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Biomedical subjects

R Schabus

Publications and source records attributed to R Schabus.

At least 37 records · Page 2Linked to original sources
PubMed1993

A new approach to the subacromial space. Technique and 2-year results in 28 rotator-cuff repair cases.

We present a new approach to the subacromial space, consisting essentially of an osseous detachment of the deltoid muscle from the anterior and lateral rim of the acromion including the osseous origin of the coraco-acromial ligament. After acromioplasty and an eventual reconstruction of a torn rotator cuff, Kessler-sutures provide stable transosseous repair of the deltoid muscle. This method generally allows immediate active shoulder motion. 25 of 28 patients with rotator cuff ruptures alone or in combination with an impingement syndrome had good results according to the UCLA-score 2 years postoperatively. No serious complications regarding the function of the deltoid muscle or any failure of the accompanying acromioplasty occurred.

Acromion↗
PubMed1993

Synthetic augmented repair of proximal ruptures of the anterior cruciate ligament. Long-term results of 66 patients.

The long-term results (five-to eight-year follow-up evaluation) of 66 patients with high proximal ruptures of the anterior cruciate ligament (ACL) who were treated operatively are presented in a retrospective and uncontrolled study. Technique of surgery was the reinsertion of the ACL in a multiple suture loop technique, augmented with Kennedy-LAD (ligament augmentation device) on over the top route in temporary double-end fixation. This technique was used in patients with proximal rupture of the anterior cruciate ligament found at arthroscopy. In the follow-up as well as in instrumented measurement, 97% of the knee joints have normal joint laxity. According to the evaluation sheet designed by the Orthopädische Arbeitsgemeinschaft Knie (OAK), excellent or good results were found in 86% of the patients. Nine percent had limited range of motion. The ACL reconstruction technique allowed 75% of the patients to regain their preinjury sports activity level. The potential advantages of synthetic augmented reinsertion of the ACL are anatomic reconstruction without destruction of other anatomic structures as grafts; securing early rehabilitation with weight bearing of the operated limb depending on individual pain tolerance; and presenting excellent long-term results of normal joint laxity.

Adolescent↗
PubMed1992

[Results of a volar approach to plate osteosynthesis of radius shaft fractures. Theoretical basis--clinical results].

This retrospective study analyses the results of 80 shaft fractures of the radius treated by open reduction and plating by a volar approach. Studies about strain distribution on the radius shaft worked out a varying pattern of tensile forces and a continuously change of the tension bend side through full range of motion. So from the biomechanical aspect an ideal position for compression plating is not determined and dorsal or volar plating brings the same stability. The advantage of the volar approach by Henry is the possibility of an easy extension of the approach to the distal or proximal part of the forearm and an optimal covering of the plate by soft tissue. To expose the superficial radial nerve is obligate, if necessary the deep radial nerve should be exposed too in proximal fractures. From 1973 to 1987 80 fractures of the shaft of the radius were treated by plating using the volar approach, since 1977 3.5 dynamic compression plate of the AO was used exclusively. Only two non-unions occurred in the beginning when the AO's third tube plate was used routinely. One massive callus formation had to be noticed with a complete loss of pronation and supination. One infection occurred, but normal wound healing and bone union could be achieved after early reoperation. Two incomplete lesions of the superficial radial nerve were seen, but normal sensibility occurred spontaneously. No other neural or vascular complication had to be noticed using this approach. In the follow-up 56 patients were seen two to 14 years postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Importance of measuring stability and function in knee ligament surgery].

To compare results in knee ligament surgery between different surgeons and between different centers, too, is difficult. We investigated if an improvement can be achieved by using easy to handle methods of measurement. The long-term results of 180 patients who underwent ACL surgery between 1983 and 1986 (n = 191) were evaluated. For international comparing of our results we used the scoring of the OAK (Orthopädische Arbeitsgemeinschaft Knie). In addition stability was measured by use of the KT-1000 arthrometer and function by "one leg hop for distance". Together with different usual functional tests those two methods were investigated for being comparable, practicable, and relevant. We found that both measurements came up to these conditions. We succeeded in rating the patients' result by measuring KT-1000 and one leg hop for distance. Examination after knee ligament surgery has to contain these two parameters for international comparison.

Adolescent↗
PubMed1991

[Biological reaction to alloplastic reinforcement of the anterior cruciate ligament].

Control arthroscopy in usually done 6-12 months after reconstruction of the ACL with ligamentum patellae transplant augmented with LAD using Marshall's technique. During these control arthroscopies the metal implants are removed and a biopsy of the synovial lining was performed in 38 cases. We normally anchor both ends of the LAD to obtain better stability and these anchors are removed after 6-12 months (release of the fixation points). Up to now control arthroscopy has been performed on 97 patients, who had their ACL reinserted and 114 patients, whose ACL were replaced by ligamentum patellae transplant, in both cases augmented with LAD. The control arthroscopy revealed 11 cases of tears of the LAD in case ACL were reinserted and 24 cases of LAD tears in case LAD were replaced by ligamentum patellae transplant. The findings of 38 biopsies of the synovial lining are as follows: In 18 cases LAD tears, in 15 cases foreign body reactions with wear particles and an instance of lymphocytic infiltration of the synovia was seen. In 20 cases arthroscopy was inconspicuous: In 2 cases wear particles were seen and lymphocytic infiltration in a single case. In all cases of LAD tears with foreign body reactions the LAD was removed.

