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Biomedical subjects

K E Rehm

Publications and source records attributed to K E Rehm.

At least 91 records · Page 5Linked to original sources
PubMed1992

[Anomalous course and anomalous division of the median nerve in the distal forearm].

An anatomic variation of the median nerve is demonstrated in a female patient suffering from carpal tunnel syndrome subsequent to a distal radius fracture with malalignment and reflex sympathetic dystrophy. The median nerve coursed anterior to the superficial flexor tendons from proximal ulnar toward the distal radial region of the distal forearm, giving off an ulnar branch just 2.5 cm proximal to the flexor retinaculum. This case proves that in the distal forearm, branches of the median nerve can be found both radial and ulnar to the midline.

Carpal Tunnel Syndrome↗
PubMed1992

[Mechanical properties of PDS-augmented patellar tendon transplants in reconstruction of the anterior cruciate ligament].

In 25 sheep the anterior cruciate ligament (ACL) was reconstructed after resection. Twelve modified "Jones procedures" were performed (transplantation of the central third of the patellar tendon with an initial load of 50 N) and 13 polydioxanone (PDS) augmentations. In 15 cases the ACL was resected from the right knee. Twenty-one sheep survived for 1 year and were then evaluated. Loss of the ACL leads to instable joints in this experiment. Within the first 6 months anterior translation occurs; after 1 year subluxations can be seen on the X-ray films. Macroscopical signs of extensive arthrosis were seen in the femorotibial and femoropatellar joints; the menisci were totally destroyed. Macroscopically strong ligaments were seen 1 year after PDS-augmented reconstruction as well as after transplantation of the patellar tendon with an initial load of 50 N. There was no difference between the two groups. The mechanical strength reached 54% of the maximum load of a control group in the Jones reconstructions and 61% after additional augmentation with a 2-mm biodegradable PDS cord. There was no statistically significant difference. Both methods are suitable for reconstruction of the ACL; the patellar tendon replaces the ACL very well.

Animals↗
PubMed1991

[Local muscle flap in soft tissue reconstruction following fracture and osteitis of the lower limb].

17 local muscle flaps were used to cover soft tissue defects in 13 open fractures (1 degree to 4 degrees) of the lower limb and in four patients with chronic ostitis associated with instable scar forming. The Musculus soleus was used in 16 cases exclusively or in combination with the Musculus gastrocnemius (three times), Musculus hallucis longus (one time) or Musculus tibialis anterior (one time). In one case the Musculus flexor digitorum was used. In 13 of 17 cases the local muscle flap was curing the soft tissue defect and contributed to the salvage of the limb.

Adolescent↗
PubMed1991

[Are patellar tension band reconstructions with absorbable materials possible? An animal experiment].

Different biodegradable tension band reconstructions of transverse osteotomies of sheep patella were tested in an experimental pilot study. Without postoperative immobilization, 4 metallic fixations in the control group dislocated secondarily 3 +/- 2 days after the operation. After tenotomy of the gastrocnemius muscle tendon, 6 other metallic fixations showed good bone healing after 12 weeks. Therefore all other fixations were immobilized postoperatively. In 5 of 6 tension band fixations with pure polydioxanone cords (PDS) ventral callus distraction started after 18 +/- 7 days, but total consolidation had taken place after 14 weeks. One PDS fixation failed for technical reasons. The combination of two axial polyglycolide rods (BIOFIX) with two ventral PDS cords showed different results: when rods 4.5 mm in diameter were used 1 fixation dislocated because the fragments were burst by the oversized rods. With rods 3.2 mm in diameter 3 other fixations were followed by complete consolidation with no dislocation after 12 weeks. Other tested combined fixation systems made up of polyglycolide and polylactide composites (cords, screws) failed secondarily, either because the fragments were burst by the oversized implants or because of the fragility of the polylactide cords. It was impossible to use polylactide screws as lag screws, because the screw heads gave way to torque. In an additional study we observed a decrease in tissue pH after implantation of polyglycolide rods in the medullary space of the tibia. Compared with the control medullary space without implants, the pH decreased from 7.38 to 6.92 at the point of greatest implant mass.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[The management of complete shoulder joint dislocation without metallic implants].

In 14 patients reduction of the acromioclavicular joint was reinforced by completely absorbable polydioxanon cord. In 3 cases parts of the cord were rejected and a fistula formed through the scar without further impairment following as a result of healing local treatment. Altogether we had 12 good and 2 poor results with respect to function, X-ray appearance and pain. The complication rate and general outcome of the method described do not differ substantially from those of other commonly used procedures. However, no second operation for removal of the metal implants is necessary.

Acromioclavicular Joint↗
PubMed1989

[Experiences with the locking nail].

