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Biomedical subjects

R Kotz

Publications and source records attributed to R Kotz.

At least 145 records · Page 8Linked to original sources
PubMed1975

Resection therapy of malignant tumours of the shoulder girdle.

Based on 30 resections in the shoulder region, operation techniques and results are precisely described with a view to curing and functioning. In the case of radical resections the rate of recurrences and cures in patients are the same as the rate of ablations. As the function of the hand is not impaired, this is a considerable advantage over amputations, although the cosmetic result of a resection may appear insufficient. In humerus resections bending contractures may frequently occur in the elbow joint and previous radiation may occasionally cause interior decubitus and exculceration. With an endoprosthetic replacement of the proximal humerous complications may be avoided, as experience with ceramic implants proved in 3 cases.

Adolescent↗
PubMedDate not supplied

Rotationplasty.

Partial limb salvage by a rotationplasty procedure is possible in patients suffering from malignant tumors of the lower extremity. Upon diagnosis of a malignant tumor of the distal femur or proximal tibia, resection of the tumor is performed with wide margins, including the knee joint. The sciatic nerve is preserved, and the lower part of the leg is retransplanted to the thigh, observing a rotation of 180 degrees. This procedure results in a shortened leg with the ankle joint at the position of the former knee joint. The resulting stump is able to bear a prosthesis. The ankle rotated at 180 degrees serves as a substitute knee joint capable of moving a shank prosthesis, an ability which would have been lost with high amputation of the leg. The foot is able to carry load via the sole skin. There is no phantom pain. Experience with 40 cases is reported.

Adolescent↗
PubMedDate not supplied

[Serum cobalt and serum chromium level in 2 patients with chronic renal failure after total hip prosthesis implantation with metal-metal gliding contact].

PURPOSE: The influence of chronic renal failure on serum cobalt and serum chromium in two patients with metal-on-metal bearing (Metasul) and cementless total hip arthroplasty (Alloclassic) is investigated. METHODS: Serum cobalt and serum chronium levels were determined in the postoperative course using atomic absorption spectrometry. RESULTS: Maximum values are found to be more than 100-fold elevated when compared to the reported median serum cobalt concentrations in patients with the same prosthesis type and no known renal disease. CONCLUSION: Chronic renal failure seems to be responsible for the marked elevation of serum cobalt and serum chromium. CLINICAL RELEVANCE: Despite evidence of adverse health reactions, a possible effect of long-term cobalt and chromium loading cannot be neglected. In our opinion, metal-on-metal bearings in THA should not be inserted in patients with chronic renal failure. Follow-up investigations (serum cobalt, serum chromium, serum creatinine, BUN, echocardiography) should be performed at short intervals.

Adult↗
PubMedDate not supplied

[Periprosthetic femoral fractures in total hip prosthesis implantation. Functional and radiological comparison between plate osteosynthesis and proximal femur replacement].

AIM: Clinical and radiological examinations were performed to compare plate osteosynthesis (group 1) with replacement of the proximal femur by tumor prosthesis (group 2) in patients with ipsilateral femoral fractures around a hip prosthesis. METHOD: Of 24 consecutive patients with 25 fractures, nine had died and one could be contacted by telephone leaving 14 hips (in one case only recent X-rays were available) for final review (nine patients from group 1; five from group 2). RESULTS: At the time of examination four patients of group 1 were using one cane or were walking without any support, all patients of group 2 needed one or two crutches. In 5 of 9 patients in group 1 and in 4 of 5 in group 2 a firm fit of the prosthesis was observed. CONCLUSION: Group 1 achieved better clinical results in postoperative mobility, whereas femoral replacement showed better radiological results. Survival of patients with tumor prostheses was considerably superior to that of patients with plate osteosynthesis.

Activities of Daily Living↗
PubMedDate not supplied

[Osteosarcoma and Ewing's sarcoma--The most frequent malignant bone tumors in children--therapy and outcome].