Anterior Cruciate Ligament↗
PubMed1991

[Control arthroscopy following alloplastically augmented anterior cruciate ligament reconstruction].

97 patients who had their ACL replaced with ligamentum patellae transplant augmented with LAD were reviewed arthroscopically after an average period of 9.1 months (4-22 months). 52 patients whose metal implants have been removed are virtually symptom-free clinically (no swelling, stable knee joint, extension limitation of less than 5 degrees, less than 10 degrees limitation of flexion). Arthroscopy on these 52 patients revealed the following; no abnormalities in 37, 11 cases of cartilage lesions, 1 case of medial meniscal tear and 7 cases of LAD tears. 45 patients who have also had their metal implants removed have complaints, arthroscopy revealed the following; hypertrophy of Hoffa's fat pad in 5 cases, 3 cases of medial meniscal tears, 2 cases of lateral meniscal tears. Tears of the LAD were seen in 9 cases. In 2 cases the transplant was missing, in 5 cases the transplant was elongated and in 2 cases the transplant showed normal structure. There were cartilage lesions in 9 cases, 4 cases of synovitis and scar tissue adhesion in 3. In all there were 16 cases of LAD tears, in 9 out of these 16 cases the transplant ACL of good structure. All of this knees were stable. Control arthroscopy is routinely carried out when we remove the metal implants. This enables us to detect any early problems, such as limitation of extension or swelling, assess the success of the operation and commence the corresponding additional therapy.

Adolescent↗
PubMed1991

[Results and analysis of poor results after conservative therapy of distal radius fracture].

The authors report on the results of a follow-up study of 120 conservatively treated distal radius fractures. Follow-up averaged 35 months (25 to 48 months). The quality of initial reduction has a crucial impact on the final outcome. 87 fractures showed nearly perfect anatomical reduction, of these, 48 resulted in excellent, 16 in good, 15 in satisfactory, and 8 in poor final anatomical outcomes. In comparison, in 33 fractures with unsuccessful initial reduction, only two cases gave excellent and 12 cases good results (42%); 11 fractures were considered satisfactory and 8 poor. The necessity of a second reduction was significantly lower in the first group of initially well-reduced fractures when compared to the second group: 8 (9.2%) to 14 (42.4%) respectively. Evaluation of the functional outcome according to the Sarmiento scheme showed a strong correlation between the AO fracture classification and the final outcome. In group A fractures, 78% gave excellent or good, 22% satisfactory or bad results. Type B fractures gave 82% excellent or good and 18% satisfactory or poor results. In group C, only 50% reached excellent or good results, the C 3 fractures having the worst prognosis, achieving excellent or good results in only 20% of the cases. Regression analysis demonstrated a significant correlation between anatomical and functional outcome.

Adult↗
PubMed1991

[Steroid hormone receptors in synovial tissue].

Among the variety of symptoms of the postmenopausal syndrome joint pain seems to be an important problem for the patient as well as for her doctor. Because of the excellent response of the hormone substitution therapy it is asked if the synovial membrane is a target organ for oestradiol. Biopsies from the knee joint of ten women (not having any hormone therapy)--excised during knee joint surgery--were examined. Only in two cases oestrogenreceptors were found. Accordingly the synovial membrane cannot be seen as a direct target organ for oestradiol and so other mechanisms must play a role in the pathogenesis of postmenopausal joint pain.

Adolescent↗
PubMed1991

[Corrective osteotomy for the treatment of carpal tunnel syndrome in malaligned healed fractures of the distal radius].

This report deals with 12 patients with fractures of the distal radius that healed with malpositioning with dorsal sinking of the articular surface. This malalignment was followed in all patients by a compression syndrome of the median nerve. All patients underwent an osteotomy by the dorsal approach to correct this malalignment of the distal radius. The carpal ligament was not released simultaneously. In 11 patients a significant reduction in the typical night pain was noticed. Normal or almost normal sensitivity was achieved within the first 2 months (2 weeks to 4 months). Only in one patient was release of the carpal ligament necessary after 6 months, because the osteotomy had no effect on the pain. In the follow-up examination after 6 years, significantly better wrist function was noticed in all patients, and 11 had normal function of the median nerve. In only one patient with moderate loss of sensitivity still present, although these was an obvious significant reduction in pain. In this patient the osteotomy was performed very late (after 10 months). Thus, an osteotomy by the dorsal approach has the advantage of restoring normal function of both the wrist and median nerve.

Aged↗
PubMed1990

[Rehabilitation following reconstruction of the anterior cruciate ligament. The effect of a 6-week training program].

