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Biomedical subjects

L Zichner

Publications and source records attributed to L Zichner.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Postoperative treatment, rehabilitation and expert assessment of patients with endoprostheses of the hip joint].

The main demands on a total hip replacement are to reduce pain or achieve painlessness and to recover or improve mobility and walking ability. Today more younger patients were operated replacing a destroyed hip joint: the reintegration in professional and sportive activities is a major part of the rehabilitation process. The postoperative management especially in physical therapy can be standardized inspite of the use of various models. Usually full weight bearing is accepted after 3 months. A review of consecutive treatment methods and professional and sportive rehabilitation measures are presented. Hip replacement leads to restrictions in activity in general. The evaluation, in relation to the different indemnifying, is differentiated.

Disability Evaluation↗
PubMed1989

[Bosworth management of acromioclavicular joint dislocation].

It is reported on 26 cases of acromioclavicular joint dislocation, which were treated by the Bosworth-method of coraco-clavicular screw-fixation. 21 patients were followed up for an average period of 27 months. In spite of osteoarthritis in 44% and calcification in 83% all patients had free mobility. 67% were painfree, 33% had little pain. A fully professional and sporting rehabilitation was achieved in 91% respectively 86%.

Acromioclavicular Joint↗
PubMed1988

[Therapy of bone and joint changes in renal osteodystrophy in adulthood].

The renal osteoarthropathy in patients with chronic renal disease undergoing hemodialysis is characterized by increased bone turnover. This is the consequence of secondary hyperparathyroidism and leads to fibro-osteoclasia and osteomalacia. Mineralization of the atypical bone fibers is diminished and the collagen texture is altered. The biomechanical properties of such bone are reduced, which means that the incidence of fractures is increased and fracture healing seems to be disturbed. Therapy given for renal failure leads to segmental necrosis of the epiphyses. In the growing skeleton longitudinal growth is diminished and deviations in the axes of long bones are often observed. Corrective osteotomies, treatment of fractures and artificial joint replacements are therefore necessary in patients with renal failure. Observations recorded in 13 patients (aged 16-67 years) with chronic renal insufficiency who underwent 21 surgical interventions and were followed up for 6 years have led to formulation of the following general recommendations. Corrective osteotomies should only be performed when they are absolutely essential; the rate of nonunions is very high. The same is true for fixation of fractures with plates and nails. When joint replacements are inserted because of segmental necrosis and fractures the course is almost the same as in patients without renal osteoarthropathy when bone cement is used for fixation.

Adolescent↗
PubMed1985

A case of bone fluorosis of undetermined origin.

After predominant theories on the causes of fluorosis are described and remarks made about the metabolism of fluoride, an observation of bone fluorosis in a 64-year-old patient is reported. Because, despite painstaking research, none of the known causes of bone fluorosis could be found in our patient, a new pathomechanism is being offered for discussion, i.e., increased renal or intestinal absorption or an increase of fluoride deposited in the bone; i.e., an inborn or acquired error of fluoride metabolism. We recently observed a similar case with none of the well-known origins.

Bone Diseases, Metabolic↗
PubMed1985

[Replacement of the cruciate ligament with heterologous connective tissue structures].

Twenty-four implantations of heterologous connective tissue structures replacing ligaments and tendons are evaluated in order to present the early results in the heterologous replacement of cruciate ligament structures. Twenty implantations are analysed after 18 to 36 months. The biologic structure which is very strong in comparison with the autologous tissue is not modified to a great extent during a period of 21 months, i.e. the ligament prosthesis remains unchanged so that the appellation "bio-prosthesis" seems justified. At present the preliminary clinical results are satisfying. Consequently, heterologous connective tissue structures can be used in repeated surgical interventions for the stabilization of chronic ligament instabilities.

Adolescent↗
PubMed1981

[Replacement of proximal end of the femur (author's transl)].

