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K H Jungbluth

Publications and source records attributed to K H Jungbluth.

At least 19 recordsLinked to original sources
PubMed1992

[Reparative processes of experimental Aitken III lesion. An animal experiment study].

This present study describes the fine structural aspects of experimentally induced defects of the proximal growth plate of the tibia in rabbits as simulation of epi-/methaphyseal fractures. We evaluated two different defect sizes. As important result we find in narrow defects of 0.5 mm no osseous bridging of the epiphyseal plate whereas with 2 mm defects there is partial transphyseal closure. Growth plate cartilage is thus capable of repairing spontaneously smaller defects.

Animals↗
PubMed1992

[Ablation of hard biological tissue with the excimer laser].

Cutting and drilling of bone- and meniscus tissue were performed using a XeCl-excimer laser combined with a tapered fiber. Ablation speed on meniscus tissue is already sufficient, the thermal damage of the adjacent tissue is minimal. Increasing of energy transmission through special fibers promises higher ablation rates also on hard biological tissue and that promoted the interest in lasers again for accident surgeons.

Animals↗
PubMed1992

[Fat pad signs and supinator fat line in cubital trauma].

The fat pad sign and the supinator fat line (SFL) are valuable diagnostic aids in the evaluation of bony cubital injuries. A total of 377 lateral X-rays of the elbow joint-including 121 fractures--were investigated. The supinator fat line exhibited bar-like and bird-like configurations in 55.9% and 41.8% of healthy test subjects, respectively. In the presence of a fracture, a wavy configuration, directed downwards from, or running parallel to, the upper edge of the radius, was seen in 95% of the cases. If in the event of an injury to the elbow a wavy configuration is seen in association with a positive anterior and/or posterior fat pad sign, bony involvement of the joint-forming elements may justifiably be suspected.

Adipose Tissue↗
PubMed1991

Studies in fiber guided excimer laser surgery for cutting and drilling bone and meniscus.

Our experiments on transmitting high-power excimer laser pulses through optical fibers and our investigations on excimer laser ablation of hard tissue show the feasibility of using the excimer laser as an additional instrument in general and accident surgery involving minimal invasive surgery. By combining XeCl-excimer lasers and tapered fused silica fibers we obtained output fluences up to 32 J/cm2 and ablation rates of 3 microns/pulse of hard tissue. This enables us to cut bone and cartilage in a period of time which is suitable for clinical operations. Various experiments were carried out on cadavers in order to optimize the parameters of the excimer laser and fibers: e.g., wavelength, pulse duration, energy, repetition rate, fiber core diameter. The surfaces of the cut tissue are comparable to cuts with conventional instruments. No carbonisation was observed. The temperature increase is below 40 degrees C in the tissue surrounding the laser spot. The healing rate of an excimer laser cut is not slower than mechanical treatments; the quality is comparable.

Animals↗
PubMed1991

[Comparative study between conservative and surgical therapy of fibular ligament ruptures of the upper ankle joint].

From January 1985 to February 1987 361 patients with ruptured lateral ankle ligaments were treated at the Department of Trauma and reconstructive Surgery at the University Hospital of Hamburg. 225 patients were included in a retrospective study. They were divided into conservative and operative groups of treatment with subdivision of immobilized treatment (Plaster Paris short-leg-cast for 6 weeks) and functional therapy (special shoe). Clinical-radiological follow-up examinations of 49 operatively and 44 conservative treated patients were carried out 2 to 4 years after cessation of therapy. The clinical results were evaluated according to a questionnaire, X-ray and clinical controls. These results lead to the conclusion that operative treatment combined with conservative plaster cast immobilization yielded better mechanical stability than conservative-functional therapy. Best results were seen after surgical treatment, but conservative immobilization with prevailing good clinical-radiological results seems to be an alternative to operative therapy in carefully elected patients.

Ankle Injuries↗
PubMed1991

[Computer-assisted data analysis of injuries of the skeletal system in polytrauma patients].

The data of 366 patients with multiple injuries were evaluated by application of data processing over a period of seven years. Age and sex distribution, location and combination of injuries, mortality, mechanism of accident, diagnostics as well as therapy were analysed. 91.3% of our patients had injuries of the skeleton. The male to female ratio was 2:1. In 55.4% the age of the patients ranged from 10 to 39 years. The mortality rate of all patients was 27.2%. In the third decade only 16.9% of the patients died. Whereas the mortality of the patients in the 1. decade as well as between the 7. and 9. decades of life was very high (33% and 50%). Most of the skeletal injuries were located in the shank (24% open fractures). The mortality rate increases with the number of injuries (Table III). Patients with concomitant injuries, such as head injuries and fractures of the extremities were the most common combination of multiple injuries. 20% of the patients in this group died. Patients with combined injuries of the head, chest, abdomen and skeleton had highest mortality (57%). X-ray examination of the skull, chest, extremities and mainly of the spine and pelvis should be subjects of routine diagnostics. In patients who were suspected of having a blunt abdominal trauma, the first diagnostic technique will be ultrasound. On account of the various number of concomitant injuries as well as the patients individuality, the estimation of prognosis by systems for the classification of the severity of injury is fraught with difficulties. The analysis of the evaluated data showed that previously small number of variables may predict the prognosis of the course of disease.