Operations on the anterior cruciate ligament (ACL) represents a great challenge to the therapeutic team. Apart from early mobilisation, increasing attention must be paid to long-term after-care. Nineteen patients receiving reconstruction of the ACL underwent 6 weeks of training an average of 7.6 months after the procedure. At the start and end of the program, a dynamometric test (Dynamatik), and a function test, modified by Noyes, comprising a one-leg standing jump and hopping on one leg for six meters, were performed. Dynamometry revealed a clearly greater improvement in knee extension in the operated leg as compared with the non-operated leg, while the function tests revealed an improvement only in the operated leg. Correlation studies revealed no relationship between knee extension and function tests. For this reason, in addition to muscular strength, both training programs and after-care should take account also of the functional components of human locomotion, and should be carried out for a number of years.

Adolescent↗
PubMed1990

[Results of conservatively treated radius fractures at typical sites].

The results of 78 displaced Colles' fractures treated with reduction and below-elbow plaster were investigated. The follow-up varied from 11 to 24 months (phi 14 months). According to the schema of Sarmiento 66.7% of the patients had a very good or good result; 33.3% had a moderate or poor result. Most of the poor results were intraarticular fractures type C (AO). Primarily anatomical reduction leads to the best results. Every further reduction leads to a poor result, as well as to a higher number of Sudeck's disease.

Adult↗
PubMed1990

[Percutaneous drill wire fixation in treating distal radius fractures at risk of dislocation].

We are presenting an investigation of 47 cases treated with Kirschner wire fixation using drill wires for distal radius fractures. The average study period was 18 months after the fixation (13-25 months). Using Sarmiento's ratings we obtained the following results: 21 patients were rated as excellent, 19 as good, 6 as fair and 1 as poor. In contrast to a good reduction with a stepless joint surface, the initial fracture form and displacement does not influence the functional end results.

Adult↗
PubMed1989

[Experimental study for clarification of the pathogenic mechanism in traumatic peroneal tendon dislocation].

An experimental trial was performed to illustrate the causative mechanism of peroneal tendon luxation. It seemed that traumatic luxation of the peroneal tendons was found to originate in dorsiflexion, abduction and eversion of the forefoot. On the other hand, unless the peroneal muscles are at high tension and the ankle joint supported with a high shoe or similar a trimalleolar ankle fracture is likely. The depth of the retromalleolar groove is only one more factor predisposing to luxation of the peroneal tendons.

Ankle Injuries↗
PubMed1989

[Dislocation of peroneal tendons].

From 1973 to 1985, 23 patients with a total of 25 peroneal tendon luxations were operated on. All luxations were successfully treated, although 1 patient had a recurrent dislocation and had to be operated on twice. At follow-up an average of 8.4 years later, 18 patients with 20 luxations were free of symptoms. In 3 patients there was a minimal loss in the range of movement in the ankle joint; in 1 the sensitivity of the skin distal to the incision was diminished and in 1 friction was found in the tendon sheath. The possibility of diagnosing these injuries precisely by tenography of the peroneal tendons and a tangential X-ray of the retromalleolar sulcus is pointed out. All fresh luxations were adequately treated by suturing the retinaculum; in some cases the sutures were secured with an additional screw. In patients with chronic luxation the procedure of Kelly can be recommended.

Adolescent↗
PubMed1987

[Differential treatment of post-traumatic carpal tunnel syndrome].

The pathogenesis and treatment of posttraumatic compression of the median nerve in the carpal canal are analysed in 36 patients. Nine patients had mal-union of a Colles' fracture. In these patients the symptoms of median nerve compression were completely relieved by correction osteotomy of the radial metaphysis, which also improved radiocarpal joint function. At follow-up examination after four years the results were satisfactory and the median nerve appeared normal in clinical and electro-physiological tests. In the other twenty-seven patients there had been a Colles' fracture in seventeen, healed with a deviation of less than 10 degrees; a carpal bone fracture in three cases; in seven patients no osseous lesion was found. In these patients the flexor retinaculum was split and resected. An anterior callus was removed in three cases. At reexamination after four years four patients still noticed diminished sensibility in the median nerve distribution, and in four cases there was wrist joint pain in relation to exercise.

Adult↗
PubMed1987

[Results of the conservative treatment of injuries of the palmar capsule-ligament system of the interphalangeal joints of the long fingers].

Results are presented following conservative treatment of 79 patients for injuries of the palmar plate of the proximal interphalangeal joint. There was in addition, a slight shell-shaped chip in the base of the middle phalanx of 73 patients. These results show that the functional results are influenced by the age of the patient and the length of the immobilization. 36 of 43 (83.7%) patients under 30 years old, who were immobilized for two to three weeks, had very good results. Immobilization for a longer period of time brought very good results for only nine of fifteen (60%) patients. In the group over thirty years, seven out of fifteen (46.7%) patients had very good results with up to three weeks' immobilization. With longer periods of immobilization, only one out of six (16.7%) had a very good result. The authors recommend fourteen days immobilization in a finger cast with the proximal interphalangeal joint at 15 degrees and the metacarpophalangeal joint at 80 degrees of flexion. Operative correction should only be considered in cases with a tendency to sublux.

Adult↗