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Biomedical subjects

L Schweiberer

Publications and source records attributed to L Schweiberer.

At least 199 records · Page 11Linked to original sources
PubMed1989

[Changes and progress in surgical treatment of fractures of the pelvic ring and acetabulum].

The diagnosis and treatment of pelvic fractures and dislocations demand that the pelvic girdle and the acetabulum be examined separately. Fractures of the pelvic girdle are present in more than 60% of cases but have to be stabilized only in 9%, in contrast to acetabular fractures, which need to be reduced and internally fixated in 55%. Combined fractures need surgical management in 66% of cases. Fractures of the pelvic girdle are best diagnosed by means of plain radiograms and computed tomograms to distinguish posterior instability. These techniques are the basis of the treatment plan for external or internal fixation. External fixation is an effective method from the aspect of hemorrhage control but not sufficient to avoid postoperative pain. Early open reduction and internal anterior and posterior fixation is the treatment of choice if good rehabilitation is to be achieved. Acetabular fractures occur mostly in young patients. Only accurate articular reduction of displaced fractures can bring about a good functional result, as this minimizes posttraumatic arthritis. Radiological evaluation is done with three standard views: 1. A. P. X-ray of the pelvis; 2. oblique view of the obturator; 3. oblique view of the ilium. When those are considered in combination with a CT scan, acetabular fractures can be classified. The Letournel classification is extremely important for reduction and fixation, as no one surgical approach has been found that is satisfactory for all acetabular fractures. Internal stabilization is provided with single screws and plates.

Acetabulum↗
PubMed1989

[Changes and progress in the treatment of fractures of the coxal end of the femur].

Consideration of technical developments, a review of the literature and of our own experience with 535 patients compared with nearly 20,000 patients of an ASIF population treated during the same period show that the indications for treatment of extra- and intracapsular fractures of the proximal femur have become much simpler. (1) Extracapsular fractures of the proximal femur fall into two groups: pertrochanteric fractures are fixed by means of the dynamic hip screw and intratrochanteric unstable fractures by means of either the dynamic hip screw (valgus type) or a 95 degrees condylar plate. (2) Intracapsular fractures are treated according to the patient's age group. In patients younger than 70 years femoral head preservation is achieved by compressing screw osteosyntheses, while in patients over 70 years head resection is performed an a total endoprothesis inserted. In patients with life expectation shorter than 3-5 years a femoral head prothesis is inserted.

Aged↗
PubMed1989

[Progress and changes in the treatment of shaft fractures of the femur and tibia].

The historical development of the treatment of shaft fractures is outlined. Nowadays there is a number of possibilities for the treatment of shaft fractures: conservative and surgical methods. Operative treatment can be done with screws and plates, with intramedullary or interlocking nailing, and with external fixators. The advantages and risks of the various methods are explained. We should now no longer ask what the best method is for any fracture, but rather what method will provide the best prospects of healing in a particular pattern of injury.

Bone Plates↗
PubMed1989

[Changes and progress in fracture treatment of the humeral shaft].

Most humeral shaft fractures are treated by early functional mobilization (Sarmiento-Bracing). In some situations (short transverse fractures, old age of patients living alone, extreme obesity, social circumstances) operative fixation may be warranted in individual patients. There are, however, several absolute and urgent indications for operative fracture stabilization: fractures involving nerve or vessel injury, open fractures, multiple fractures on the ipsilateral arm, and delayed fracture healing. Osteosythesis with a dorsally placed femoral DC plate gives the best results.

Amputation, Traumatic↗
PubMed1988

Dynamic angioplasty--a milling catheter for transcutaneous and intraoperative treatment of vascular occlusive disease.

Balloon angioplasty and bypass graft surgery are common procedures for treating vascular occlusive disease. The purpose of this preliminary investigation was to evaluate the effectiveness and the safety of a new catheter system, first introduced by KR Kensey. The system involves a flexible catheter with a high speed rotating tip, driven by an electrical motor. The tip is cooled by a continuous flow of sterile saline containing dextran 40, heparin and urokinase. Radiopaque contrast medium may be infused through the catheter to allow the device to be guided and to detect lesions and to evaluate the efficacy of treatment. The system was applied in three patients with occlusive vascular disease (Stage IIb) and segmental or total occlusion of the superficial femoral artery (SFA). The milling catheter was introduced percutaneously into the common femoral artery and guided to the area of occlusion under DSA control. In two patients total recanalisation was achieved after passage of the milling catheter. In one patient the totally occluded SFA could not be cannulated and a femoro-popliteal bypass was performed one week later. Complications such as perforation of the vessel or peripheral embolisation were not observed. Pedal pulses were improved significantly in one patient. Further investigations will be necessary to demonstrate whether the milling catheter can be safely used to revascularise patients with limb threatening peripheral vascular disease.

Angioplasty, Balloon↗
PubMed1987

[Compression syndromes in the popliteal area].

In young, active patients with intermittent or sudden-onset ischemic pain in the lower leg, the presence of an entrapment syndrome of the popliteal artery must be considered. This compression syndrome can be clinically and angiographically verified by an interruption in the continuity of the middle segment of the artery. As irritation of the arterial wall can lead to complete occlusion of the artery, all cases of entrapment syndrome within the popliteal fossa--even those causing few symptoms or none at all--require surgical revision. A dorsal approach should be used, and the anatomical variations of the artery listed elsewhere must be considered. The surrounding musculature on the fibrous structures causing compression must be incised or resected; in some cases vascular reconstruction is necessary. In the relatively rare soleus syndrome, there is entrapment of nerves and veins as well as of the artery. In such cases, the tendon of the soleus muscle must be split to obtain adequate decompression of the vascular nerve bundle.

Constriction, Pathologic↗
PubMed1987

[Anatomy and clinical aspects of sartoriusplasty].

According to Mathes and Nahai (1982) the sartorius muscle is supplied in a segmental fashion (Type IV) from six to ten branches arising from the superficial femoral artery. They state that the use of this flap is limited because of the segmental blood supply. In contrast, dissecting 40 cadaver specimens at the Anatomy Department of Munich University a different vascular anatomy was revealed in which only two to four branches from the femoral artery supply the whole muscle. Based on this pattern of intramuscular vascular connections, the most proximal arterial branch provides the blood supply to the whole muscle. Elevated on the proximal vascular pedicle the muscle can cover defects of symphysis, fill the acetabulum following disarticulation of the septic hip joint and osteomyelitic defects of femur.

Arteries↗