[Stability investigations of various osteosynthetic materials in femoral neck fractures].
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Aged↗
Biomedical subjects
M H Hackenbroch
Publications and source records attributed to M H Hackenbroch.
[Localized osteolytic processes in spondylarthritis ankylopoietica].
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Adult↗
[Surgical removal of a cervical vertebral body for giant cell tumor and ventral chip fusion].
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Adult↗
[Cryosurgical ablation of bone tissue with a newly developed miniature cryoprobe--adaptation of the method for use in bones in vitro and in vivo].
AIM: Up to now, modern miniature cryoprobes have been used successfully for local destruction of soft tissue tumors without damaging adjacent healthy tissue. In this study, the methodology of cryoablation was applied to bone and the freezing effect as well as the cooling capacity of the probe was examined in vivo and in vitro. METHODS: Freezing was performed by cooling one or two probes, with a diameter of 3.2 mm to -180 degrees C with liquid nitrogen. The cooling capacity of the probes was determined under thermic control by an in vitro measurement on human bone, followed by an in vivo measurement on femoral and tibia bones of a sheep. RESULTS: The in vitro freezings achieved a sufficient tissue cooling using one or two cryoprobes. The simultaneous use of 2 probes resulted in a synergistic effect between the probes. According to the body heat, the registered temperature curves, during the in vivo freezings, showed a more flat trend. Nevertheless, temperatures below -50 degrees C were achieved at a distance of 1 cm from the probe due to the synergistic effect. Local or systematical intraoperative complications have not been observed. CONCLUSION: An adequate tissue cooling of bone matrix can be achieved within in vivo freezings through the use of one or more miniature cryoprobes so that the use of this probe could possibly become an alternative or supplement to the surgical resection of pathologic bone processes.
Animals↗
[Costal osteoid osteoma].
We report about a rare case of osteoid osteoma of the 9th rib in a 32 year old woman. A search of medical literature yielded only 16 reports about costal osteoid osteoma. This tumor should be considered in cases of painful rib without anamnestic trauma.
Adult↗
[Experiences with the Cologne treatment plan in epiphyseolysis capitis femoris juvenilis].
From the results obtained we conclude that standardized radiograms in two planes were able to demonstrate the full extent of the basic lesion and thereby to facilitate planning of accurate therapy. Operative fixation of low grade dislocation as inaugurated by Imhäuser and intertrochanteric corrective osteotomy of higher grade dislocations, respectively, have been proved useful as well; whether or not the critical angle is to be assumed at 30 degrees cannot be proved by our material and won't be able to be proved until our own longstanding epicritical observations are available as well as the results of patients treated by different regimens. Based on our experiences with patients treated at other places we believe in operative fixation of the "healthy" contralateral hip in accordance with Imhäuser. This statement can be made as a result of our experiences with 83 patients suffering from chronic dislocation of the upper femoral epiphysis. In future it appears desirable to concentrate on the problem of primary chondrolysis because chondrolysis as well as the remaining residual deformity after treatment appears to be decisive for the fate of the joint.
Adolescent↗
[Treatment results of Imhäuser's method of treating neonatal clubfeet].
The results of treatment of newborn clubfoot are reported 6 years and 3 months after operation. 88 children with 123 clubfeet were treated beginning at the neonatal period with redressment and casting followed by achillotenotomy and dorsomedial and dorsolateral capsulolysis of the talocrural and talocalcaneal joints at 4 to 7 months of age. After that a strict protocol of physiotherapy, orthetics and controlling was used. For clinical and radiological assessment the criteriasof Magone (40) and Simons (51, 52) were used. The significance of parental cooperation was analysed. At follow-up the result was good or acceptable in 83.7% according to clinical findings and 43.6% according radiology respectively. There was obviously no correlation of clinical and radiological findings. The mobility of the ankle joint proved to be important regarding the functional result, especially in cases with flat-top-talus it has been limited. Parenteral cooperation is of special importance for good results in clubfoot-therapy.
Achilles Tendon↗
[Recalcification of an 8 x 4 x 4.5 cm large brown tumor with spontaneous fracture following parathyroidectomy. Case report and course].
Primary hyperparathyroidism is typically accompanied by a vast array of symptoms and the occurrence of so-called brown tumors often localized in the metaphysis of bone. These tumors are radiologically and histologically hard to distinguish from giant cell tumors. Usually they recalcify after parathyroidectomy, except in case of genuine cysts. We report on an extended brown tumor of the tibia located just below the knee joint of a 45-year-old woman. It was a large as 8 x 4 x 4.5 cm and had been noticed after a spontaneous fracture. Complete recalcification occurred after parathyroidectomy and the bone recuperated fully after 6 months.
Bone Neoplasms↗
[Computerized tomography in lumbar compression syndrome].
Computertomography has been shown to be a reliable method for evaluation of lumbar compression syndromes. Excellent apparative equipment and differentiated examination techniques are required. As compared with myelography CT offers the advantages of a non-invasive procedure. Due to simultaneous axial visualisation of bone and soft tissue all components contributing to lumbar compression syndromes are included. This so far cannot be achieved by conventional radiographic methods. CT is superior to myelography concerning specificity and sensitivity of the diagnosis of primary and surgically treated herniated discs. It demonstrates extreme lateral dislocation of disc tissue as well as centrally located disc material at the L5/S1 level. Furthermore, compressing structures such like monosegmental osseous stenosis and stenosis of the spinal canal are well to be recognized. Tumors may be ruled out. Verification of postoperative hematoma and scar formation is of high clinical value. Myelography, however, remains being the method of choice when clinical symptoms are not to be appointed to a certain segment.
Diagnosis, Differential↗
[Size and localization of exposed bone surfaces in advanced degenerative changes of the femur head].
