Biomedical subjects
Publications and source records attributed to J Heisel.
First, the main operative techniques (Franke, Perthes, Bauer and Lindemann) are shortly described. Since 1964 we have performed in our clinic 20 tendon transplantations for radial paralysis, 16 of our patients could be controlled clinically 7.6 years average after the operation. The functional results were altogether very satisfactory.
Representation of the causes of failure of cemented total hip prostheses concerning long-term-results due to wear problems and cement destruction. In order to avoid a further weakening of bony structures we recommend the use of the self-locking Autophor-prosthesis (Mittelmeier) in case of revision. At the same time additional bone-grafting for better ingrowth of the prosthesis often becomes necessary. By means of the casuistry of our clinic (1975-1983) with altogether 102 revision cases with self-locking Autophor-prostheses we represent the results. With the exception of 5 failure cases these results were very satisfactory.
Metastasizing uterine leiomyomata are rare anatomical and clinical entities characterized by the early development of a uterine leiomyoma (average age 33 years), with the appearance of pulmonary metastases in the premenopausal period (average age 43 years). This clinical condition is somewhat puzzling because of two contradictory findings: the tumor's benign histology and its metastasizing capabilities. The prognosis is good due to its slow-growing characteristics and stabilization in the menopausal period.
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Reports about 147 ruptures of the Achilles tendon which were mainly caused by sports activities (85%). The authors also report on the operative methods used in our clinic, and on the long-term results (up to 16 years) of our cases. The complication rate was relatively low, and reoperations were necessary in a few cases. Healing of the Achilles tendon was achieved in every case. The disability to work was relatively short. Most of the patients were able to resume their former sports activity.
A brief outline of special morphological features of meniscus structure during growth is followed by an analysis of meniscus lesions during this age period. Between 1964 and 1981, we performed altogether 3,579 meniscectomies in our clinic; at that time, only 19 patients (0.5%) were between 3 and 12 years old, 223 cases (6.2%) between 13 and 18 years. Whereas dysplastic changes of menisci were the main causes for meniscectomy in childhood, traumatic lesions of the menisci were prominent in adolescence. A causal relationship to regular activity in sports is assumed. 188 cases (77.7%) could be controlled clinically after an average postoperative period of 8.5 and 10.0 years, respectively. The subjective results were altogether satisfactory. In 11 cases, x-ray examination showed arthrotic changes of the knee joint.
Report on about 67 cases of knee arthrodesis (septic and aseptic cases). In aseptic cases we preferred arthrodesis with autocompression plates in 21 patients. In the other cases we preferred Fixateur externe. We could follow up the patients for an average period of 25.4 months. The arthrodesis was consolidated in 98.3%; the infection could be cured in 92.9% of the cases.
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This is a report about the clinical and roentgenological results of 11 patients who had single lower-leg fractures (average age at times of operation 15.6 years) average 4.8 years after medullary nailing, and about 11 patients with single femoral fractures (average age at times of operation 13.3 years) average 6.4 years after the operation. The Küntscher-nail had already been removed. Beside inquiring subjective statements we checked the possible influence of medullary nailing on the still growing skeleton. We did not find any severe faults in axis or rotation. Acceleration or retardation of bone growth were mainly found in younger patients (10-12 years of age at first operation), in distal localised fractures or in case of longer pre- or intraoperative bone reduction. We did not find essential differences in length of the legs in cases where the fractures had been nailed during the final period of bone growth (15-17 years).
After discussing the relevant literature concerning indication, results and complications of total-hip-replacement by special prothesis of the upper end of the femur in cases of tumors or serious traumatic bone destructions of the intertrochanteric region of elder patients we representate our own 30 patients (from the years 1973 to 1982). Often, this special prothesis could be only a palliative regional solution in the cases of local removal of the tumor because of the advanced disease. But this treatment is important for temporary reconstruction; even in cases of aged patients with serious fragmented fractures of the pertrochanteric and subtrochanteric region we could reach an early remobilisation. This operation represents--in certain indications--an essential improvement of therapeutic facilities.
This is a report about the treatment and the results of 100 patients with primary traumatic dislocations of the shoulder. Dependent on the age of the patient the shoulder was kept in place after the reduction either by a shoulder-arm-plaster-cast for 3 weeks or by Desault's bandage for 4-7 days. 68 patients were controlled clinically and roentgenologically 1-6 years after the dislocation. The sight was kept on the function of the joint, on the development of calcifications of the capsule and on the occurrence of recurrent dislocations.
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The clinical application of the arthroscopy is described. The results of 300 cases are evaluated and discussed. There is a striking discrepancy between the clinical diagnosis before and after arthroscopy. The clinical diagnosis of a damage to the meniscus seems less reliable; the value of arthrography is limited, too. As conclusion it can be stated that the results presented favour a generous use of arthroscopy. More often arthroscopies will be performed after fresh injuries of the knee joint.