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Biomedical subjects

P Habermeyer

Publications and source records attributed to P Habermeyer.

At least 73 records · Page 4Linked to original sources
PubMed1987

[Compression syndromes of the shoulder and their differential diagnosis].

Compared to other painful conditions on the shoulder suprascapular nerve entrapment is an obscure and uncommon syndrome causing severe shoulder pain and disability, and is easily cured if only it is recognized. The condition was described by Thompson and Kopell in 1959, Schilf reported a case of isolated suprascapular entrapment in 1952. The nerve passes through the suprascapular notch, the roof of the notch is formed by the transverse scapular ligament. The shape of the suprascapular notch may be guilty for entrapment symptoms. Suprascapular nerve compression may result of acute trauma, of transmitted forces, fracture of collum scapulae, of kinking or traction of the nerve over the edge of the foramen, of sling effect, of compression by ganglia, or its cause may be idiopathic. The hallmark of suprascapular nerve entrapment is a deep and poorly delineated pain, localized to the posterior and lateral aspect of the shoulder. Atrophy and weakness of the supraspinatus and infraspinatus may be noted. Adduction of the extended arm across the body tenses the nerve, increasing the pain. Blocking the nerve by local anesthetic a dramatic, but not long lasting pain relief may be achieved. Electromyographically a decrease in the amplitude or marked polyphasicity of evoked potentials is significant as well as an increased latency time, indicating an impaired conductibility. A surgical release is indicated in case of constant pain and pathological changes of EMG-patterns. From a postero-superior approach decompression of the nerve is performed by simple removal of the transverse scapular ligament.

Diagnosis, Differential↗
PubMed1987

[Anatomy and clinical aspects of sartoriusplasty].

According to Mathes and Nahai (1982) the sartorius muscle is supplied in a segmental fashion (Type IV) from six to ten branches arising from the superficial femoral artery. They state that the use of this flap is limited because of the segmental blood supply. In contrast, dissecting 40 cadaver specimens at the Anatomy Department of Munich University a different vascular anatomy was revealed in which only two to four branches from the femoral artery supply the whole muscle. Based on this pattern of intramuscular vascular connections, the most proximal arterial branch provides the blood supply to the whole muscle. Elevated on the proximal vascular pedicle the muscle can cover defects of symphysis, fill the acetabulum following disarticulation of the septic hip joint and osteomyelitic defects of femur.

Arteries↗
PubMed1985

[Soft tissue and bone defects of the tibia. Treatment with pedicled muscle transfer and a microvascular anastomosed myocutaneous flap].

The free tissue transfer by microvascular anastomoses has opened new dimensions in reconstructive surgery. However a free microvascular myocutaneous flap should only be used in case of a local pedicled flap being impossible. In treating complicated defects of soft tissue and bones a clear cut gradation of therapeutic steps has to be observed: 1. control of wound infection, 2. wound debridement, 3. soft tissue repair, 4. bone reconstruction.

Adult↗
PubMed1984

[The problem of load stability in pathological fractures. Considerations on its indications using typical cases as examples].

Differentiated management of pathological fractures and multiple bone metastases is shown by means of 7 typical case examples. In the proximal femur, the total replacement of tumor-bearing bone areas by total hip prosthesis seems to provide the best stability. The femur shaft is stabilised without risk by intramedullary nailing, whereas metaphyseal stabilisation is best done by means of the interlocking nail. In the humerus, neutralisation plates are used, but they should be chosen long enough to anchor the implant in zones free fo tumour. The limitations of operability are demonstrated in one case. On the other hand, one case is shown where multiple metastases were treated palliatively by excochleation and filling the defect with bone cement, thus preserving the functional ability of the limb and the independence of the patient.

Aged↗
PubMed1984

[Arterial supply of the sartorius muscle].

According to dissections of 40 specimen we received an impression of the arterial supply of the sartorius muscle. The results were as following that the sartorius is supplied by 2-4 arteries, occasionally up to 9, which originate from the middle and distal third of the femoral artery. As a result of the dissections we may state that the sartorius receives an adequate supply, when only the proximal or distal artery remains intact. Because of the above, the sartorius is suitable as a proximally or distally based flap in plastic surgery of the abdominal wall and as covering of bone defects of the hip, femur and knee.

Femoral Artery↗
PubMed1984

[Restoration of an infected hip joint with sartorius-plasty].

