Search PubMed⌕ Search

Biomedical subjects

L Brückner

Publications and source records attributed to L Brückner.

At least 19 recordsLinked to original sources
PubMed1999

Decrease in phantom limb pain associated with prosthesis-induced increased use of an amputation stump in humans.

The experience of phantom limb pain, non-painful phantom limb sensation and telescoping was ascertained by questionnaire in a group of upper extremity amputees wearing a functionally effective Sauerbruch prosthesis which permits extensive use of the affected limb and in a group of patients wearing a cosmetic prosthesis that did little to increase the utilization of the amputation stump. The Sauerbruch prosthesis group exhibited a significant and large decrease in amount of phantom limb pain while the cosmetic prosthesis group showed no change. Neither group experienced a decrease in non-painful phantom limb sensation or telescoping. The amount of phantom limb pain has been found to be highly correlated with the amount of injury-related, afferent-decrease cortical reorganization. It is possible that the increased use of the amputation stump induced by wearing a Sauerbruch prosthesis produced a countervailing use-dependent, afferent-increase type of cortical reorganization that reversed the phantom limb pain. These preliminary results require replication. Their therapeutic implications are discussed.

Adult↗
PubMed1999

Abnormal motor cortex organization contralateral to early upper limb amputation in humans.

We performed both a functional magnetic resonance imaging (fMRI) study using single slice FLASH technique and an investigation with transcranial magnetic stimulation (TMS) in a 21-year-old patient. He had suffered a left upper extremity amputation at age 7. Anteflexion of the amputation stump produced an unusual, broad activation contralateral to the movement. TMS revealed an enlarged cortical motor output area of the deltoid muscle at the amputation stump. Application of paired magnetic stimulation demonstrated decreased intracortical inhibition (ICI). A T1-weighted image indicated a lack of the characteristic shape of the central sulcus contralateral to the amputation. In addition to previous functional studies, these new structural data suggest that maturation of the central sulcus develops in response to daily practice of the contralateral hand, possibly until adolescence.

Adult↗
PubMed1998

[Longitudinal study of vascular patients with standardized Brückner distal limb amputation].

OBJECTIVE: The present study aims to evaluate early and late results after standardized below-knee amputation according to Brückner in vascular patients. PATIENTS AND METHODS: During the period 1982 to 1989 72 patients with occlusive arterial disease stage IV underwent below-knee amputation at an average age of 69.7 years. 38 of the amputees could be re-investigated at the end of 1991 after an average follow-up of 5.3 years. Evaluation criteria consisted of wound healing, knee joint preservation, prosthetic fitting, stump appearance, gait capacity or ambulation, the need for assistance by another person and patients own valuation. Accordingly, rehabilitation level was classified to be good, satisfying or dissatisfying. RESULTS: Knee joint preservation rate amounted to 91.7% (66 patients). Postsurgical prosthetic fitting could be achieved in 55 amputees (76.4%). All the 38 re-investigated stumps were inapparent. 27 of the patients (71.1%) showed good and 7 patients (18.4%) satisfying rehabilitation, whereas the rehabilitation level was dissatisfying in 4 cases (10.5%). This objective evaluation was affirmed by patients own estimation: 33 amputees (86.6%) would again agree to the operation. CONCLUSIONS: Early as well as late results in this series indicate that the standardized below-knee amputation according to Brückner promises high rates of healing, knee joint preservation and thus successful rehabilitation in patients with occlusive arterial disease.

Adult↗
PubMed1992

A standardised trans-tibial amputation method following chronic occlusive arterial disease.

The histo- and biochemical parameters of leg muscles from patients with chronic occlusive arterial disease were examined. The outcome of these tests indicated that it is not possible visually to determine the amputation level accurately at the time of surgery. These test results therefore encouraged the authors to develop a standardised surgical procedure for trans-tibial amputations. With this standardised technique specific musculature is resected to assure that no pathological tissues remain. This surgical prophylaxis is meant to prevent the development of gas gangrene and thus to obtain primary healing. Eighty-six trans-tibial amputations were performed and in 93% of these the knee joint was preserved.

Amputation, Surgical↗
PubMed1990

[Experience with the reintroduction of the Sauerbruch-Lebsche operation (Sauerbruch's kineplasty)].

We have initiated the kineplasty to Sauerbruch in our clinic again. 5 patients are operated up to now. This 5 patients have one middle long and three short forearm stumps respectively one middle long upper-arm stump. One patient had a shoulder exarticulation on the contralateral side. In the first case we performed a forearm channel and in the four other cases a biceps channel. All channels have a good stroke, so the patients can have an active and cosmetic very good prosthesis with very good functional results. We ask for presentation of patients with indication to kineplasty to Sauerbruch.

Adolescent↗
PubMed1990

[Shaft fractures of the middle third of the femur].

Femoral shaft fractures in the middle third location 81 patients with damaged femoral shaft of 390 patients with femoral fractures between 1976-1986 were examined. The material of osteosynthesis, the stability, the complications, the duration of stationary stay and the postoperative function of the hip joint respectively knee joint are represented.

Adolescent↗
PubMed1990

[Treatment results of distal femoral fractures with involvement of the knee joint].

Results of treatment distal femur fractures with damaged knee joint 20 patients with damaged distal femur and knee joint of 390 patients with femur fractures between 1976-1986 were examined. The material of osteosynthesis, the stability, the complications, the duration of stationary stay and the postoperative function of the knee joint are represented.

Adolescent↗
PubMed1989

[Diabetic osteoarthropathy--not a primary indication for amputation].

The comparatively unknown pathological pattern of diabetic osteoarthropathy and its primarily conservative treatment are reported in this paper, with reference being made to five cases. The hypothesis is established that amputation still is too often used to tackle diabetic osteoarthropathy.

Aged↗
PubMed1988

[Is there a renaissance of the Sauerbruch kineplasty?].

Kineplasty had been inaugurated by Sauerbruch in 1916. It has provided for direct coupling of stump muscles to the prosthetic joint and has yielded good functional results in numerous cases. The authors permanently look for three patients who had received kineplasty for injuries in the second world war which necessitated amputations on their upper extremities. They are one patient with one forearm amputation, one with an upper arm amputation, and one with upper arm amputation left and exarticulation of the right shoulder joint. - The authors' own experience and observations made by other authors appear to suggest the method to be recommended for handless patients and for those with one upper arm amputation.

Activities of Daily Living↗
PubMed1981

[Orthopaedic findings of the foot as related to age and body weight among women (author's transl)].

In a cross-sectional evaluation of 103 women belonging to the material of the Leipzig Longitudinal Study of the GDR Gerontology Project, foot trouble and objective foot changes were studied in relation to body weight and age. The subjects were divided into four age classes and two weight groups. The following objective foot parameters were obtained from the podogram: the angle of the big toe, the isthmus value, and the length-breadth index. Further data such as the total foot angle, the height of the plantar arch and the instep height were derived from the lateral radiograph of the foot under load. In 36.89 per cent of the subjects foot trouble was established. Two frequency peaks (15.8 years and 51.5 years) were determined for the age at which the first symptoms manifested themselves. The investigations showed a growing influence of physiological changes due to ageing on foot trouble. The dependence of foot trouble on body weight is evidenced by the fact that overweight women are more prone to develop foot trouble than women with standard weight. The angle of the big toe, in particular, is clearly weight-related, i.e. the risk to develop hallux valgus is greater in overweight women over 55 years of age than it is in standard-weight females. This finding is corroborated by the fact that, on an average, the group of overweight subjects has lower length-breadth-index values, which is indicative of a broadening of the forefoot in the process of splay-foot development.

Aged↗