Biomedical subjects
Publications and source records attributed to L Weh.
Report of a case with dislocated fracture of the clavicle and dysplasia of the first rib with consecutive armplexus paresis and thrombosis of the axillar and brachial vein. In such cases operative treatment is advised.
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AIM: A systematic review was performed to evaluate the clinical effects of specific back muscle and non-specific physical fitness training in chronic low back pain. METHOD: A computer-aided Medline research (19861999) of randomised clinical trials concerning both rehabilitation concepts was conducted. A rating system was used to assess the methodological score of each study. The results were analysed and a final statement for evidence according to three main parameters (back pain, physical capacity, and patients comfort) was postulated. RESULTS: Twelve randomised clinical trials were identified. Nine studies were determined as high-quality trials. For chronic low back pain specific back muscle exercises as well as non-specific fitness training were able to improve the patients' conditions sufficiently. In comparison with passive treatment or no treatment there is strong evidence for pain and physical capacity in both groups, but only a positive influence for patient' comfort in fitness groups. Nevertheless, a confrontation of both concepts in two studies did not reveal any notable differences in all three parameters. CONCLUSION: Principally, a specific strength training for back rnuscles as well as a non-specific fitness training are comparably effective to rehabilitate chronic low back pain.
Functional Independence Measure (FIM) is a method for uniformly recording functional status in rehabilitation patients. It has been under development in the USA since 1985. In this study, the prognostic value of function tests by FIM on admission to the rehabilitation clinic was investigated in two groups (45 patients in all). Thirty-three patients were admitted for rehabilitation following apoplectic shock, the remaining 12 following treatment of fractures of the femoral neck by total hip replacement. A highly significant correlation was found between the total FIM score on admission and the patient's status on discharge. Of the individual functions studied, the activities "dressing and undressing" and "walking/riding in wheelchair" were found have the highest predictive value.
In cases of spontaneously occurring patellar pain, there is generally some slight damage to the nerve roots and anterior horn cells of segments L3 and L4. Divergent patellar movement can be measured roentgenologically. When the quadriceps is contracted the patella normally medialward in varus joints, and lateralward in valgus joints and when the leg position is axially correct. In peripatellar pain syndrome, however, lateral movement can be demonstrated in varus joints. Additionally, there is a tendency for the rotation of the patella to depend on the innervation disorder. The discrepancy between the muscular guidance of the patella and the performed guide bed may be one of the factors causing patellar pain. Etiologically, axial malpositions of the leg appear to be important predisposing factors and innervation disorders of the quadriceps muscle realization factors.
The influence of the shape of the patella and of the plica medialis parapatellaris on cartilage changes was studied in 161 knee joints (autopsy material). The cartilage changes were cartographically recorded and transferred to a computer matrix. The type and size of the plica were documented. The material studied was classified according to age, patellar shape, and degree of prominence of the plica. Cartilage lesions were found on the odd facet even in younger material. The cartilage damage depended on the shape of the patella. The more convex the medial facet, the less cartilage damage had occurred. The odd facet was found to be the point of origin of chondromalacial changes on the medial side of the patella. It is assumed that the plica medialis parapatellaris and the fat fold located there encourage the development of chondromalacia, especially where the medial facet is convex in shape.
The mechanical behaviour of anulus fibrosus is dependent on collagen fibers and influences the prolapse disposition. The aim of study was the comparison of constitutional mechanical tissue properties between a group of patients with disk herniation and normal. A computerized finger hyperextensiometer was developed which was able to analyse the viscoelastic tissue properties. In the disc herniation group the hyperextension angle of the metacarpophalangeal joint was smaller (p < 0.001), the relative integral area of the force/angle regression was larger (p < 0.001), the relative area under the secant of the curve (p < 0.01) and the recover value were smaller (p < 0.01). The results suggest that a anulus fibrosus with constitutional reduced extensibility, stress absorption capacity and recovery is disposed to herniation.
The innervation pattern of arm muscles in tennis elbow during defined movement of the wrist was analysed by polymyography. 30 patients with tennis elbow and 40 control persons had been investigated. Dorsal and palmar movements of the wrist joint lifting 5 kg had been performed. The electromyogram of 8 muscles had been registered. There was no abnormality in palmar flexion. The height and integrals of amplitudes in extensor muscles during extension had been considerably smaller. It is suggested that in tennis elbow the dorsal extension is exerted by a smaller number of fibers. This might be the cause of enthesiopathy.
Studies were performed in order to obtain information on the pathogenesis of patellar tip syndrome (PTS). Using a finger hyperextensiometer, ligamental laxity tests were performed on athletes, non-athletes and controls. Ninety-eight PTS patients who did not indulge regularly in sports, 39 patients from the German federal volleyball league, and 400 healthy controls were examined. No difference in the extensibility of ligaments was found between the patients from the group of competitive athletes and the controls. However, a significantly increased extensibility of the finger joints was found in all age and sex groups with "spontaneous" PTS. The authors conclude that 1) constitutional laxity of the ligaments is a key predisposing factor for PTS, and 2) PTS is triggered by physical stress. Susceptibility to microtrauma at the insertion of the patellar ligament is a function of the constitutional strength of the ligaments.