Adolescent↗
PubMed1990

[Humerus head resection as therapy of compound fracture of the upper arm--results].

Proximal humeral fractures are frequent injuries in older patients. Most of these fractures respond satisfactorily to conservative treatment. Problems arise in cases of four-part displacements and in head-splitting fractures with massive defects in the articular surface. Between 1970 to 1988 eight patients were treated in our clinic in this situation by resection of the humeral head. 6 patients could be followed-up for an average of 69 months. Postoperative findings showed a restricted range of motion in all operated shoulders. The average abduction of the arm was 60 degrees (40-80 degrees) and elevation 60 degrees (40-80 degrees). The patients showed a mean external rotation of 17 degrees (5-30 degrees) and an internal rotation of 48 degrees (5-90 degrees). Only one patient was painless, 2 patients had pain during the night, and 3 patients suffered from various pain symptoms. Nevertheless 5 of 6 patients assessed the result as satisfactory and one patient as good.

Aged↗
PubMed1990

[Histomorphological studies on the development of the radial condyle fracture of the humerus in the growth years].

The dislocation of the lateral humeral condyle represents a typical fracture in childhood. Possible mechanisms of the traumatic displacement of the lateral humeral condyle got investigated by several publishers recently. Our examinations were concerned with the microarchitecture of the growing distal humeral cartilage. Here we discovered a bundle of collagenous fibers reaching in an angle of 15 to 30 degrees from the capitulum to the trochlea. The described fracture follows this collagenous bundle as we could demonstrate. It is evident that the microarchitecture of the cartilage paves the way for the dislocation of the lateral humeral condyle.

Child↗
PubMed1990

[The horizontal patellar dislocation].

The horizontal dislocation of the patella is a very rare event and little described in literature. On the occasion of a 35 years old motor car driver accident mechanism an therapeutic management are discussed.

Accidents, Traffic↗
PubMed1990

Compound fractures of the lower leg: clinical experiences and concept of treatment in multiple injury patients.

From 1980 to 1986 in 15 patients (16 lower leg fractures) with crush fractures of the lower limb, five had to be amputated primarily under emergency conditions, and four had successful reconstruction but required medical treatment for an average of one year. Seven secondary amputations were carried out because of infection of the bone, soft tissue and vascular occlusion. The level of amputation was at the proximal third of the tibia according to Dederich and Burgess. One leg was amputated 'through the knee'. The indication for amputation was based mainly on clinical findings, supplemented by bone X-rays, arteriography or arterial DSA. Doppler sonography was used for monitoring short intervals of blood flow in the emergency case unit, in cases of doubt.

Adolescent↗
PubMed1989

[Perilunar dislocations and dislocation fractures in polytrauma patients--diagnosis and therapy].

Between 1978 and 1987 about 700 multiply injured patients were treated at the Department of Emergency Surgery (University Hospital Hamburg-Eppendorf). Seven of these suffered from injuries of the wrist, in detail six perilunar dislocations with fractures of the scaphoid and one dislocation of the triquetrum. In six cases the correct diagnosis was found primarily by clinical and X-ray examinations. The real extent of one patient's wrist injury was revealed by control radiograms which were taken twelve weeks after the accident, when the patient was transferred to our hospital. Follow-up examinations were made at an average of 40 months after the injury. We suggest the following procedure in cases of perilunar dislocations: 1. Early closed reduction and prolonged immobilization in casts. 2. In cases where closed reduction cannot be achieved open reduction, pinning (Kirschner-wires) and immobilization should be performed. 3. Fractures of the scaphoid are provided with screws.

Adult↗
PubMed1989

[Initial results of the biocompatibility, cytotoxicity and genotoxicity of Aramid].