For treatment of infected hip joints we use the proximally based sartorius muscle. After ligation of the vessels in the distal part of the muscle, the sartorius muscle is elevated and transposed to the floor of the deep joint cavity. By completely filling the space defect, reinfection of the osteomyelitic cavity is prevented. In addition, the transposed muscle flap directs optimal blood perfusion to the hypoxemic capsule tissue via its own vascular pedicle.

Aged↗
PubMed1979

The effects of deep hypothermia and circulatory arrest on systemic metabolic state of infants undergoing corrective open heart surgery: a comparison of two methods.

Fortyone of 187 infants undergoing corrective surgery for their congenital cardiac lesions using profound hypothermic circulatory arrest were randomly selected for metabolic studies. Deep hypothermia of 21 to 22 degrees C core temperature was reached by two different techniques: 1. Perfusion cooling by extracorporeal circulation (ECC-C) 2. Surface cooling with ice bags combined with perfusion cooling (SC + ECC-C) After circulatory arrest (34.2 min. ECC-C v.s. 46.7 min. SC + ECC-C) bypass rewarming was used in both groups. The metabolic reaction to these interventions are described. No significant differences in acid base status in oxygen consumption, lactate concentration, serum electrolytes (K+, Na+, Ca++,Cl-) and serum enzyme activity (CPK, alpha-HBDH, LDH, SGOT, SGPT) could be demonstrated between the two groups of patients during the entire course of cooling, circulatory arrest and rewarming. The glucose concentration was significantly lower in the ECC-C group during the entire period of operation. Total cooling time was significantly shorter in the group without surface cooling. (ECC-C: 12 min, v.s. SC + ECC-C: 64 min). Since no favourable effects of the SC + ECC-C method on systemic metabolism could be demonstrated and operative results were similar we now prefer the time-saving ECC-C technique.

Acid-Base Equilibrium↗
PubMedDate not supplied

Evolution of lesions of the labrum-ligament complex in posttraumatic anterior shoulder instability: a prospective study.

The aim of this study was to evaluate the evolution of intraarticular disease in posttraumatic shoulder instability. Ninety-one patients with posttraumatic shoulder instability were examined arthroscopically. The intraarticular disease was recorded on a special documentation sheet (containing 67 descriptive items). The patients were divided into 5 subgroups: first-time dislocation (n = 9); first or second recurrence (n = 12); 3 to 5 recurrences (n = 23); 6 or more recurrences (n = 32); and chronic subluxations (n = 15). All data were examined statistically. Each lesion was correlated with stage of evolution, age, and number of recurrences. The most frequent lesions were regrouped into "lesion families." The initial and most constant lesion was the periosteal disinsertion of the anteroinferior labrum (single lesion). The labral detachment was succeeded in a second stage by the disinsertion of the glenohumeral ligament complex (double lesion). With additional recurrences, stress mechanisms altered the detached structures through tissue damage (triple lesion). The fourth stage saw the extension of the degenerative process, which led to failure at the insertion site and destruction of the labrum-ligament complex (quadruple lesion). This study reveals that recurrences progressively damage stabilizing structures. A pathophysiological classification into 4 stages is proposed, however, that would permit a precise therapeutic strategy for arthroscopic shoulder stabilization.

Adolescent↗
PubMedDate not supplied

[Shoulder arthroplasty - Clinical results in 171 patients].

AIM: Review and critical evaluation of 181 shoulder arthroplasties performed on 171 patients between December 1992 and January 1997. METHOD: We performed 118 hemiarthroplasties and 63 total shoulder replacements in 171 patients with an average age of 56.5 years. The patients were examined clinically and radiologically before surgery and followed-up for an average of two years. The Constant score was used for postoperative functional assessment. RESULTS: 46 % of the patients were very satisfied and 31 % were satisfied with the outcome. We found a significant pain reduction and an improvement of active joint function. The average Constant score was 34.9 preoperatively and 65.2 postoperatively. Overall, we found the best results after joint replacement in patients treated for avascular necrosis or fracture sequelae of the humeral head. A revision surgery had to be performed in 16 patients (8.8 %). CONCLUSION: The results of this study are encouraging and underline the growing importance of shoulder arthroplasty. The preoperative limited range of motion, previous surgeries, and the status of the rotator cuff are preoperative indicators for a favourable postoperative outcome. Preoperative planning, anatomical reconstruction, and an optimal rehabilitation programme are the keys for successful shoulder arthroplasty.

Adult↗