Biomedical subjects

K-J Prommersberger

Publications and source records attributed to K-J Prommersberger.

4 recordsLinked to original sources

PubMed2003

[Ulnar head prosthesis].

The ulnar head prosthesis has been the subject of a prospective multicenter-study since 1995. Until 2000, it has been used in 57 patients by the study group. In 35 patients, the indication was painful instability of the distal end of the ulna following previous resection arthroplasties, and in 22 patients it was painful arthritis of the distal radioulnar joint (DRUJ). The mean follow-up was 38 months. Pronation increased from a preoperative mean of 63 degrees to a postoperative value of 78 degrees, while supination increased from 43 degrees to 76 degrees. Grip strength improved from a preoperative mean of 51% to a postoperative mean of 77% of the opposite limb. Pain, measured on the verbal pain scale (1-4), was reduced remarkably from a preoperative mean level of 3.6 to a postoperative mean of 1.7. Patient' satisfaction was evaluated using the visual analog scale (0-10) and improved from a preoperative mean of 2.1 to a postoperative mean of 7.9. With one exception of loosening, we consistently found bony integration of the shaft of the prosthesis. Stability of the DRUJ was achieved in all but three patients. This method has given reliable and excellent results as a salvage procedure for failed resection arthroplasties of the DRUJ with painful instability of the distal end of the ulna. We consider the method an alternative treatment option for the arthritically destroyed DRUJ. Sufficient soft tissue to stabilise the prosthesis is needed to successfully reconstruct the DRUJ.

Adult↗

PubMed2003

[The hemiresection-interposition arthroplasty as a salvage procedure for the arthrotically destroyed distal radioulnar joint].

The arthrotically destroyed distal radioulnar joint will lead to painful limitation of forearm rotation. Alternative treatment options are the hemiresection-interposition arthroplasty or the Kapandji-Sauvé procedure. The aim of our study was to evaluate the clinical and functional results following the hemiresection-interposition arthroplasty in non-rheumatoid patients. The most common posttraumatic cause of the arthrosis was the malunited distal radius fracture. In a retrospective study we examined 36 of 51 patients with a mean age of 53 years after an average follow up of 34 months clinically, radiologically and using the DASH questionnaire. The average preoperative pain measured 7.8 on the visual analog scale and was reduced statistically highly significant (p < 0.01) to 3.9. Whilst pronation increased statistically not significantly from a mean of 74 degrees to 76 degrees (p = 0.428), supination improved significantly from 54 degrees to 69 degrees (p - 0.012). The average grip strength increased statistically highly significant (p<0.001) from 40% to 64% compared to the unaffected side. Patients' satisfaction with the result averaged 6.9 on a visual analog scale. Using a modified Mayo-wrist score, six patients were rated to have an excellent, eleven patients a good, ten patients a satisfactory and four patients a poor result. The average DASH score measured 35. In 21 patients radioulnar impingement was found. This appeared to be painful in 14 patients and required revision surgery using the ulnar head prosthesis in five patients. In three patients, secondary ulnar shortening had to be performed due to a remaining painful impaction of the distal ulna against the lunate and triquetrum. Comparing our clinical results with the reported results following the Kapandji-Sauvé procedure from the literature, there was no evident superiority of either of the procedures. There is a need for a functional evaluation following the Kapandji-Sauvé procedure to compare the remaining functional impairment following both procedures. In conclusion both procedures have to be classified salvage procedures and therefore the indication should be limited to the arthrotically destroyed distal radioulnar joint.

Adult↗

PubMed2003

[Scapho-trapezio-trapezoid arthrodesis (triscaphe arthrodesis)].

BACKGROUND: Scapho-trapezio-trapezoid (STT)/triscaphe fusion is used to stabilize the radial column of the wrist. However the reported results are controversial. MATERIAL AND METHODS: 111 patients were treated with STT fusion from 1992 to 1997. Indications were chronic dissociation of the scapholunate joint (n = 15), idiopathic arthrosis of the scaphotrapeziotrapezoid joint (n = 11), Kienböck's disease in advanced stage (n = 84) and dislocation of the trapezium (n = 1). This study reviews the results after an average follow-up period of four years (range, two to eight years). RESULTS: Patients showed an average wrist motion (ROM) in extension and flexion of 81 % of the preoperative range and in radial and ulnar deviation of 68 % of the preoperative range. Preoperative pain values (VAS) were reduced 76 % (non-stress) and 55 % (stress). The average grip strength improved to 65 % of the contra-lateral side. Good results were reached according to the modified Mayo wrist score with a score of 66 points (71 points in arthritis of the STT joint; 62 points in Kienböck's disease, 60 points in SL-dissociation). The patients described low disability in the DASH scores, with an average of 27 points. CONCLUSIONS: Our data show that STT fusion is reliable and effective for treatment and pain relief and offers reasonable functional results in the above mentioned indications.

Adolescent↗

PubMed2002

[Preoperative Intermittent Pneumatic Soft-Tissue Distraction in Patients with severe Dupuytren's Contracture].

PURPOSE: Evaluation of the outcome of preoperative intermittent pneumatic soft tissue distraction (IPD) in patients with severe contractures in Dupuytren's disease with special regards on recurrent deformities. METHOD: In a prospective study, nine patients with Dupuytren's contracture grade III and IV according to the classification of Tubiana were treated with a preoperative intermittent soft-tissue distraction using a pneumatic extension device followed by a standardized operative correction and follow-up program. Sixteen fingers were involved: grade I and II four fingers, grade III and IV twelve fingers. Nine fingers - grade III and IV seven fingers - in six patients had a recurrent deformity. RESULTS: The preoperative reduction of contracture simplifies the surgical treatment. Preoperatively using the IPD, the flexion contracture was reduced between 5 and 60 degrees. With an average of 29 (10 to 60) degrees, the improvement was greater in fingers with severe contracture (grade III and IV according to Tubiana) than in fingers with a minor contracture averaging 10 (5 to 25) degrees. In fingers with recurrent deformity, the reduction of the flexion contracture averaged 27 (5 to 60) degrees. There were no complications leading to break off of the distraction. CONCLUSION: The intermittent pneumatic distraction is a good alternative to the method introduced by Messina for preoperative soft-tissue distraction in patients with severe Dupuytren's contracture.

Aged↗