In case of clear indication, the locking nail system brings about good results in the treatment of problematic long bone fractures. The indication for primary static locking should be defined in a wide manner. Early loading is possible and is applied by us more and more in not adipose patients with static locking, too. From our point of view, the following factors are some of the drawbacks of the system: bolt loosening due to different causes, the impractical aiming device for distal locking, problems with the lavage of the medullary cavity in case of infection, pains in the knee joint after transcondylar implantation of a Steinmann nail. In case of long bones with narrow medullary cavities (young women) for which the thinnest nail has to be used, slotted nails bear the risk of distortion.

Adolescent↗
PubMed1985

[Modified Schanz screws for the external fixator].

In order to make a comparison with conventional implants, our recently developed 5/8 mm screws of Schanz were put in the lateral clamp of an external fixation unit applied to the femur. By using the modified 5/8 mm screws of Schanz, an increased stability and a reduced number of implants can be achieved. The results are not only applicable for the external fixation of the femur investigated by us, but also for unilateral fixation of the tibia.

Biomechanical Phenomena↗
PubMed1985

[Continuity resections of long tubular bones and subsequent bone reconstruction].

The osseous restitution of extended deficiency pseudarthroses is possible by means of modern osteosynthesis methods which exactly immobilize the bone. However, numerous operations are required in order to prevent infections and to reconstruct the osseous stability by subsequent bone chip grafts. The treatment may take three to five years, and relapse and even failure will occur frequently. This aspects have to be discussed with the patient before beginning such a treatment, and there must not be any doubt that the patient really desires to be treated in this way.

Adolescent↗
PubMed1985

[Ligament replacement with polydioxanone (PDS)].

Experimentations on animals have been performed in order to verify the applicability of the slowly resorbable suturing material Polydioxanon (PDS) in the transposition of ligaments in general and the transposition of cruciate ligaments in particular. After six weeks, the absorption of a twisted cord of 2 mm diameter still has a traction tolerance of 58%. The experimentations made on rabbits and sheep suggest that PDS can be used to fasten ligament sutures and to reinforce ligament grafts. Under extremely favorable soft tissue conditions, the substance can even be used as ligament substitute. Good clinical results can be achieved in the problematic plastic surgery of the anterior cruciate ligament if the reinforcement of the autologous transplant is performed with PDS in the sense of an augmentation graft.

Animals↗
PubMed1984

[Treatment of pathologic fractures and its results].

In case of pathologic fractures caused by metastases, operative stabilizing of the fractures is indicated if the general condition of the patient just permits an operation. It is the aim of treatment to reestablish the function of the extremity, to reduce pain and to give psychological support to the patient during his remaining life time. The operative procedure depends on the general conditions of the patient, the spreading and localisation of the metastases.

Adult↗
PubMed1983

[New implants for chest wall stabilization].

A new rib plate is presented in two models with identical physical properties, but different methods of fixation. By means of a decrease of the plate thickness for both the screw fixation and the claw fixation, a symmetrical distribution of the charge to the fixation points is achieved. Such, a high stability as well as the desired elasticity are attained. A loosening of the implant or necrosis of the clasped parts of cartilage were not observed, so primary bone healing without the typical ball-shaped callus is possible. The elasticity of the thorax is not restrained.

Bone Plates↗
PubMed1983

[Indication, technic and value of arthroscopy of the upper ankle joint].

The authors demonstrate on several joint preparations that essential parts of the upper ankle joint can be directly looked at by endoscopic examination with access at three different points. In case of osteochondrous fractures such as osteochondrosis dissecans, arthroscopy can be a means to determine the therapeutically relevant stages. A series of clinical examples is presented in order to demonstrate that this method, which is still seldom employed, represents a considerable extension of diagnostic and also therapeutic possibilities.

Ankle Joint↗
PubMed1983

New target device for ligament grafts in the knee joint.

New instruments for cruciate ligament grafts through a rectilinear drill hole are presented. They are applicable in order to simplify the procedure performed under X-ray view or arthroscopy in the open joint as well as in the close joint. The precise fixation of the grafts at the anatomical ligament end points is the essential advantage of this method.

Arthroscopes↗
PubMed1983

[Osteosynthesis procedure in replantation surgery].

A number of methods of bone fixation are recommended in microreplantation, none of which fully meets the requirements. The individual procedures are shown and their suitability for stabilisation of the long bones of the hand is discussed. The oblique Kirschner wire with either transosseous wire or a parallel bore wire emerges as the method of choice. Until an alternative method, such as a resorbable bone-peg, is developed, which might possibly satisfy the requirements completely, this procedure must be preferred.

Amputation, Traumatic↗
PubMed1982

[Reaction of tissue after microvessel anastomoses. Comparison of absorbable and not absorbable suturing material].

Twenty anastomoses of the aorta of rats were performed; the anterior and the posterior wall were sutured alternately with absorbable and not absorbable microsurgical suturing material 10-0. Histologic examination of the anastomosis and examination by electron raster microscope clearly showed the superiority of the absorbable suturing material. The difficulty to discern the suture by microscope has to be regarded as a disadvantage. The handling need exercise, but after having been accustomed to it, we think it nearly better than that of the not absorbable material.

Animals↗