BACKGROUND: Osteosarcoma and Ewing's sarcoma are the most frequent malignant bone tumors in children and young adults with relatively poor overall survival rates. METHODS: Between January 1980 and December 1994, 175 children with osteosarcoma and 64 children with Ewing's sarcoma were treated at the author's institution. 22 children had synchronous metastases, 19 patients had a pathologic fracture. Both groups were treated systemically with chemotherapy regimens (COSS and CESS). Local therapy was amputation or tumor resection and endoprosthetic replacement or biological reconstruction with wide or radical resection margins. In case of Ewing's sarcoma in 35 patients postoperative radiation therapy was done. RESULTS: Five-year overall survival rate for osteosarcoma and Ewing's sarcoma patients is about 63 %, ten-year survival rate for osteosarcoma patients is 60.2 %, for Ewing's sarcoma patients 54.5 %. Prognostic factors significantly influencing overall survival rates are tumor response to chemotherapy (p values = 0.0056 and 0.013, respectively), surgical treatment with adequate resection margins (p value = 0.0001 for osteosarcoma patients) and development of postoperative metastases (p value = 0.0001 for both groups). CONCLUSION: For both groups of malignant bone tumors systemic chemotherapy as well as adequate surgical therapy are necessary to reduce the rates of local recurrences and to achieve better survival rates.

Adolescent↗
PubMedDate not supplied

[Treatment of foot deformities in patients with Duchenne muscular dystrophy].

AIM: There are different approaches to treat foot deformities in Duchenne muscular dystrophy. Some authors recommend conservative, others only surgical means. The purpose of this study was to compare the outcome of both non-surgical and surgical treatment. METHOD: The records of 91 boys with DMD were retrospectively evaluated. The three treatment groups studied included group 1, those who had no surgery, group 2, those who had surgery to correct foot position, and group 3, those who had surgery to maintain ambulation and correct foot position. RESULTS: Although conservative treatment of the feet in group 1 was carried out, severe equinovarus deformities developed. Surgery for the foot deformity including posterior tibial transfer was successful in 94 % at mean 8.5 years post-operative follow-up. The mean age of cessation of ambulation for those who had surgery to maintain ambulation was 11.2 years versus 10.3 years of those who did not have surgery (p < 0.05). CONCLUSION: In patients with DMD, lower extremity surgery including posterior tibial tendon transfer can successfully correct and maintain foot position, as well as prolong ambulation. Early surgical treatment is required since conservative means can not prevent progression to severe equinovarus deformities.

Activities of Daily Living↗
PubMedDate not supplied

[Surgical treatment of osteoid osteoma of the extremities].

AIM: It was the aim of this retrospective study to evaluate the frequency of recurrences and complications in patients treated by conventional surgical methods at our institution between 1980 and 1996 and to compare them to those observed in patients treated by minimal invasive methods reported in the literature. METHOD: 70 patients with osteoid osteomas located at the extremities were treated by conventional surgical treatment. 51 patients underwent curettage and 19 patients had en bloc resection. After curettage an additional stabilising plate was implanted in 12% of the cases, after en bloc resection in 68%. RESULTS: There are 66% event-free patients after curettage versus 47% after en bloc resection. Local recurrence rate after curettage was 7%, after en bloc resection no patient developed a recurrence. In both groups a postoperative fracture was observed. Persistent pain due to the implant was reported by 7% after curettage and by 24% after en bloc resection. CONCLUSION: The rate of complications rises with increasing invasiveness and it is necessary to balance the security concerning a local recurrence and the danger of persistent postoperative pain. Curettage is the surgical method of choice in the therapy of the osteoid osteoma, en bloc resection is justified only for recurrent lesions. Curettage is an alternative to minimal invasive methods in cases of superficially located osteoid osteomas or in cases of unfavourable locations of the nidus (near joint or growth plate, inaccessibility).

Austria↗