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Biomedical subjects

M Gebhart

Publications and source records attributed to M Gebhart.

At least 37 records · Page 2Linked to original sources
PubMed1997

Ewing sarcoma of the cubitus reconstructed by a non vascularized autologous fibular graft.

A 19-year-old white man presented with an Ewing sarcoma of the left cubitus. A preoperative chemotherapy was administered according to the T9 Rosen protocol. A wide excision was performed with a 19 cm bone defect, reconstructed in the same operating time by a non vascularized autologous fibular transfer. The postoperative chemotherapy was administered without any major problem. Both surgical and functional evolution are here presented and the osteointegration is evaluated. A discussion of this type of reconstruction is presented evaluating donor site morbidity and possible complications.

Adult↗
PubMed1997

Osteosarcoma of the proximal fibula: report of 3 cases.

Osteosarcoma of the proximal fibula represents about 2% of all osteosarcomas. The complexity of anatomical structures in this region led in the past to low transfemoral amputation in order to achieve local control. Three patients aged 14, 13 and 14 were treated in our institution and surgical margins were free of tumour after a wide en bloc resection. To achieve that, the lateral wall of the tibia and the anterior tibial artery were taken out with the proximal fibula. All three patients are alive without evidence of disease. The functional results are evaluated according to Enneking system recommended and adopted by the Musculo-Skeletal-Tumor Society (M.S.T.S). Overall functional results were 80, 100 and 100%.

Adolescent↗
PubMed1996

Internal hemipelvectomy.

Until recently, tumours involving the pelvis were usually treated by hemipelvectomy, otherwise called "hindquarter amputation". A more recent approach of treating these tumours is the 'conservative hemipelvectomy', which consists of removing the tumour and sparing the lower extremity. A patient with Ewing's sarcoma of the pelvis underwent such a procedure. The femoral head was fixed temporarily to the remaining parts of the acetabulum and the iliac wing by a Steinman pin. The Steinman pin was removed 6 weeks after the operation and the patient was then put into traction for another 6 weeks. Weight-bearing was gradually allowed after 3 to 6 months. The patient remodelled a neoacetabulum, which gave sufficient stability to the hip joint. Walking without external help was possible. The patient presented with a 2 cm limb-shortening. No local recurrence was observed during a follow-up of 30 months. This experience with internal hemipelvectomy shows an encouraging result in terms of tumour control and gait function.

Adult↗
PubMed1996

Evaluation of patch test results with denture material series.

791 patients, among them 59 dental technicians and 732 other patients, were tested with the denture material series (DMS) recommended by the German Contact Dermatitis Research Group (DKG) in the hospitals of the Information Network of Departments of Dermatology (IVDK) between January 1990 and July 1993. Most frequently, positive reactions occurred to cadmium chloride in both groups. However, there was no evidence at all for relevance of these reactions. Benzoyl peroxide (BPO) ranked 2nd in patch test positivity. Although not statistically significant, reactions were more frequent in dental technicians, who might be exposed to BPO the in working environment. Methyl methacrylate (MMA) and triethylene glycol dimethacrylate (TEGDMA) were common sensitizers in dental technicians but not in other patients. This finding, too, has its explanation in the working process of manufacturing dental prostheses.

Adult↗
PubMed1996

Contribution to the vascular origin of the unicameral bone cyst.

Vascular occlusion between bone cyst and intramedullary venous system seems to be the primum movens in the genesis of a unicameral bone cyst. High speed injection of saline and alternative aspiration injection of the cyst fluid and reaming of the medullary cavity clearly open vascular channels connecting the bone cyst to the intramedullary venous system. This was monitored by pre- and postmanipulative radiographs. This technique was employed in 12 patients with a unicameral bone cyst. All but one went on to healing with increasing diameter of the cortical bone and filling of the cystic cavity.

Adolescent↗
PubMed1995

Lymphangiosarcoma. Reports of 3 cases and review of the literature.

Three cases of lymphangiosarcoma have been followed recently. All were finally treated by amputation. Only one is actually disease-free. The other two developed local recurrence at the thoracic cage. An extensive review of the literature follows the case presentation.

Combined Modality Therapy↗
PubMed1993

Functional evaluation of megaprostheses replacing the proximal femur.

Between 1987 and 1991, 20 large proximal femoral replacements were performed in 19 patients (10 males and 9 females). The median age was 60 years (15 to 89 years). Four patients presented with a primary sarcoma involving the proximal femur; 15 had bone destruction secondary to metastatic disease. Twelve of the 20 had a pathological bone fracture. The average length of the proximal femoral resection was 12 cm (7 to 26 cm). Fourteen patients could be evaluated for pain and function according to the SICOT hip-evaluation score. All patients, except one with rapidly progressing local disease, were able to walk again independently using one or two crutches. Limping and a positive Trendelenburg sign were observed in all cases but two.

