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Biomedical subjects

M Pritsch

Publications and source records attributed to M Pritsch.

50 records · Page 3Linked to original sources

Ankle arthroscopy.

Arthroscopic assessment of the ankle joint can be an important diagnostic aid for intra-articular pathologic conditions. The major portals of entry are anteromedial and anterolateral. In one patient with loose bodies of the ankle, the authors successfully localized the loose bodies and determined the status of the articular surface by arthroscopy. In a second patient with pain and a roentgenogram suggestive of an osteochondral fracture, arthroscopic evaluation determined that the articular surface was intact, and the patient was successfully treated non-surgically. Precise indications for arthroscopy of the ankle have not yet been determined, but its role will certainly be less extensive in the ankle than in the knee.

Adult↗

Recurrent dislocation of the shoulder and the Putti Platt operation.

Recurrent dislocation of the shoulder has long been recognized, and more than 100 techniques for repair of the injury are described. This survey describes 113 patients who suffered from recurrent anterior dislocation of the shoulder and were operated upon in accordance with the Putti Platt technique. The most significant preoperative finding was inadequate immobilization after the primary dislocation (62% of the patients). Postoperative recurrence was uncommon (1%) and a relative increased limitation of motion in the postoperative period improved gradually to almost a full range of movement.

Adolescent↗

Efficacy of ceftriaxone and gentamicin in an abscess model.

The therapeutic efficacy of ceftriaxone and gentamicin was investigated in a foreign body induced abscess model in the rat by implanting a dialysis tube contaminated with Klebsiella pneumoniae into the subcutaneous tissue. Animals were treated for four days with ceftriaxone, gentamicin, and their combination starting immediately following or 48 h after the implantation. Peak free ceftriaxone and gentamicin abscess fluid levels were 4.3 and 2.6 mcg/ml, which were 7.3% and 37.5% of peak blood levels respectively. Both agents persisted longer in abscess fluid than in blood. Ceftriaxone inhibited the development of abscess formation when administered shortly after the implantation of the contaminated foreign body whereas gentamicin alone was without beneficial effect. When administered after 48 h ceftriaxone was less effective than immediately after implantation and gentamicin was again without any therapeutic effect. The effect of the combination of ceftriaxone and gentamicin was slightly better than ceftriaxone alone. Low oxygen tension may be an explanation for the lack of bactericidal effect of gentamicin. Ceftriaxone may be more suitable for the therapy of closed space infections caused by susceptible microorganisms than gentamicin.

Abscess↗

Manipulation and external fixation of metacarpal fractures.

We have developed a method of manipulation and external fixation of metacarpal fractures using Kirschner wires bonded with acrylic resin. This simple procedure requires no special instruments and it facilitates accurate reduction and stable fixation of the fracture while allowing free movement of the hand. Access to the wound is unhampered in open fractures. Thirty-six fractures were treated by this technique. All healed within five weeks, during which time free movement of the hand was encouraged. There were no complications.

Acrylic Resins↗

An unusual fracture of the base of the fifth metatarsal bone.

An unusual fracture of the base of the fifth metatarsal bone is described. The type of fracture and the displacement of the proximal fragment was unlike that of most other fractures of this region of the foot. It requires open reduction and internal fixation which was successfully carried out by means of tension wires.

Adult↗

An operative technique for recurrent shoulder dislocations in older patients.

Recurrent anterior shoulder dislocation in the elderly is not as exceptional as it was once thought to be. That anterior shoulder dislocation in older patients is caused by a rotator cuff tear through the posterior mechanism is well accepted. However, in the subset of patients who have multiple recurrent or intractable dislocations develop, there may be combined pathologic conditions at work: large or massive rotator cuff tears together with anterior capsulolabral injuries such as a Bankart lesion or fracture of the glenoid rim. These patients have multiple recurrences because of disruption of both the anterior and the posterior stability mechanisms. We suggest a procedure that provides anterior stabilization with the capsular shift technique and that is supplemented by Bankart repair as necessary. The capsule transfer is performed superiorly and posteriorly to close the defect in the cuff. In this way a capsulodesis effect can be achieved that displaces the humeral head downward and produces active centering of the head in the course of abduction. Use of only the anterior capsule for the shift, and not the subscapularis tendon, does not compromise subscapularis function. Between 1990 and 1996, we used this technique to treat 16 patients older than 55 years of age with multiple recurrent anterior shoulder dislocation and massive rotator cuff tear. We report the results for the first 10 patients with a minimum follow-up of 2 years (range 2 to 7 years) and an average follow-up of 52 months. There were 7 excellent results, 2 good results, and 1 fair result according to the Rowe criteria. None of the patients had a recurrence of the dislocation. All the patients regained full or functional range of motion with stable shoulders, and most of them could perform activities of daily living without limitation. The average Constant score was 83%. This procedure appears to be successful in treating older patients with recurrent shoulder dislocation.

Aged↗

A wide and versatile combined surgical approach to the shoulder.

Complex injuries and conditions of the shoulder may necessitate wide exposure during the operative procedure. The commonly used approach today is a wide anterior deltopectoral approach with extensive detachment of the deltoid muscle, leading to muscle damage, which may result in difficult postoperative rehabilitation and deteriorated function. We describe a simple combined approach that consists of a deltopectoral approach in conjunction with a subcutaneously performed lateral deltoid split with a single skin incision. We believe this surgical technique provides another useful tool to achieve wide and versatile exposure of the shoulder without jeopardizing the function of either the deltoid muscle or axillary nerve.

Fractures, Comminuted↗

[Stüve-Wiedemann syndrome in two siblings: focusing on a male patient with the longest actual survival rate].

BACKGROUND: We report on two siblings with Stüve-Wiedemann syndrome (SWS). The older patient, a 16-year-old boy, is -- as to our knowledge -- the longest-term survivor of this syndrome worldwide. The younger sister with the same clinical and radiographic findings died at the age of 10 months. DEFINITION: Characteristic clinical symptoms are: muscular hypotonia, camptodactyly; respiratory insufficiency, swallowing difficulties; reduced sweating with heat intolerance, episodes of hyperthermia. Typical radiographic findings are: progressive bone bowing, unusual bone fractures, abnormal trabecular pattern, middle face hypoplasia. GENETICS: The SWS is identical with the Schwartz-Jampel syndrome (SJS) type 2, which is gene-located on chromosome 1. So far further genetic details of the SWS can be expected in the near future. The genetic transmission is autosomal recessive. In inbred high risk populations the occurrence of the SWS is increased. THERAPY: For the present only symptomatic therapy is available: extended intensive care during infancy, supportive pediatric orthopedics later on.

Abnormalities, Multiple↗