Tissue biocompatibility of aramid fibres was tested over up to 16 weeks after subcutaneous (A = nine) and intraarticular (B = twelve animals) implantation in the rabbit. Histologically all specimens showed connective tissue ingrowth with interspersed mesenchymal cells. Foreign body giant cells were numerous and demonstrated intracellular dye or aramid particles. Following implantation into the knee joint the aramid ligament was invaded by longitudinally arranged, stress-oriented collagen fibres as soon as four weeks postoperatively. In spite of reactive new bone formation a functional bony anchorage in the bore holes did not take place during the 16 week period. Additional investigations in bacteria (particularly the Salmonella-microsome Assay according to Ames) and mammalian cell cultures showed no evidence for any cyto- or genotoxic effects of aramid fibres.

Animals↗
PubMed1989

[The biomechanical significance of the periosteum for the epiphyseal groove].

In a study of 72 rabbits, four, eight, twelve and 16 weeks old, the mechanical resistance of the distal radius and ulna epiphyseal plate against shear strength has been examined. On one side the extremity has been freed of all soft-tissue attachments except the periosteum, on the other side the periosteum of the epiphyseal plate additional has been removed. The mechanical strength of the epiphyseal cartilage increases with age. A decrease of the resistance during sexual maturation has not been observed. In all age groups the stability of the epi-metaphyseal junction is significantly higher with the periosteum. In younger animals it is more marked than in older ones. The biomechanical behaviour of the periosteum can be explained with the principle of a "traction strap": the fibrous periosteum, firmly attached at the perichondrial ring, is stretched from epiphysis to epiphysis and fixes the epiphysis to the metaphysis. The periosteum and its continous tension takes not only part in regulating the longitudinal growth but also increases the resistance of the growth cartilage against shear strength. The dominated influence of the periosteum on the integrity of the epiphyseal cartilage is also supported by corresponding results dealing with the occurrence of Salter and Harris-type I or II fractures in absence or presence of the periosteum.

Age Factors↗
PubMed1989

[Fatal injury in childhood. Analysis of 160 autopsies].

During the period from 1971 to 1987 160 deadly injured children were dissected at the Institute of forensic medicine in Hamburg-Eppendorf. 72.5% of the children died after a traffic accident. Injuries of the head as cause of death is the most detected reason. 62% of the children died because of a head injury, 13% in consequence of bleeding and 10.8% because of contusion of the medulla oblongata by injuries of the upper vertebral column. The majority of the children died by injuries of only one cavity (42%). It is conspicuous that the portion of infants (none to three years) is greater than we expected.

Abdominal Injuries↗
PubMed1988

[Periosteal bone resorption in the area of the metaphysis of growing bone as a precursor of epiphyseal injuries. A polarization optical and scanning electron microscopy study].

Macerated epiphyses of the growing infant bone exhibit an irregular surface which can already be observed at the macroscopic level. Polarizing microscopy demonstrates extended zones of bone resorption on the cortical surface, deductable from numerous lacunae of Howship. Ensuing experimentally induced epiphysiolyses, cortical bone fragments adhering to the inner surface of the periosteum are demonstrable by scanning electron microscopy. Having been torn out of the bone together with the periosteum, these cortical fragments leave corresponding defects on the bone surface. Due to the remodelling of the bone, involving the readjustment of the shape of the extremity, the attachment of the periosteum is relatively poor in the metaphyseal region of the growing bone. The influence of pathological forces can therefore easily cause a detaching of the periosteum in this region. The latter results in a significant weakening of the epiphyseal fastening in the zone between the epiphyseal plate and the metaphysis. The patterns of injury in the region of the growth plate are therefore essentially determined by the varying attachment of the periosteum to the metaphysis.

Adolescent↗
PubMed1987

[Bone cement containing cytostatic drugs: new aspects in the treatment of malignant bone tumors. I. Experimental studies].

Radical surgery in malignant bone tumors can either be limited by anatomical structures or seems inadequate in the palliative stabilization of bone metastases. Incomplete removal of the tumor and stabilization by compound osteosynthesis or endoprosthesis contains two problems: 1) the wide spread of malignant cells by manipulation in the tumor bearing area; 2) progressive destruction of bone due to remaining tumor. To overcome these problems we developed methotrexate bone cement (MTX-Palacos) with the aim to obtain high local concentrations of methotrexate in order to destroy remaining tumor cells and avoid systemic side effects. In vitro studies showed that methotrexate is released continuously from this cement without relevant changes of its biomechanical properties. Animal studies with transplanted osteosarcomas and mamma carcinomas in mice showed a considerable decrease of tumor growth when a plug of MTX-Palacos was inserted in the center of the tumor. Histological findings showed that in the surroundings of the plug the tumor was destroyed considerably contrary to normal bone cement which had no effect on the tumor at all. The results are discussed with regard to clinical application of MTX-Palacos.

Animals↗