Search PubMed⌕ Search

Biomedical subjects

L R von Laer

Publications and source records attributed to L R von Laer.

5 recordsLinked to original sources

[Fracture of the radial condyle of the humerus in the growth period].

In an overview the clinical and academic problems of this kind of fractures are described and their treatment is discussed. The most important problem is the pseudarthrosis that can happen in the framework of a conservative treatment of displaced fractures, rarely after operative treatment with K-wires. A rather academic problem is the obligatory growth disturbance of a partial stimulation of the lateral part of the growth plate. This leads to radial overgrowth and thus to a more or less distinct varus deformity. The extent of varus deformity is dependent on the time till consolidation, which is longest in conservatively treated fractures and shortest in those treated with compression screw osteosynthesis. An additional academic problem is the so-called fishtail deformity that becomes radiological visible at the end of growth. This deformity has no clinical significance. Pseudarthrosis, varus and fishtail deformity are a result of increasing instability of primarily or secondarily displaced fractures. All three problems can be avoided by metaphyseal compression osteosynthesis with an AO small-fragment screw with an additional axial K wire in the trochlea. Our own long-term results are shown and compared with the results of other procedures in the literature.

Adolescent↗

[Prognosis of proximal radius fractures in the growth period].

Fractures of the proximal radius in children may lead to deformities of the radial head and functional disturbance of pro- and supination. However, traumatization is not only caused by the injury itself, but may also occur secondary to surgical reduction, manipulation of fracture fragments and excessive physiotherapy. In a prospective long-term follow-study (2-20 years after trauma) of 38 children with displaced proximal radius fractures we found functional disturbances in 11% of children only. These were not caused by radial head deformities, which were present on 83% of follow-up radiographs. Functional impairment was mainly seen after open reduction or secondary growth disturbances. On follow-up radiographs all conservatively treated fracture angulations up to 60 degrees had corrected themselves spontaneously. In view of the high complication rates after open reduction and the poor functional results, as well as the inconvenience for the pediatric patient and the economic aspects, we recommend a primary conservative treatment concept of proximal radius fractures in children.

Adolescent↗

[Not Available].

Explore the source record for details and available documents.

Journal Article↗

[Post-traumatic growth disorders and corrective measures on the growing skeleton].

In order to develop efficient therapies in paediatric traumatology we investigated 1500 patients in all age groups with bony lesions of the growing skeleton. In particular we wanted to evaluate the limits and reliability of the correction mechanisms. Having done this evaluation we found some completely new correction mechanisms, and also we defined the reliability of the known mechanisms of repair. Also we wanted to determine the frequencies of the various disturbances of growth and how far these could be influenced by primary therapy. The rare disturbance of partial stimulation of growth, resulting in consecutive deformity was the only one which could be primarily influenced by therapy.

Child↗

[The etiology of the refracture of the forearm in childhood (author's transl)].

The etiology of the refracture after forearm fractures in childhood has been studied in a follow-up examination of 199 patients with dislocated forearm fractures. The incidence of the refracture was 13%. In all cases the primary fracture was a greenstick fracture of at least one of the two forearm bones. The incompletely broken through greenstick fracture was found to be significantly responsible for the refracture. Duration of immobilisation or residual axis deviation at consolidation showed no relationship. The pathophysiology is briefly discussed. In every greenstick-fracture of the forearm the necessity of completing the fracture by total reposition is emphasized to prevent a refracture.

Child↗