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T Fritz

Publications and source records attributed to T Fritz.

At least 19 recordsLinked to original sources
PubMed2000

[Trans-scaphoid perilunar dislocation of the wrist (de Quervain) as a rare complication of electric injury].

We describe the case of a 67-year-old man with an electricity inflicted injury in the left hand and a transscaphoidal perilunear dislocation of the opposite right hand. On admission, the injury was missed on the standard ap-radiogram of the right hand, so the operative reconstruction was delayed. Later on, the lunate showed aseptic necrosis and wrist collapse as consequence.

Aged↗
PubMed2000

Teaching model for intraoperative spinal sonography in spinal fractures. An experimental study.

To improve the technique of intraoperative sonography of the spinal canal, a teaching model of the thoracolumbar spine was developed. It allows to simulate the typical spinal stenosis of a vertebral fracture and the sonographic procedure to detect and measure such a lesion. Moreover, partial laminectomy and modification of a fixateur interne set-up, which are preconditions for successful sonography, can be simulated. Independent of the surgical qualification, a high precision in sonographic localisation and measurement of the spinal canal stenosis was achieved by the training. The results could be validated in the cadaveric model. Thus, sonographic expertise acquired with the teaching model proved to be reliable in the clinical situation.

Cadaver↗
PubMed1999

[In Process Citation]

To optimise the microsurgical training in our clinic we organized a permanent possibility to practice microsurgical techniques of vascular anastomosis. This includes step-wise education by means of plastic materials, human placenta and the rat model. The most important role in this concept is played by the placenta. It supplies a realistic simulation of different in vivo situations concerning microvascular anastomosis. As to availability, handling and costs the placenta is superior to animal models and has replaced them almost completely in our educational concept.

Journal Article↗
PubMed1999

[The struggle with the ego: the assessment center in the selection of physicians-in-chief].

The assessment center (AC), which played an important role in the recruitment of officers at the beginning of the century, nowadays is used in the business for the selection of managers. Also in the medical institutions the AC is of increasing significance, since the accentuation of economic aspects have led to a change in the qualities expected of a physician in chief. Usually the AC in the classic form is not applied; more often, hospitals take advantage of professional counselors who obviously use the basic elements of the AC. Physicians who are concerned are recommended to study the essence of the AC.

Ego↗
PubMed1999

[The subacromial shoulder dislocation].

We report on a case of subacromial shoulder dislocation, which resulted from a combination of a cranial glenoid fracture and an acromial fracture. The patient sustained this rare injury while playing handball. The whole implication of the injury was revealed only after extensive workup with CT scan of the shoulder. After reduction of the shoulder dislocation, the glenoid fracture was stabilized by osteosynthesis. The postoperative results showed anatomical reconstruction of the glenoid joint surface. After completion of therapy, the patient has achieved good functional results with a full range of motion (abduction 180 degrees ) and has been able to work full-time again.

Acromioclavicular Joint↗
PubMed1999

Prospective randomized comparison of gliding nail and gamma nail in the therapy of trochanteric fractures.

In a prospective randomized study, we compared the new intramedullary implant of the gliding nail to the gamma nail in the fixation of 80 unstable trochanteric fractures in elderly patients. The preconditions of both groups were comparable. We found no differences concerning the operation time, blood loss, period of stationary treatment or social situation. Also, the anatomic reconstruction and the long-term function according to the Merle d'Aubigne score were comparable. Regarding postoperative complications, the gliding nail showed a minor tendency of cutting out; this we attribute to the special design of the dynamic blade and regard it as the most favourable advantage of this new implant.

Aged↗
PubMed1999

Combined Kirschner wire fixation in the treatment of Colles fracture. A prospective, controlled trial.

For surgical treatment of the unstable Colles fracture we developed a new form of osteosynthesis, which consists in a modification of the dynamic Kirschner wire fixation described by Kapandji. It allows early motion without the typical risk of palmar dislocation noted with the Kapandji method. We prefer this method in elderly patients with reduced bone quality. The analysis of a collective of 110 fractures including a clinical and radiological follow-up examination of 72 patients revealed good anatomical reconstruction of the distal radius. The loss of motion was minimal on average and consistent with a good wrist function. Major restrictions resulted from stress-dependent pain as a consequence of posttraumatic arthritis or algodystrophy. A minor loss of reduction by dorsal impaction was observed in the follow-up evaluation, but it had no functional relevance. The most frequent complication was paraesthesia within the area of the superficial radial nerve. According to the NYOH score the following results were achieved: excellent 35%, good 50%, fair 10%, poor 5%.

Bone Wires↗
PubMed1999

The classic nail in the therapy of trochanteric fractures.A prospective, controlled study.

In a prospective controlled study we analysed the classic nail, a new intramedullary implant for the fixation of peritrochanteric fractures. By means of lateral bending of 4 degrees, unreamed implantation is generally possible. Our collective of 85 patients was characterized by elderly mean age (82.3 years), a predominance of female patients (4.3 : 1), a minor trauma aetiology without relevant additional injuries, and a high rate of concomitant disease (92%). Only 31A-type femur fractures were treated, with a low specific complication rate of 13%, whereby operative revision was necessary in only two patients (3%). A good anatomic reconstruction and full weight-bearing with the osteosynthesis was achieved in the majority of patients. No secondary shaft fractures and only one case of cutting out was observed. The mortality (30 days: 18%, 6 months: 25%) as well as the high rate of unspecific complications (20%) were caused by the patients' multiple morbidity. Deficits in the Merle d'Aubigne score at follow-up after 6 months can be interpreted within the same context. Nevertheless, 85% could return to their former social environment and only 15% became dependent on a nursing institution in connection with the fracture treatment.