The article reports on replacement of the proximal end of the femur, including the acetabulum, by means of special endoprostheses in a total of 49 hips. Besides treatment of pertrochanteral and subtrochanteral fractures of the femur in individual cases, and an increasing field of application within the framework of prosthetic exchange operations, resection and replacement of the coxal femur are mainly employed in tumour processes. Primary malignant tumours require pre-treatment and after-treatment by chemotherapy (with the exception of chondrosarcoma) in order to meet the demand of oncological radicality. Tendency to luxation, which is the most frequent component, can be reduced by employing a sophisticated surgical technique, good physiotherapy, appropriate training of the patients, and application of a Hohmann's bandage. The radiological course indicates that all the complications involved in endoprostheses, especially loosening, may be expected, even though they may occur with a certain delay of time. Besides general osseous atrophy of the prosthesis-bearing diaphysis, it is mainly the lateral "traction" side which is affected. Sintering of the prosthesis can temporarily delay breakdown of the anchoring. Prosthesis fractures are possible. Hence, the special endoprosthesis proximal to the hip joint is a recommended alternative to surgery of a crippling nature. In view of the fact that it is hardly possible to retract one's steps at a later date, indications towards special endoprosthesis must continue to be highly differentiated and closely adapted to each individual case.

Adolescent↗
PubMed1981

[Diagnosis of focal spinal diseases - a critical review].

The article offers a critical review of the diagnosis of focal diseases of the vertebral column, based on 200 histological vertebral column examinations. The findings obtained by means of the roentgenological, histological and bacteriological examinations can be subdivided into 6 groups: 1. Non-specific and specific cases of spondylitis (59 patients); 2. Systemic malignant diseases and primarily malignant tumours (23 patients); 3. Metastases (71 patients); 4. Benign tumours (11 patients); 5. Miscellaneous cases (28 patients) and 6. Unclarified cases (8 patients). The authors comment on the following points with specific reference to the results obtained by them: a) Possibilities and limitations of roentgenological diagnosis: roentgenologically, the inflammatory diseases are most easy to identify, but is not always possible to differentiate safely between non-specific, specific and plasmacellular spondylitis. There are clear limitations to the diagnosis of the type of focal diseases of the spinal column; this applies particularly to the benign and malignant types of tumours. b) Necessity of arriving at an accurate diagnosis: it is imperative to aim at an accurate diagnosis before any meaningful therapy can be initiated. The mandatory need for this is explained via examples covered by the present study. c) Closed or open biopsy: it is shown by means of a review of the literature that open biopsy yields more representative material for the histological examination than closed needle biopsy. It goes without saying that this is a true prerequisite for an accurate histological diagnosis. In this connection, the authors go into the details of the difficulties governing any histological examination. d) informative value of further additional examinations: Scintigraphy, tomography and computer tomography may be valuable aids in the discovery and better visualisation of a vertebral focus, but they are not helpful in arriving at a diagnosis regarding the type of focus involved. Laboratory examinations are not very helpful, either. e) Accuracy of the authors' own diagnostic measures: in spite of open biopsy, 177 cases only out of 200 (88%) could be diagnosed on a purely histological basis. In 12 further cases, diagnosis was established after correlation of the histological finding with the x-ray film. 8 cases (4%) could not be clarified. In 7 patients (3.5%) it must be assumed that the focus was not located despite open biopsy.

Adolescent↗
PubMed1980

Clinical experience with Mueller total hip endoprostheses of different design and material.

Patients of the Orthopaedic University Hospital in Frankfurt operated between 1970 and 1977 were examined to control the success of implantations of total hip endoprostheses. Ninety-three percent of totally 1497 implanted hip prostheses are Müller standard type, additionally there have been implanted 44 Weber-Huggler prostheses and 54 special long stem prostheses. During the follow-up period of 10 years 7.4% of the primarily implanted prostheses had to be revised. The reasons for revision were loosening of the stem and/or socket in 56% of the cases, 20% infections, 14% technical errors and in 11% of the cases fractures of the stem occured. Fifty-two percent of the implanted Weber-Huggler prostheses with rotational ball heads made of polyester had to be revised in the meantime, 78% of the cases because of loosening of the prosthetic components. It could be shown that the number of infected cases could be diminished after introduction of an ultraclean air operating box. The change of the cross section of the Müller-type-stem from a round medial wedge to a flat one and the introduction of CoNiCrMo wrought alloy Protasul-10 instead of CoCrMo cast alloy Protasul-2 as stem material in 1973 resulted in a much smaller rate of loosened prostheses without fractures of the forged Protasul-10 stems. During the 6 examined years there has been no fracture of a prosthetic stem made of Protasul-10.

Alloys↗