographic examination techniques in habitual and recurrent shoulder dislocation.

Preoperative planning of recurrent shoulder dislocation requires an accurate knowledge of bone and soft tissue lesions affecting the joint. A new method of double-contrast CT examination is presented which allows an accurate evaluation of the soft tissue structures important for the stability of the joint. Forty-two patients were examined with this technique, twenty-seven of whom (28 shoulders) were operated on, the procedure being selected on the basis of the CT findings. In all cases the preoperative CT findings corresponded to the intraoperative findings.

Contrast Media↗
PubMed1987

Effects of buphenine (nylidrin) on the perfused mammalian eye.

Buphenine (nylidrin), a beta-adrenergic agonist, is used therapeutically for its vasodilating effect on the peripheral circulation and possibly on the cerebral circulation as well. In spite of its ophthalmic usage in degenerative retinal disease and glaucoma, buphenine's ocular effects and their mechanisms are not sufficiently established. Consequently, we studied the action of 4.5-120 microM buphenine in isolated, arterially perfused cat eyes, and then used light-evoked electrical signals, perfusion flow rates and the diameters of the retinal vessels as parameters for the drug's effect. Our findings showed that buphenine induced a marked, dose-related, reversible increase in the amplitude of the electroretinogram (ERG) b-wave, a decrease in the c-wave, but no significant changes in the standing potential and light peak of the DC-ERG. The compound action potential of the optic nerve revealed dose-dependent and reversible changes in configuration. However, the flow of perfusate was not affected by the drug, and the diameter of retinal vessels did not change significantly. Our studies suggest that the interaction of buphenine with retinal adrenergic receptors is not related to the vasculature present but to elements involved in information processing. It is likely that these receptors are linked to neurons, since the beta-agonist affected the ERG b-waves as well as the compound action potential of the optic nerve.

Adrenergic beta-Antagonists↗
PubMed1987

[Comparative results of compression and non-compression operation methods following medial femoral neck fracture].

This is a personal clinical and radiological follow-up of 65 patients with fractures of the femoral neck who were treated in 1973 to 1984 at our hospital. 30 patients were operated by nailing according to Smith-Petersen and in 35 patients osteosynthesis was performed by means of three or four lag screws. A comparative study between these two methods was done. The two main complications of femoral neck fracture, a vascular head necrosis and pseudarthrosis, were of special interest. The mean follow-up time was 7.2 years with the fracture fixed by nailing and 4.1 years, with the fractures operated by lag screws. Out of the 65 patients the total rate of femoral head necroses was 21.5% and 10.7% of pseudarthrosis. In the fractures treated by the nailing method the rate of necrosis was 23.3% and the rate of pseudarthrosis 13.3%. In the fractures operated by lag screws the incidence of head necrosis was 20% and 8.5% by pseudarthrosis. Fracture displacement was primarily responsible for the development of aseptic necrosis, but we could see also a relation between head necrosis and the inclination of the fracture line. Fractures of the type PIII/GIII/IV are those with the highest rate of avascular necrosis. Furthermore, the development of both, aseptic necrosis and pseudarthrosis, is strongly influenced by incomplete reduction.

Adult↗
PubMed1987

[Significance of rotation errors in supracondylar humeral fractures in the child].

To get information about the importance of malrotation for posttraumatic varus or valgus deformity a clinical, radiological and CT follow-up examination of 20 children who were treated for supracondylar fracture from 1983 to 1985 was done. Rotational-displacement was measured on computed tomographical images taken from the region where fracture had happened. On the ap follow-up X-ray from both, the fractured and the other side, and the X-ray which was made after reduction, the medial and lateral colonne were measured from a "special point" in the middle of the shaft of the humerus. The length of the colonnes and their difference were compared. 15 of the 20 patients showed internal malrotation, 1 patient external malrotation and 4 showed no rotational-displacement. In 15 of the 16 patients with malrotation, the rotational-displacement caused a change in the length of the colonnes. Just in one case malrotation caused a minimal deformity of the carrying angle without alteration of the length of the colonnes. 93% of the cases with internal malrotation showed varus deformity. In 3 cases we saw growth disturbance of the epiphyseal plate, but the induced alteration of the length of the colonnes were minimal compared with the changes caused by malrotation.

Child↗
PubMed1986

[Sonography as a new diagnostic procedure for resolving shoulder problems].

Eighty-one sonographic examinations of patients with complaints relating to the shoulder joint have shown that this is the method next in value to radiological examination. So far, lesions of the rotator cuff and of the long head of the biceps could only be demonstrated by invasive procedures such as arthrography or arthroscopy. In these situations, sonography attains a similar accuracy. Diffuse lesions can also be diagnosed correctly, making arthrography and arthroscopy unnecessary. In addition, sonography can demonstrate inflammatory and degenerative changes and incomplete sub-acromial and intermediary tears of the rotator cuff, unlike conventional diagnostic methods. In future, arthrography and arthroscopy will only be necessary as additional diagnostic methods if sonography remains inconclusive.

Adult↗
PubMed1986

[Long-term results after conservative and surgical treatment of fractures of the distal end of the tibia].

This is a clinical and radiological follow-up on 78 patients with 84 Pilon tibial-fractures which were treated in our hospital between 1970-82. The fractures were arranged in three types after the classification of Rüedi, Matter, Allgöwer. 49 conservatively treated fractures were compared with 35 cases operated upon. The radiological follow-up focussed on posttraumatic development of arthrosis, the mobility of the ankle as well as on the posttraumatic result of reduction. The patient's own assessment concerning the result was found out by means of a questionnaire. The comparison of the fracture type I and II showed almost the same development of arthrosis after conservative and operative treatment, but the operated fractures of type III resulted in 33% in heavy arthrosis, whereas the cases treated conservatively showed heavy arthrosis in 50%. A close correlation exists between the quality of operative reduction and the development of arthrosis. A postoperative incongruity of the articular surface is followed by heavier arthrosis than a comparable incongruity after conservative treatment. An indication of an open reduction is given only if anatomical reconstruction can be predicted.

Adolescent↗
PubMed1985

[Roentgen examination in recurrent shoulder luxation--value of different exposure technics].

Clinical and radiological examination was done in 61 patients in whom a Bankart procedure had been performed. In an X-ray follow-up the value of different techniques proving the Hill-Sachs-lesion and degenerative changes of the bony glenoid rim, as described in literature, was investigated. Eight X-rays were performed in each patient. Most of the Hill-Sachs-lesions (76%) were found by internal rotation of 60 degrees in a.p. direction. A three dimensional idea can be obtained by an additional X-ray in tangential projection. Degenerative changes of the bony glenoid rim were found by the Bernageau technique in 25 percent. Standard X-ray before operation should include techniques in various projections: a.p. and simultaneous internal rotation of 60 degrees of both sides, tangential projection, and X-ray as described by Bernageau.

Female↗
PubMed1985

[Indications for the Bankart operation].

This is a clinical and radiological follow-up on 61 patients operated upon between 1973 and 1983 according to the Bankart technique. In 84 per cent of all cases primary dislocation had taken place before the age of thirty. On an average 11 recurrent dislocations occurred before the operative procedure was performed. The radiological follow-up comprised X-rays in a.p. position with internal rotation of 60 degrees, in tangent plane according to Hermodsson as well as in dorsal tangent plane. In the modified score of Caroit and Cyprien 34 operations had excellent, 25 good, 2 moderate and 2 poor results (recurrent postoperative dislocation and deep infection). Neglecting those cases with severe deformation of the glenoid one can state that the Bankart technique offers fair results in the treatment of recurrent dislocation of the shoulder.

Adolescent↗