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Biomedical subjects

T Lein

Publications and source records attributed to T Lein.

4 recordsLinked to original sources
PubMed2006

[Morel-Lavallée lesion. A grave soft tissue injury].

The Morel-Lavallée lesion is a rare condition that was first described by the French physician Maurice Morel-Lavallée in 1853. The lesion is caused by forces of pressure and shear stress at the borders of subcutaneous tissue to the muscle fascia or bone as they are seen in run-over accidents. It leads to a shear of skin and subcutaneous tissue from the neighboring fascia followed by the development of a blood-filled hollow space at predestined regions of the body. If therapy is insufficient, large areas of necrosis can form, which will negatively influence operative measures. We report about three patients with the diagnosis of a Morel-Lavallée lesion. The history and the impressive clinical findings are demonstrated as well as the differential operative therapy performed, partially with osteosynthesis of accompanying bone injuries. According to the recommendations of the literature known to us, an adjusted therapeutic regime suited to the particular findings was carried out and in all three cases uncomplicated healing can be reported. Our results are in line with the existing recommendations, which are to relieve the soft tissue hematoma in time and sufficiently, and secondly to carry out débridements initially as well as planned second-look operations.

Accidental Falls↗
PubMed2005

[Prosthetic care of proximal femur fractures].

The endoprosthetic replacement of the hip joint or its components in fractures of the proximal femur is a standard method. Indications for replacement are strongly dislocated intracapsular femoral neck fractures in elderly patients, fractures with an existing arthritis of the hip joint, and profound osteoporosis. Improved perioperative management and more gentle anesthetic techniques have helped to reduce perioperative mortality from nearly 50% to 11.5% over the last 40 years. As routine treatment options, the bipolar endoprosthesis without replacement of the acetabular joint surface and total hip replacement in case of degenerative arthritis of the acetabular joint surface are commonly used. The mere replacement of the femoral head with a simple femoral head prosthesis should be reserved for exceptional cases. For the implantation of a hip joint prosthesis and its uncomplicated post-treatment and long-term durability, careful preoperative planning is essential together with the selection of a suitable implant, its optimal bony fixation, avoidance of intra-operative complications and restoration of the anatomical landmarks such as the centre of rotation of the hip joint, the offset of the prosthetic shaft as well as leg length. Despite the high standard of endoprosthetics in Germany, the results are still improvable in comparison to other countries. Measures which preserve the joint as well as the bone will be increasingly important in prophylaxis of further complications. In addition, more attention should be paid to the prophylaxis of falls and a sufficiently guide-lined therapy of osteoporosis for the prophylaxis of fractures of the elderly.

Arthroplasty, Replacement, Hip↗
PubMed1995

Why patients fail to attend psychiatric outpatient follow-up: a pilot study.

Patients who failed to attend psychiatric outpatient follow-up were compared with a group of comprising regular attenders. There were 71 defaulters out of 1,664 appointments given during the study period. Schizophrenia was the most common diagnosis. The defaulters did not differ from the controls in terms of age, sex, ethnicity, occupational or marital status. The unemployed were not more likely to be regular, instead, the better educated, shorter intervals between appointments and those given morning appointments were. Those solely on oral medication were more likely to default. The largest proportion gave reasons of work commitments and of not being free to attend; others claimed they had forgotten their appointments or had lost their appointment cards. Patients who said they did not come because they felt well or still had medication were cause for concern because of possible lack of insight and non-compliance with their medication.

Adult↗