Aged↗
PubMed1998

[Gliding nail osteosynthesis. A new universally applicable implant for management of per- and subtrochanteric femoral fractures].

Age, high physiological load and the great number and different fracture types of the proximal femur are the main challenges for implants used in the management of these fractures. For use in these types of fracture with immediate restoration of full weight-bearing capacity and for reduction of the intra- and postoperative complication rate, the gliding nail was developed. The development is based on a large number of experimental and clinical examinations of per- and subtrochanteric fractures. The advantages of an intramedullary implant and the gliding screw systems are combined with increased moment of resistance of the double-T femor-neck blade profile. We performed a prospective clinical evaluation of the first 186 patients with per- and subtrochanteric fractures who were treated between 15 September 1994 and 29 February 1996 in the Aschaffenburg Trauma Department with a follow-up examination at least 3 months after the operation. The intraoperative complication rate was 1.1%. The postoperative complication rate was 4.9%. Change of the blade because of fracture impaction and tractus iliotibialis problems was the most frequent problem with 2.2%. The most severe complication (1.1%) were caused by subchondral placement of the blade in the cranial one-third of the femur head. In these cases reosteosynthesis was indicated. Ninety-three percent of the survivors were able to return home. The rate of bed-ridden patients (7.7% and 11.7%) was not very different before or after the operation. However, many patients do not reach the condition they had before the fracture and they are one step worse in mobility and social independence.

Activities of Daily Living↗
PubMed1998

[Pigmented villonodular synovitis. Case reports and review of the literature].

Because this disease is so rare the optimum treatment of pigmented villonodular synovitis (PVNS), in particular the diffuse form differs in the literature. The most important surgical procedures are arthroscopic and open synovectomy. The prevention of disease progression, as well as joint destruction and dysfunction, depends upon the early diagnosis of PVNS. During 1994 and 1995, we treated four cases of PVNS surgically and followed the patients for a time period of more than 12 months. Two patients were treated with complete synovectomy, one patient underwent partial synovial resection, and in the final case an arthrodesis was performed. Our results indicate that an MRI is essential for diagnosis and treatment planning. For the localized form of PVNS, it appears that a partial synovectomy is appropriate. However, in the event of diagnostic uncertainty or obvious diffuse involvement of the synovium, a total synovectomy is indicated because of the high recurrence rate. In our study, all four patients had disease involving secondary bony lesions and, in one case, joint destruction. Based on our findings, it is clear that early surgical therapy is the only recommended curative intervention. The decision regarding the surgical approach, arthroscopic versus open, depends on the form of PVNS, the extent of the disease and secondary changes of the joint.

Adult↗
PubMed1998

Ultrasound measurements at the proximal phalanges in healthy women and patients with hip fractures.

Measurements of bone mineral density (BMD) are useful for the assessment of fracture risk in osteoporosis. First prospective studies showed that quantitative ultrasound as measured at the calcaneus also predicts future hip fracture risk, independently of BMD and as accurately as BMD. The aim of this study was to compile a reference population for a new ultrasound device that determines amplitude-dependent speed of sound (AD-SOS) through the proximal phalanges of the hand and to prove its ability to distinguish between health volunteers and osteoporotic patients. In a case-control study we examined 139 healthy women aged 21-94 years and a group of 24 female patients aged 69-94 years with recent hip fractures. In the healthy reference population additional BMD measurements were performed with dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound measurements at the calcaneus were carried out. In vivo precision of AD-SOS measurements through the phalanges was 0.52% CV. Simple regression analyses showed a negative correlation with age (r = -0.73, p < 0.001); modest significant correlations with BMD of the lumbar spine (r = 0.36, p < 0.001) and BMD of the femoral neck (r = 0.37, p = 0.002) as measured with DXA were shown. The comparison with another ultrasound device measuring SOS and broadband ultrasound attenuation (BUA) through the calcaneus showed correlation with SOS (r = 0.50, p < 0.001); no significant correlation was found with BUA measurements. Furthermore a dependency of AD-SOS values in anthropometric factors such as body mass index (r = 0.37, p < 0.001), height (r = 0.40, p < 0.001) and weight (r = 0.23, p < 0.05) was shown. First study results on 24 clinically diagnosed osteoporotic patients, defined as patients with recent (< 1 week) pertrochanteric or femoral neck fractures, showed a good separation between age- and sex-matched controls and osteoporotic patients (Z = -2.0 SD). Receiver operating characteristic (ROC) curves showed an area under the fitted curve of 0.83 +/- 0.06. These results are powerful for a device measuring AD-SOS through the proximal phalanges of the hand, and further prospective studies have proven the capability of phalangeal ultrasound in fracture risk assessment.

Absorptiometry, Photon↗