Area and localization of bone exposure are examined in 37 femoral heads being removed for total arthroplasties. Both are inhomogeneous and show no relation to the duration of clinical complaints nor the changing of stress following limitation of motion or contracture. There have been numerous descriptions of the stress on femoral heads and the location of degenerative cartilage disease in zones of more or less stress, however all theories can be verified or disproved by the types of localization of bone exposure described. The theory that loss of cartilage is not as much due to stress but to chemical alterations cannot be confirmed. A new theory including all observations or a schema of localization of progressive degenerative disease cannot be presented for the present.
Aged↗
[Modified intracorporeal lithotripsy for cement removal in hip prosthesis exchange operations--experimental principles].
INTRODUCTION: Particularly problematic in total hip revision arthroplasty is the cement removal out of the depth of the femoral canal; it is also costly in time and effort. The extracorporal shock wave lithotripsy proved to be an unsuitable method. With the present paper we proved experimentally a newly developed endoscopically controlled modified intracorporal lithotripter (Swiss Orthoclast) for the removal of bone cement. METHODS: We tested the efficiency on standardized cement specimens of different manufacturers in vitro. We compared both conventional removing techniques with mallet and chisel and a pneumatically powered chisel with formalin fixed human femora. During these experiments we measured the intrafemoral pressure distally to the cement layer. RESULTS: We achieved a high energy (max. 450 mJ) and a very effective fragmentation of the cement (40 mg fragments calculated on the single impulse of 350 mJ). The endoscopic control ensures a safe control of the cement removal even in the depth of the femoral canal. No bone damage occurred macroscopically and radiologically. No heat or toxic products developed. Using the Swiss Orthoclast the intrafemoral pressure was the lowest possible (7 mbar). Even with hammer and chisel or the pneumatically powered chisel the pressure was too low (max. 55 mbar with mallet and chisel) to cause a fat embolic syndrome. CONCLUSION: As a result of these experiments we started with clinical trials (with permission of the Ethic commission) to evaluate the practicability of the modified intracorporal lithotripter (Swiss Orthoclast) for cement removal.
Arthroscopes↗
[Relations between degenerative changes in the femoral head and the radiologically determined biomechanical magnitude of effects].
40 femoral heads taken at hip arthroplasty are examined. The position and expansion of cartilage loss are determined and related to the preoperative X-rays. Femoral "bald heads" appear most frequently at the lateral ventral aspect. The angle phi formed by the hip resultant (Pauwels) and the longitudinal axis of the body is related to the CE-angle (Wiberg) as follows: Small CE-angles are associated with large phi and vice versa. Coxa valga (projected CCD-angles greater than 141 degrees) is associated with predominantly lateral location of areas of bone exposure. Low CCD-angles (less than 120 degrees) and large CE-angles (greater than 30 degrees) go along with larger "bald heads". In cases with overweight the expansion of bone exposures does not exceed the amounts found in "normal body weight". Thus bone exposing destruction of cartilage is mainly situated near the point of penetration of the resultant force through the weight bearing surface of the joint. Larger "bald heads" occur favourable at the "deep" acetabula revealing high CE-angles and at low CCD-angles.
Aged↗
[Atypical Achilles tendon rupture in Haglund exostosis--a case report].
We report about an unusual case of a rupture of the Achilles tendon in a patient with Haglund's exostosis and long term achillodynia. Intraoperatively, we found a fresh superficial typically located tendon-rupture and an old deep round shaped rupture which was located directly over the cranial edge of the calcaneous bone spur. We presume that the sharp edge of Haglund's deformity was the cause of the deep tendon rupture, because the location of the round shaped rupture was near the exostosis. The additional superficial rupture, caused by an inadequate trauma, induced operative revision consisting of double layer transosseous suturing. In conclusion early operative resection of Haglund's deformity in cases of repeated irritations of the Achilles tendon should be performed to avoid mechanical damage, including the risk of rupture by the hypomochlion-like effect of the exostosis.
Achilles Tendon↗
Prophylactic dynamic screw fixation of the asymptomatic hip in slipped capital femoral epiphysis.
Prophylactic dynamic screw fixation (DSF) of clinically and radiographically unaffected hips of 34 patients with a contralateral slipped capital femoral epiphysis and no evidence of an endocrinopathy or systemic disorder was performed using a single cannulated screw. Follow-up ranged from 2 to 12 years (average, 5.4 years). There was no case of perioperative complication and no avascular necrosis or chondrolysis occurred. No preslip or slip became apparent. In all 34 hips, no tendency toward premature closure of the epiphysis could be observed, no growth disturbance including greater trochanteric overgrowth, coxa brevis, or coxa vara was noted. This study supports the prophylactic treatment of the asymptomatic hip, using a simple and safe fixation method.
Adolescent↗
Thyroid function in Legg-Calvé-Perthes disease: cross-sectional and longitudinal study.
Thyroid function was studied in 59 consecutive children with Legg-Calvé-Perthes disease (LCPD) and 239 controls. The subjects of both groups were generally euthyroid. In the Perthes group, however, plasma concentrations of free thyroxin (FT4) were increased by 16% (p < 10(-8)) and those of free triiodothyronine (FT3) were increased by 10% (p < 0.001) as compared with controls. There was a tendency toward higher FT4 levels in children with necrosis of more than one half of the femoral head (p < 0.015), as compared with those with lesser involvement. The observed moderate hormonal changes were already evident at the time of diagnosis of LCPD and were not appreciably influenced by stage of disease or mode of treatment, as determined by longitudinal evaluation of 38 children. Our data may support the assumption of other investigators that systemic abnormalities exist in children with LCPD, but the relation between these findings and the femoral head necrosis is not known.
Adolescent↗