Biomedical subjects

K-D Schaser

Publications and source records attributed to K-D Schaser.

8 recordsLinked to original sources

PubMed2006

[Management problems in the diagnostic work-up and treatment of pathological fracture of the proximal femur. Clinical case report].

Pathological fractures caused by primary bone tumours are rare compared with fractures evolving in response to general osteoporosis or bone metastases. Nevertheless in cases of fracture due to inadequate trauma the underlying causality has to be clarified including histological analysis prior to the operating procedure. This case report demonstrates diagnostic and therapeutic standards in cases of pathological fracture of the proximal femur caused by osteosarcoma.

Adult↗

PubMed2005

[60 year old patient with soft tissue infection of the right leg].

Group A streptococcal necrotizing fasciitis is a rare disease associated with high mortality. Since severe toxic shock syndrome is a common complication, only immediate and aggressive surgical intervention, adequate antimicrobial therapy and supportive intensive care can be life-saving. We report about successful treatment of a 60-year old patient with necrotizing fasciitis and multiple organ failure.

Anti-Bacterial Agents↗

PubMed2005

[Periprosthetic fractures after total knee joint arthroplasty].

Periprosthetic fractures of the femur, tibia and patella are being registered with increasing frequency due to the rising numbers of total knee replacements. Depending on the site of the fracture, apart from mere traumatic mechanisms, implant specific parameters and implant loosening may represent the main causes of periprosthetic fracture. Moreover, general risk factors promote the manifestation of a periprosthetic fracture. Nowadays, valid classifications are available to categorize periprosthetic fractures of the femur, tibia and patella, and to create the basis for specific decision-making in choice of treatment. Despite a wide field of treatment options, the actual functional outcome after therapy and the high rates of complications imply that an adequate analysis of the fracture etiology and the corresponding transfer into an individualized treatment concept offer the chance of functional restoration of the patient similar to the pre-fracture state.

Arthroplasty, Replacement, Knee↗

PubMed2004

[The multidisciplinary approach to reconstructive surgery of the extremities-considerations for trauma and orthopedic surgery].

Interdisciplinary reconstructive surgery of the extremities involves a variety of indications ranging from IIIB/C open fractures with major segmental loss of bone and soft tissue, to arterial vessel injury necessitating vascular repair, and to biological, plastic reconstruction following resection of musculoskeletal tumors. The multidisciplinary approach involving trauma/orthopedic surgery combined with vascular, plastic, and neuro- resp. microsurgery has significantly increased the rate of limb-sparing operations and improved morbidity, function, quality of life, and long-term oncological outcome. The multidisciplinary treatment of both complex trauma and malignant bone/soft tissue sarcoma of the extremity is an integral task of surgical trauma and tumor centers. Close interactive communication between the individual surgical disciplines has decisively influenced prognosis and is the precondition for priority-adapted therapeutic strategies.

Amputation, Surgical↗

PubMed2004

[Interdisciplinarity in reconstructive surgery of the extremities].

From the perspective of trauma and orthopedic surgery interdisciplinary reconstructive surgery of the extremities encompasses different indications ranging from IIIB/Copen fractures with major segmental loss of bone and soft tissue, to arterial vessel in-jury necessitating vascular repair and to biological, plastic reconstructions following resections of musculoskeletal tumors. The interdisciplinary treatment concept including trauma-orthopedic surgery combined with vascular, plastic and neuro- as well as microsurgery has significantly decreased amputation rates and functional deficits thereby improving quality of life and long-term oncological outcome The multisdisciplinary management of both complex trauma and malignant bone/ soft tissue sarcoma of the extremity is an integral task of the surgical trauma or tumor center. Close interdisciplinary communication and expierence are the precondition for performance of a priority-adapted therapeutic strategy, low complication rates and improvement of overall prognosis.

Extremities↗

PubMed2003

Noninvasive analysis of conjunctival microcirculation during carotid artery surgery reveals microvascular evidence of collateral compensation and stenosis-dependent adaptation.

OBJECTIVE: Hemodynamically relevant internal carotid artery (ICA) stenosis is a major cause of ischemic stroke. Despite its long-term benefit, carotid endarterectomy may also be associated with severe neurologic deficits. Intraoperative and early recognition of ischemia in the region of the ICA may reduce this risk. To date, direct imaging and quantitative analysis of microvascular structures and function in the human ICA region have not been possible. We purposed to visualize and quantify ischemia/reperfusion-induced microcirculatory changes in the terminal vascular bed of the ICA in patients undergoing unilateral ICA endarterectomy. METHODS: Sequential analysis of the ipsilateral and contralateral conjunctival microcirculation was performed with orthogonal polarized spectral imaging in 33 patients undergoing unilateral ICA endarterectomy because of moderate or severe ICA stenosis (North American Symptomatic Carotid Endarterectomy Trial score, 75% +/- 13%), before clamping the ICA (baseline), during clamping of the external carotid artery and ICA, during reperfusion of the ICA (intraluminal shunt), during the second clamping of the ICA (shunt removal), after declamping (reperfusion) of the external carotid artery and ICA, and 15 to 20 minutes after the second ICA reperfusion. RESULTS: During ICA clamping for shunt placement, ipsilateral and contralateral conjunctival capillary perfusion was significantly decreased, but it was completely restored after reperfusion with carotid shunting. Reclamping of the ICA for shunt removal caused microvascular dysfunction, which was significantly less pronounced than that observed during the first clamping. The individual degree of ICA stenosis was inversely correlated with the ipsilateral and contralateral decrease in conjunctival functional capillary density during the first ICA clamping. CONCLUSIONS: These results suggest adaptive mechanisms of capillary perfusion with increasing stenosis and development of collateral compensatory circulation in the vascular region of the human ICA. Conjunctival orthogonal polarized spectral imaging during unilateral ICA reconstruction enables continuous noninvasive analysis of bilateral conjunctival microcirculation in the terminal region of the ICA and enables monitoring for efficient carotid shunt perfusion during and after endarterectomy.

Adaptation, Physiological↗

PubMed2002

[Treatment concepts of benign bone tumors and tumor-like bone lesions].

The indications for surgical treatment of benign bone tumors and tumor-like lesions depend on the biological activity, clinical symptoms and anatomic location of the the lesion. Clinically silent lesions ("leave me alone Lesions") lacking any scintigraphic enhancement and without danger of pathologic fracture or malign transformation only need surveillance and do not require surgery.However, tumors becoming symptomatic, displaying progression after termination of skeletal growth or radiographic signs of malignancy should be scheduled for surgical intervention. For most benign tumors intralesional curettage and subsequent bone grafting is the treatment of choice, maintaining structural integrity and functional stability of the bone and adjacent joint. In case of uncertain histopathological diagnosis an open biopsy should be performed followed by definitive either marginal or en-bloc resection, preferably at a single procedure. Depending on the tumor-specific risk of recurrence, adjuvant measures as phenol instillation or cryotherapy using liquid nitrogen may additionally be applied. As for the unicameral juvenile bone cyst or osteoid osteoma alternative minimal invasive techniques like corticoid injection and CT-guided percutaneous eradication of the nidus have been successfully introduced into clinical practice. Depending on the activity of the tumor recurrent lesions are recommended to be treated by marginal or enbloc resection. The radical and aggressive mode of surgical therapy has to be balanced with the treatment-related morbidity, i.e. complication rate, possibilities for reconstructive stabilizations and resultant functional deficits,making the decision a responsible challenge to the orthopedic surgeon.

Adolescent↗

PubMed2002

[Bone tumors].

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Bone Neoplasms↗