Activities of Daily Living↗
PubMed1991

A radiographical and biomechanical study of demineralized bone matrix implanted into a bone defect of rat femurs with and without bone marrow.

Repair of large bone defects represents a challenge to orthopedic surgery since autogenous graft is not available in large amounts. Demineralized bone matrix (DBM) which contains bone morphogenic protein, a potent osteoinductive glycoprotein, and collagen, an osteoconductive matrix, may be an effective substitute for these graft materials. Bone marrow which contains osteoprogenitor cells could potentiate the osteoinductive and osteoconductive properties of demineralized bone matrix. This study tested the ability of demineralized bone matrix with and without bone marrow to bridge large segmental defects, and evaluated the results both radiographically and biomechanically as compared to autogenous (isogeneic) cancellous bone graft. Demineralized bone-matrix segments implanted into a plated femoral segmental defect in rats resulted in firm union in most animals. Bone marrow significantly enhanced bone formation of demineralized bone-matrix implants at an early stage but with time, differences between bone marrow-augmented and bone marrow-deprived demineralized bone implants were no longer demonstrable radiographically and biomechanically. Newly formed bone had about 50% of the strength of the contralateral control bones. Femurs implanted with cancellous bone isografts had similar evidence of absolute union rate, radiographic and mechanical properties as DBM-implanted femurs.

Animals↗
PubMed1989

Upper extremity function after conservative interscapulo-thoracic tumor resection.

Six patients who had undergone an en bloc interscapulo-thoracic excision (for primary bone or soft tissue sarcoma in five, and metastatic disease in one) were subject to review, with special emphasis on the functional outcome of the operated arm. Active shoulder motion was poor in all patients, but this did not prevent passive positioning of the hand and elbow. Elbow and particularly hand function was either not, or only slightly, impaired so that two patients regained full use of their upper extremity. Three patients had satisfactory but impaired function and one with metastatic disease of the should had a poor functional outcome.

Adult↗
PubMed1989

Surgical treatment of bone metastases of the peripheral skeleton--a review of 33 cases.

Out of a total of 31 patients (26 females and five males) there were 24 complete and nine impending pathological fractures. These, treated from October 1985 to September 1987 at the Bordet Institute, were evaluated. Breast cancer was the most frequent underlying disease (66%) followed by lung cancer (12%). Eighteen lesions were treated by endoprosthetic replacement and 15 by an intramedullary fixation device. Bone cement was added to either of these. Satisfactory pain relief was obtained in 82% of the treated areas and restoration of function in 76%. Complications were rare but included one easily resolved superficial wound infection, four deep venous thromboses, movement limited to 21% (seven joints), and the changing of two fixation or reconstruction devices. Median survival time was 6 months; 35% of the patients were still alive after 12 months and 10% after 24 months.

Adult↗
PubMed1989

[Resection of bony tumors around the knee and lengthening of the stump by the Van Nes rotation plastic surgery technic].

The Van Nes rotation plastic surgery technic is a procedure to lengthen the femoral stump. It is used for patients with an immature skeleton who present a malignant bone tumour around the knee. The operation is an alternative to high transfemoral amputation. Nine patients treated with this procedure are reviewed. In five surviving patients, characteristics of walking, extension strength of the foot, and early and late complications were satisfactory.

Adolescent↗
PubMed1988

Modified hemipelvectomy: conservation of the upper iliac wing and an anterior musculo-cutaneous flap.

Very large bone and soft tissue tumors located in the pelvis or upper thigh may require hemipelvectomy if local excision is not possible. Classical hemipelvectomy is associated with a high risk of local complications and usually with a poor functional result. This paper describes a modified hemipelvectomy where the preservation of the upper iliac wing provides a counterpressure for the external prosthesis, and a vascularized anterior musculo-cutaneous thigh flap decreases the risk of skin necrosis and wound problems.

Adult↗
PubMedDate not supplied

Thyroid carcinoma metastasis to the sternum: resection and reconstruction.

Metastases of thyroid carcinoma to the sternum are not so frequent and ablative surgery enables the patients to live longer with a better quality of life. After such a resection, the surgical defect has to be covered either by autogenous or artificial substitutes. We present a 62 years old patient with an asymptomatic sternal metastasis of a poorly differentiated follicular thyroid carcinoma. After radical excision, including the sternum, both clavicular heads and an upper mediastinal dissection, the defect was reconstructed in two layers, combining a Marlex mesh and a pedicled pectoralis major muscle flap. Postoperative course was uneventful and respiratory function was not disturbed.

Carcinoma↗