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Biomedical subjects

P Hoffmeyer

Publications and source records attributed to P Hoffmeyer.

54 records · Page 3Linked to original sources
PubMed1993

Fat embolism syndrome.

Twenty cases of clinically patent fat embolism syndrome (FES) were observed at the authors' institution between 1964 and 1989. There were 4 deaths (20%). The injury severity score (ISS) was computed for each patient upon admission and ranged from 9 to 50 (median, 17). The ISS was significantly higher in the 4 deceased patients (P = .014). The incidence of FES amounted to 0.26% of all patients hospitalized with at-risk fractures (femoral and tibial shaft fractures and pelvic fractures). The findings of the 25-year study indicate the following: (1) clinically patent postfracture FES is rare; (2) FES is significantly more frequent in patients with several at-risk fractures than in those with one at-risk fracture (P < .0003); and (3) prognosis appears to be more directly related to ISS than to FES itself.

Adult↗
PubMed1992

[Stabilizing the open fracture with the external fixator].

External fixation plays a major role in contemporary trauma care. Indications are not limited to the obviously open fracture but also to cases with severe "closed" soft tissue injuries (contusions, burns etc.). The technique is reviewed and importance of pin placement, fixator geometry, minimal internal fixation and staged fixator removal are stressed. The modern external fixation techniques may be used to obtain bony union or they may be used temporarily switching to definitive internal fixation upon obtention of soft tissue healing.

External Fixators↗
PubMed1992

[Biomechanics of the shoulder--kinematics and intra-articular vacuum].

There being little skeletal stability, the shoulder joint must have a complex soft tissue anatomy in order to achieve sufficient stability in addition to good range of motion. The intra-articular vacuum provides some support for the joint structures in this function. Kinematic results obtained using a new spatial measuring systems (magnetic field system) have again quantified the clinical value of this vacuum phenomenon.

Biomechanical Phenomena↗
PubMed1992

Treatment of humeral diaphyseal fractures with Hackethal stacked nailing: a report of 33 cases.

Hackethal's technique of stacked intramedullary (IM) nailing was used to treat 43 consecutive acute fractures of the humeral diaphysis. Of these, 6 were lost to follow-up and 4 additional patients were excluded for pathologic fractures. All of the remaining 33 traumatic fractures were followed until union. The average age was 34 years. Mean operative time was 90 min. Usually four or five 2- or 3-mm IM Kirschner wires were introduced in a retrograde manner, through a posterior unicortical window under radioscopic control. Closed reductions were performed in 28 patients, and open reductions were performed in the other five. Time to follow-up averaged 3 years 5 months (range 8 months to 13 years). There were no infections. There were three nonunions (9%), and two nails in 1 patient penetrated the greater tuberosity and one nail migrated distally in another patient. This method of internal fixation is not complicated and causes minimal trauma. It provides good stability at the fracture site and permits early mobilization of patients with excellent functional results.

Adolescent↗
PubMed1990

Pathological changes in the triceps surae muscle after rupture of the Achilles tendon.

Biopsy of the triceps surae muscle was carried out in 11 patients who had sustained a spontaneous rupture of the Achilles tendon during sports. All the specimens showed important histological and ultrastructural changes, the most striking being the presence of large quantities of lipid droplets within the muscle fibres. A factor common to every patient was a period of inactivity before resuming sports. Preliminary training may be valuable in producing positive adaptive changes in the muscles, and the consequent improvement in function may reduce the risk of rupture of the Achilles tendon.

Achilles Tendon↗
PubMed1990

Glenohumeral elevation studied in three dimensions.

We studied the position and rotational changes associated with elevation of the glenohumeral joint, using a three-dimensional magnetic-field tracking system on nine fresh cadaveric shoulders. The plane of maximal arm elevation was shown to occur 23 degrees anterior to the plane of the scapula. Elevation in any plane anterior to the scapula required external humeral rotation, and maximal elevation was associated with approximately 35 degrees of external humeral rotation. Conversely, internal rotation was necessary for increased elevation posterior to the plane of the scapula. The observed effects of this rotation were to clear the humeral tuberosity from abutting beneath the acromion and to relax the inferior capsular ligamentous constraints. Measurement of the obligatory humeral rotation required for maximal elevation helps to explain the relationship of the limited elevation seen in adhesive capsulitis and after operations which limit external rotation.

Biomechanical Phenomena↗
PubMed1990

Stabilizing mechanism of the glenohumeral ligaments.

By using the electromagnetic tracking system, the kinematics of the glenohumeral joint in the shoulder complex was studied. With the location of the glenohumeral ligament insertions digitized, the change of ligament length and direction could then be calculated throughout a given movement. This technique provided a useful method for in vitro assessment of the capsuloligamentous constraints of the shoulder joint.

