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Biomedical subjects

H Tscherne

Publications and source records attributed to H Tscherne.

At least 325 records · Page 18Linked to original sources
PubMed1984

[Therapy of acute and subacute epiphysiolysis of the femur head].

Therapy and prognosis of the slipped capital femoral epiphysis are discussed in connection with the results obtained in the authors' own patients. Reduction of a dislocated femoral head is always desirable. If closed reduction fails, it will be necessary to reduce in full view. In smaller children, fixation is effected by means of several Kirschner wires, in older ones via screw osteosynthesis. Bone pegging or osteotomy are not suited for treatment of an acute or subacute slipped capital epiphysis.

Acute Disease↗
PubMed1984

[Traumatic shoulder dislocation. Late functional results with reference to the frequency of redislocation].

This study reports on the after-examination of 86 out of 107 patients with primary shoulder dislocation. Of greatest interest was the question which period of immobilisation would yield the best results. The most frequent type of dislocation was the subcoracoid position in 62% of all cases. In 44% the dislocations were associated with fractures especially of the greater tuberosity. The greatest number of dislocations occurred between 61 and 80 years of age (= 42%). The second highest number was found between 21 and 40 years of age (= 29%). In 47% of all cases the shoulder was immobilised for a week, in 40% between one and two weeks and in 13% for more than two weeks. The incidence of recurrence was 15% (13 patients). In 8 cases (= 9%) a recurrent dislocation of the shoulder resulted, whereas in 5 cases (= 6%) only one relapse occurred due to a repeated intense trauma. The function of the injured shoulder is most significantly impaired and rendered worse by the factors: higher age (greater than 41 years) and associated fractures. The duration of immobilisation itself has neither a significant influence on posttraumatic function of the shoulder nor on the incidence of recurrence. Therefore, an uncomplicated dislocation of the shoulder should be immobilised for a short period only. However, in cases of associated fractures, immobilisation will be necessary for a longer time.

Adolescent↗
PubMed1984

[Disorders of fracture and osteotomy healing. An analysis of aseptic complications].

The analysis of aseptic complications of bone healing shows that after conservative treatment failures are based mainly on an inadequate indication (37 of 68 patients). An operative procedure would have been better in these cases. Insufficient and recurrent reductions (11 of 68 patients) as well as over-extension with diastasis (9 patients) were less frequent. Osteosyntheses without bone healing were very frequent after failures in the operative technique (92 of 219 patients) and when bone defects (56 patients) remained. It is generally noticed that there is a relatively small number of bone healing problems following intramedullary nailing (13 patients) compared with plate osteosynthesis (119 patients). Both techniques are separately analyzed concerning the kinds of complications. Therapeutic priorities for the treatment of fractures are derivated.

Bone Plates↗
PubMed1984

[Indications and technic of functional fracture treatment with the Sarmiento brace].

Fracture bracing is a way of conservative fracture treatment on the extremities, which avoids fracture disease by long-term immobilization. Indication is given in humerus shaft-, ulna shaft- and tibia or lower leg fractures, if there is no contraindication like angulation, shortening, muscle distraction or nerve injury. If these and other contraindications are taken into account, functional fracture bracing can be expected to be successful.

Braces↗
PubMed1984

[Femoral neck fractures during the growth period. Treatment principles, results, prognosis].

Therapy and prognosis of femoral neck fractures in children is illustrated by means of 14 patients, treated by us. In adequate treatment, prognosis of fractures type II (medially) and III (laterally) is good. Medical care has to relieve the hip joint emergently, either by operative opening of the joint during osteosynthesis or at least by punction. Because of the tendency to dislocation, it is necessary to make an internal fixation even of little or not dislocated fractures of the neck. Screws are best suited for osteosynthesis. They must not cross the upper femoral epiphysis. To prevent further damage to the epiphyseal plate, the traumatic separation of the upper femoral epiphysis (fracture type I) is stabilized by K-wires. The postoperative treatment in a spica cast is necessary only in unreliable children.

Adolescent↗
PubMed1983

[Management of wounds in fractures with soft tissue injuries].

The results of fracture treatment are based mainly on the correct management of the soft tissues and the correct estimation of damage to muscles and skin. Depending on the extent of the soft tissue damage closed and open fractures are divided into four categories. The important principles in the management of fractures in connection with soft tissue injuries are: Reduction and splinting of fractures and sterile wound dressing at the scene of the accident avoids infection and posttraumatic damage of the soft tissues. Debridement must include the excision of all avascular and polluted skin, muscle and bone. Primary rigid internal or external fixation is considered as optimal for guaranteeing undisturbed healing of fracture and of soft tissues. Wound closure has to be absolutely strainless. In most cases the wound should remain open and be covered with artificial skin. Delayed closure may be done by means of split-thickness skin grafts, muscle transfer or free tissue transfer with microvascular anastomosis. In the future, the surgeon should pay close attention to closed fractures in connection with severe soft tissue damage. Likewise, these injuries demand an urgent and meticulous surgical procedure.

Anti-Bacterial Agents↗