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Biomedical subjects

S Weller

Publications and source records attributed to S Weller.

At least 145 records · Page 8Linked to original sources

[The problem of the polytraumatized patient (author's transl].

From 1977-79 a number of 140 patients suffering from polytrauma were in need of treatment at the Berufsgenossenschaftliche Unfallklinik Tübingen, as the degree of severity by the injuries caused acute danger of life. In all patients fractures of the extremities were found in combination to injuries of the body cavities. In 87 p.c. associated traumata of the skull, in 47 p.c. of the thorax, and in 30 p.c. of the abdomen indicated a broad variation in polytraumatized patients, which became manifest in 66 patients as a double, in 58 patients as a triple and in 16 patients as a quadruple combination of severe injuries. 25 casualties had to die involving 6 p.c. og the first, 24 p.c. of the second and 44 p.c. of the third group. Any therapy has to considerate the individual pattern of systemic lesion under concern to the vital systems of brain, breathing and circulation. Operative procedure following the classification into term of vital urgency has to distinguish among operations by urgent priority, among those of secondary urgency and treatment of choice. Early osteosynthesis can help effectively avoid complicating factors.

Abdominal Injuries↗

[Fresh fibular rupture of the lateral capsular ligaments - diagnosis - treatment - results (author's transl)].

The frequent injuries of the lateral capsular ligaments of the ankle joint should be diagnosed and differentiated by an accurate case report and by physical and standardised radiological examination. Precise judgement and an adequate treatment are necessary to avoid recurrent subluxation of the ankle joint, a possible factor in the eventual development of post-traumatic arthrosis deformans. A primary suture should be preferred in all cases of fresh and severe instability, especially in young patients and in patients who are active in sports. After healing of the soft tissue and active functional treatment of the ankle joint, a plaster cast bearing the full weight of the patient is used for another four weeks. Follow-up examinations of 150 patients of a group of 552 patients, treated from 1971-1980, showed good results in 92.3% of the patients.

Adolescent↗

[Results of a modified Watson-Jones graft used in the treatment of chronic fibular instability of the lateral ligaments (author's transl)].

Pathogenesis, signs and diagnosis of the chronic instability of the lateral ligaments of the upper ankle are described. The advantages and disadvantages of a modified Watson-Jones graft are discussed and are compared with other surgical procedures. From 1970 to 1980, 157 modified Watson-Jones grafts were performed at the Trade Association Accident Clinic in Tübingen. Follow-up examinations were possible in 100 patients. In none of the patients was it possible to demonstrate the same extent of pre-operative instability; the functional reduction of mobility appeared minimal. 39 of 54 athletes resumed full sports activities, and 89% of the patients stated they were satisfied with the results. The modified Watson-Jones graft, in spite of the well-known objections, is recommended as a satisfying method of treating chronic fibular instability.

Adolescent↗

[Biomechanical principles of surgical treatment of bone fractures (author's transl)].

Amongst the basic biomechanic principles of osteosynthesis we distinguish interfragmentary compression from intra- or extramedullary splinting. Special techniques and implants to achieve optimal stability are available. For special situation a combination of both principles is advantageous. Whenever operative treatment in fractures is indicated these principles should be followed strictly.

Biomechanical Phenomena↗

[Wrist fractures].

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Carpal Bones↗

[Osteosynthesis].

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Fracture Fixation, Internal↗

[Experience in surface replacement arthroplasty of the hip (author's transl)].

A four year follow up trial of 109 cases of the Wagner type of prosthetic surface replacement has been undertaken. It has been found that this type of arthroplasty has been associated with a higher rate of loosening that the conventional total hip replacement. This loosening mainly affects the femoral component. The morphological changes which occured below the loosened femoral component did not show typical avascular necrosis due to implantation of the prosthesis. The changes seen were due to mechanical failure of the bone which resulted from previous structural weakness of the femoral head. Hence loosening of the implant occurred mainly in femoral heads which had cysts, partial necrosis or osteoporosis. Loosening of the implant was not definitely related to the position of the hip and occured in both the valgus as well as the biomechanically unfavourable varus position.

Bone Cysts↗

[Indication and use of Septopal in chronic osteitis (author's transl)].

In 50 cases of chronical osteitis it is demonstrated that after sanitation of the remaining cavity by short time application of PMMA-chain a qualified bed for cancellous bone graft can be created. The followup 15 months after PMMA application shows a demonstrable improvement of the bone infection. In 26 cases no more fistula was seen. The short time application of the chain for 10--14 days with consecutive bone grafting shows the best results.

Adolescent↗

[Therapy and results of a treatment for fresh injuries of the foot distal to the Chopart joint (author's transl)].

The traumatic lesion of the foot is very often a severe and not a negligible injury. The results of 100 patients, treated during 1973--77, with fresh injuries distal the Chopart Joint are pointed out. A high rate of infection and amputations has to be reported. Nearly 1/3 of all the patients are suffering from foot-deformities, loss of function, posttraumatic dystrophy and arthrosis. More than 1/2 of all the patients need orthopaedic aids. Therefore consistent therapy of these often neglected injuries seems to be very important and general directions are given.

Adult↗

[Influence of the treatment of fractures on the development of pseudoarthroses of the humerus shaft (author's transl)].

The evaluation of 98 pseudoarthroses of the shaft of the humerus showed that 42 of these occurred after conservative and 56 after surgical treatment of the original fracture. It appears that pseudoarthroses are caused in conservative treatment chiefly by the traction methods. Among the surgical methods, intramedullary nailing does not seem to bring about sufficient stabilization with a satisfactory measure of safety, whereas in the case of plate osteosynthesis, errors in respect of operation technique are mainly responsible for causing pseudoarthroses. All 98 pseudoarthroses returned to normal condition after proper plate osteosynthesis and, if necessary additional deposition of cancellous bone graft.

Adolescent↗

[Soft tissue injuries in compound fractures (author's transl)].

Problems in the management of soft tissue injuries in compound fractures are presented. They usually originate from the initial traumatic force, but may be the result of pitfalls of the primary treatment as well. The management of open fractures--as it is performed in this clinic--is presented in detail. After primary stabilization of the fracture attention is directed to the associated soft tissue injuries, which require utmost care in the further course of treatment. Primary wound closure should never be forcefully obtained, since closure under tension will result in severe secondary tissue damage. In our experience temporary open wound treatment and delayed closure is the method of choice in the initial management of open fractures. For temporary cover we successfully use the synthetic skin substitute Epigard. Since we adopted this policy, the rate of infection declined drastically, and anaerobic infections as well as generalized sepsis could be totally avoided.

Debridement↗