Biomechanical Phenomena↗
PubMed1988

High resolution computed tomography in the chronically painful ankle sprain.

A series of 31 consecutive patients with chronic residual ankle pain following ankle sprain were analyzed using high resolution CT scanning. In 13 patients avulsed intra- or juxta-articular fragments of traumatic origin were detected; 12 of these patients had surgical revision. The usefulness of CT scanning in chronic post-traumatic residual ankle pain in the presence of negative standard x-rays is stressed.

Adolescent↗
PubMed1988

The subtalar sprain. A roentgenographic study.

Subtalar and ankle sprains are more frequently associated than previously suspected. In this study, 40 patients were analyzed, using subtalar arthrograms and ankle stress films. Thirty-two of the 40 patients had a rupture involving components of both subtalar and ankle capsuloligamentous structures. If ignored or improperly treated, these lesions may develop into a sinus tarsi syndrome or a chronically painful and unstable ankle. Negative stress films in the presence of a clinically serious ankle injury should arouse suspicion of an underlying subtalar sprain, as demonstrated in six patients with positive arthrograms.

Adult↗
PubMed1988

Muscle in hallux valgus.

Muscle imbalance is cited widely as a major factor in the production of hallux valgus deformity. The authors, therefore, performed muscle biopsies in 57 patients (53 women and four men; average age, 45.3 years) to examine the histology and ultrastructure of the intrinsic muscles about the great toe. The biopsy study was correlated with gait analysis. In 53 biopsy specimens the muscles were found to be histologically abnormal, presenting myogenic and neurogenic alterations. Furthermore, ultrastructural examination showed enlarged mitochondria with paracrystalline inclusions in 31 of the 57 cases. Gait analysis showed an abnormal rollover pattern in 70% of the gait cycles examined in 19 symptomatic hallux valgus patients (18 women and one man), while in 19 asymptomatic volunteers (16 women and three men) 80% of the cycles examined were normal. The surface electromyographic (EMG) activity of the intrinsic muscles also was abnormal in the patient group when compared with the volunteer group; five different patterns of electrical activity were found. These findings may be interpreted as a result of chronic ischemia caused by the elevated pressure occurring within the foot during gait.

Adolescent↗
PubMed1987

Ultrastructural modifications of muscle in three types of compartment syndrome.

The histological and ultrastructural aspects of three cases representing different types of compartment syndromes are analyzed. In the acute syndrome edema is the prominent feature. The two chronic cases are characterized by an accumulation of intermyofibrillar lipid globules. All three have in common mitochondrial enlargement, disorganization of the cristae and paracrystalline inclusions. These pathological findings are discussed in the light of lesions seen in striated muscle ischaemia or in certain metabolic myopathies.

Acute Disease↗
PubMed1987

The treatment of hallux valgus in runners using a modified McBride procedure.

We have carried out a modified McBride procedure in 21 patients with hallux valgus which caused pain during running. They have been followed up for a mean of 5.5 years. Metatarsophalangeal pain and metatarsalgia were relieved or significantly decreased in the majority of patients, but callosities beneath the second metatarsal head were not affected. When the angle between the first and second metatarsals did not exceed 14 degrees before operation, satisfactory correction could be obtained. In the absence of degenerative changes in the first metatarsophalangeal joint and with a moderate hallux valgus, a consistently good result was obtained in this group of active patients.

Adolescent↗
PubMed1984

The value of computerized tomography in fractures of the pelvic ring.

Thirty four fractures of the pelvic ring were examined by computerized tomography and the findings compared with those obtained with conventional radiography. CT scanning enabled precise delineation of the fracture sites in the posterior ring. A new classification is proposed which defines five patterns of fracture of the posterior ring. Computerized tomography is a valuable aid in planning operation in these injuries.

Adolescent↗
PubMed1982

[[Clodronate therapy of hypercalcemia caused by hyperparathyroidism].

The diphosphonates, powerful agents which inhibit osteolysis, have been used parenterally with success to treat malignant hypercalcemia. 4 cases of anatomically confirmed primary hyperparathyroidism (age of patients 58-78 years) were admitted with a serum calcium of over 4 mmol/l in one case, over 3,5 mmol/l in a second case and over 3 mmol/l in the other two. The patients received an infusion of isotonic saline and dichloromethylene-diphosphonate (clodronate) parenterally in a dose of 500 mg a day. Serum calcium began to fall in all four patients 48 hours after the treatment was started. Intravenous clodronate therefore appears to be the treatment of choice for parathyroid crises and allows surgery of the adenomas in better metabolic conditions.

Aged↗