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Biomedical subjects

K Klaue

Publications and source records attributed to K Klaue.

41 records · Page 3Linked to original sources

[Labrum lesions and acetabular dysplasia in adults].

Thirty-seven operatively treated patients with residual acetabular dysplasia without arthritis had a labrum tear in the antero-lateral quadrant. A sensation of hip locking, or of a "dead leg" and episodes of "giving-way" were found to predict the presence of the tear. 95% of patients had an acute onset of pain. We treated the patients with a peri-acetabular osteotomy and in 12 cases the tear was repaired with a transosseous suture. We excised the labrum lesion in 21 cases with an extended avulsion from the bony rim and 4 tears were not severe enough to require attention. Twenty-two patients were available for a 4.5-year follow-up (range 2-8 years): 18 patients had no pain, 3 had mild pain and one had severe pain. Final pain outcome was not influenced by intraarticular treatment of the tear. The labrum tear is responsible for a well-defined clinical presentation of hip dysplasia and precedes secondary arthrosis. Early diagnosis helps to define the time to perform reconstructive surgery. The treatment consists of improving the coverage and stability of the femoral head by means of a multiplanar peri-acetabular osteotomy. The osteotomy unloads the torn fibrocartilage and allows it to heal by moving it out of the weight-bearing area.

Acetabulum↗

Early full weightbearing and functional treatment after surgical repair of acute achilles tendon rupture.

We prospectively evaluated the clinical outcomes of 20 patients (mean age, 42.8 years) with early full weightbearing and functional treatment after surgical repair of acute Achilles tendon rupture according to a prospective intra- and postoperative protocol. All patients underwent open repair using a Kessler-type suture and simple apposition sutures. The postoperative regimen included a plantigrade splint for 24 hours and 6 weeks of early full weightbearing in a removable walker. All patients were evaluated with clinical and ultrasound examination and according to a new scoring system at 3, 6, and 12 months after repair. After 3 months, the score averaged 73 of 100 points; after 6 months, 86; and after 1 year, 94. All patients reached the same level of sports activities as preoperatively and demonstrated no significant difference in ankle mobility and isokinetic strength. There were no reruptures. One patient had a deep venous thrombosis 3 weeks after the operation after having prematurely stopped thromboprophylaxis. We believe that early careful ankle mobilization and full weightbearing in a removable walker after primary Achilles tendon repair does not increase the risk of rerupture. An accelerated rehabilitation program improves early foot function with excellent recovery of plantar flexion strength and amplitude.

Achilles Tendon↗

Osteochondral fractures of the glenoid fossa of the ulna in children: review of four cases.

Osteochondral fractures of the glenoid fossa of the ulna are exceptional injuries in children. These lesions can present diagnostic problems because the fragments are often radiolucent. We followed four children for 3, 6, and 24 months and 12 years, respectively. The elbow was definitely dislocated in two, and was probably dislocated in two other, children. The most reliable paraclinical examination was conventional sagittal tomography. Open revision is mandatory for reduction of the fracture and, when performed early, may lead to excellent functional results.

Adolescent↗

Acetabular rim pathology secondary to congenital hip dysplasia in the adult. A radiographic study.

Major rim pathology is a precursor of osteoarthritis of the hip secondary to residual acetabular dysplasia. The symptoms are acute pain in the groin and impaired function; the anatomopathologic lesions consist in avulsions of the labrum from the bony rim, and separated bone fragments or "Os acetabuli", as well. A detailed radiographic, comparative inquiry to assess the preoperative morphology of 178 dysplastic hips which underwent a multiplanar periacetabular osteotomy was undertaken. The study showed that the 37 hips with a labral avulsion had a less pronounced anterior and lateral insufficiency of the acetabulum and a less pronounced lateral subluxation than dysplastic hips without these lesions. No specific radiologic features could be found in the 23 hips with bony fragments of the acetabular rim. The instability of the joint exerts abnormal stress on the acetabular rim which tends to tear it. This condition leads to rapid arthrotic degeneration of the hip; early diagnosis increases our ability to preserve the integrity of the joint through reliable reconstructive surgery.

Acetabulum↗