Biomedical subjects

H U Sons

Publications and source records attributed to H U Sons.

41 records · Page 3Linked to original sources

PubMedDate not supplied

[Diagnosis and therapy of sternoclavicular joint dislocation].

Luxation of the sternoclavicular joint is described on the basis of the case histories and progress of patients with this very rare form of injury who underwent surgical treatment on the Orthopedic Clinic of Düsseldorf University Hospital in the years 1978 to 1988. Four of the 6 patients in our study were subjected to a follow-up examination as out-patients. After preliminary remarks on the anatomical and biomechanical peculiarities of the sternoclavicular joint, the various types of luxation and the customary Allmann I-III classification for degree of severity are discussed. Surgical treatment is essential only for injuries of the IIIrd degree. Dislocation of the sternal end of the clavicle is most frequently found ventrad, as was also the case in all 6 patients in our study; the rarest finding is dorsad. The symptoms and the necessary diagnostic measures are described. Surgical treatment of the retrosternal luxation of the sternoclavicular joint is indicated as absolutely essential on account of the possibility of life-threatening complications. A relative indication of operative treatment exists for anterior luxation of the sternoclavicular joint where severe functional impairment and pain are present, e.g. during work and sport. The various operative methods currently in use are described. Reference is made to the importance of imaging techniques. A warning is given that, because of the risk of fatal complications, Kirschner wiring should not be used for retention of the reduction unless the K-wires are reliably secured.

Adult↗

PubMedDate not supplied

[Correlation of the degeneration of the AC joint (acromioclavicular) and rupture of the rotator cuff].

During the past various factors were quoted to be causative of a degeneration of the rotator cuff. In this study 122 shoulder specimen, aged 58-95 years, were dissected. A high correlation between severe degeneration of the ac-joint and rupture of the rotator cuff was found. The correlation was even higher between distally pointing osteophytes and cuff ruptures. The results demand to clearly define the degeneration of the ac-joint and the rotator cuff in patients suffering from shoulder pain. A simultaneous occurrence has to be considered. If conservative treatment fails in patients with cuff tear and ac-joint degeneration, surgical revision is recommended. This should comprise: 1. suture of the cuff-rupture 2. excision of the coraco-acromial ligament 3. anterior acromioplasty according to Neer 4. excision of the outer end of the clavicle

Acromioclavicular Joint↗

PubMedDate not supplied

[Sternocostoclavicular hyperostosis].

On the basis of 4 patients from our own records we describe the rare syndrome of "Hyperostosis sternocostoclavicularis". The etiology of this disorder is still unclarified. In addition to a swelling that is generally only slightly tender to pressure, the most important symptom is usually a long-standing, intermittent, dull pain in the upper sternum, the claviculae and the adjacent uppermost ribs. Laboratory diagnosis usually shows an accelerated blood sedimentation rate, but other laboratory findings are unremarkable and rheumatological serology gives a negative result. The changes detected by radiography are described, as are the histological findings. Primary or secondary malignant osteomas are also to be taken into account in differential diagnosis. For therapy most authors recommend medicinal treatment with non-steroidal antiphlogistic agents.

Adolescent↗

PubMedDate not supplied

Results of surgical treatment for acute pancreatitis.

The results following the surgical treatment of acute pancreatitis in 67 patients are presented. The male:female ratio was 1.5:1; the average age for all patients was approximately 54.5 years. From an etiological viewpoint, biliary pancreatitis was found in 50.7% of the cases, followed by alcoholic (32.8%), idiopathic (7.5%), postoperative (6%) and traumatic (3%) pancreatitis. In most cases drainage operations were performed (92.5%) in conjunction with necrosectomy, whilst resectional techniques were used in five patients (7.5%). The perioperative mortality for all patients was 30%; it was higher among patients operated upon in the first week (44%) than in those whose operation was delayed (12.9%). The extent of organ necroses and the presence of extrapancreatic necroses were of decisive prognostic significance. The findings are compared with data given in the literature.

Acute Disease↗

PubMedDate not supplied

Gastric carcinoma after surgical treatment for benign ulcer disease: some pathologic-anatomic aspects.

The study presents the autopsy findings on 55 patients with carcinoma of the operated stomach. This figure corresponds to a proportion of about 0.12% of the total number of autopsies (46,593) in the period under review (1950-1982), and of about 7.24% of the overall number of gastric carcinoma patients autopsied during that period. The male:female ratio was 5.1:1. The average "free interval" until the manifestation of cancer was 22.6 years after Billroth II resection, 23.4 years after Billroth I resection, and 34.4 years in the case of patients upon whom gastroenteroanastomosis had been performed without resection. The older the patient was at the time of the operation, the shorter was the interval before the occurrence of gastric cancer. In the majority of cases the carcinoma was localized in the gastric stump (65.4%), whereas in a quarter of the cases (25.5%) the carcinoma occurred in the area of the anastomosis itself, and in 9.1% of cases it was localized in the region of the cardia. Histologic classification of the tumors revealed 52.7% as being predominantly of the intestinal type, and 38.2% as being predominantly of the diffuse type. The organs most frequently affected by direct tumor infiltration "per continuitatem" were the pancreas (18.2%), liver (16.4%) and colon transversum (14.6%). The lymph nodes most often affected were the paragastric (63.6%) and parapancreatic lymph nodes (49.1%), those at the porta hepatic (38.2%) and the para-aortal (34.6%) lymph nodes. Haematogenous metastases were found most frequently in the liver (30.9%), skeletal system (16.4%), adrenal gland (10.9%) and lung (9.1%).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