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Biomedical subjects

W Blauth

Publications and source records attributed to W Blauth.

At least 55 records · Page 3Linked to original sources
PubMed1980

[Syndactylia recurrences and their treatment (author's transl)].

Recurrences following correction of syndactylia are usually the result of inappropriate skin incisions, or of delayed wound healing. These recurrences are examplified by interdigital cutaneous and scar bridges which may result in contractures of even rotational deformities as the result of growth. Early and late syndactylia recurrences can be differentiated. Early operative treatment is recommended and splints and bandages or similar conservative measures are useless. Considerable experience, suitable instruments and adequate surgical technique are required for these corrections.

Child↗
PubMed1978

[Repair of defects in the Achilles tendon with the peroneus brevis muscle (author's transl)].

The authors report a dynamic plastic repair of the Achilles tendon in cases of neglected rupture: The peroneus brevis muscle is used to bridge the gap. The muscle remains intact at the proximal end, its tendon is dissected immediately above its insertion, then pulled through the calcaneus by a bore-hole and fastened to itself and to the ends of the Achilles tendon. If a plantaris tendon exists, it may be used to strengthen the defect by resecting it as far as possible proximally and then fanning it out to cover the gap. The distal end of the peroneus brevis tendon is sutured side-by-side to the peroneus longus tendon. This technique was first applied in 1968. During the last 5 years 8 patients underwent repair of the Achilles tendon by this method at the Department of Orthopaedic Surgery at the University of Kiel. In all cases the results obtained were good or excellent. The patients were very content and returned to a comparable level of preoperative activity. They were able to go as well on tip-toes as on the heels, though dorsal extension in several cases was slightly restricted. Calf atrophy up to 3 cm was found in several cases, which, however, was due partly to preoperational influences. In two cases wound healing complications occured without disturbing the functional results. The authors can recommend their technique, which seems to be superior to other methods especially in difficult cases with large gaps and unfavourably anatomic conditions.

Achilles Tendon↗
PubMed1978

["Apert's foot" (in acrocephalo-syndactyly) (author's transl)].

The authors discuss foot abnormalities in Apert's syndrome (acrocephalo-syndactyly). Characteristic of these deformities are bilateral, mostly symmetrical syndactlys of the toes; incorrect hyperextension positions of the first toe with large toes in flexed positions; intermetatarsal synostoeses, above all between the first and second metatarsal bones; multiple synostoses in the tarsal region; bi- and monophalanges with pseudo-, delta- or arcuate epiphyses. A classification of Apert's foot is presented, using 68 examples from the literature and 12 cases treated by the authors. The calssification is analogous to the hand deformities in Apert's syndrome. Three types can be distinguished: In type I, toes II-IV are webbed together. However, the large and small toes are still well separated. Syndactilys of toes II-V are present in type II, and all toes have grown together in type III. The deformity can be accompanied by stress pain and difficulties in providing shoes. In this case surgical correction is indicated in childhood: the incorrect position of the large toe is eliminated. Good results can be achieved via osteotomies of the metatarsal bones and resections of the intermetatarsal bone bridges.

Abnormalities, Multiple↗
PubMed1978

["Fibula-pro-tibia-fusion" (Hahn-Brandes-Graft) in treatment of bone defects of the tibia (author's transl)].

The authors use the "fibula-pro-tibia fusion" (also called Hahn-Brandes Graft, for the treating large bone defects of the tibia shaft. This method is preferred both with congenital partial tibial aplasias with acquired extensive pseudarthrosis defects of the tibia. In congenital cases, grafting of the distal end of the fibula onto the calcaneal end of the foot with careful preservation of the epiphyseal disc, should precede surgery. Large differences in leg length can be treated after fusion surgery by means of elongation osteotomies. Attention is drawn to this method in the second example of pseudarthrosis defect. Lastly the authors mention a further method for mediation of large diaphyseal tibia defects, namely the transplantation of the opposing fibula. This can lead to good results when an aggressive form of fibrous dysplasia is not present, as was the case however in the third example. In such a case the process only heals after removal of the cover of the periosteum as well.

Adult↗
PubMed1978

[Arthrolysis in the treatment of post-traumatic extensor rigidity of the knee (author's transl)].

Extensor rigidity of the knee may be due to a wide variety of causes and is certainly quite often a sequela of an injury. Rigidity is caused by damage to tissue distant or proximal to the knee joint, in the joint itself, or simultaneously at several locations. In many cases considerable improvement can be achieved by arthrolysis. However, this requires detailed knowledge of the involved and expected pathologic changes. Besides detailed clinical and x-ray examination via arthrography it is particularly important to select and prepare the patients properly. Knee arthrolysis can never be based on only one surgical procedure. The authors differentiate between covered and open loosening of the stiffened joint besides intraarticular and extraarticular arthrolysis, and a combined intraarticular and extraarticular procedure. Postoperative followup treatment is at least just as important as the surgical procedure itself. Complications can be largely avoided via subtile technique and sufficient experience. The authors report on 16 followup examinations effected during the past four subsequent to arthrolyses of the knee. On the average there was an improvement in flexibility and stretch-ability by 70 degrees, or a relative flexibility increase by 80%. No serious complications were seen. Arthrolysis of the knee is recommended as a well-tried and highly successful surgical procedure.

Adult↗
PubMed1977

[Present situation of hinge-type artificial knee joints (author's transl)].

The introduction explains the general problems of knee joint replacement by artificial hinge-type prostheses, due to the reduction of the physiological "degrees of freedom" to only rotational movements around a horizontal axis. These problems are compared with the advantages of this type of prosthesis. Subsequently a description of some significant constructional characteristics of the hinge-type prosthesis, 13 given as there are placement of the joint, size of the contact surface, safety of the rotational device, design of the hinge-mechanism, the patella shield and the prosthetic stems as well as the breaking of dynamic forces, which all are subsequently compared in their values. Finally a hinge-type prosthesis is described with characteristics judged optimal according to our present scientific knowledge. We statistically evaluated our material of hinge-type prostheses with regard to final results and frequency of serious complications.

Biomechanical Phenomena↗
PubMed1977

[Therapeutic possibilities malformations of the metacarpus].

The most common deformities of the metacarpus occur in conjunction with poly- and oligodactyly. The authors first refer to the most important operations in treating these deformities and emphasize that in certain cases solitary resection of surplus fingers is not enough: in addition, outgrown articular process must be removed, bent metacarpals osteotomised and capsular defects closed. The treatment of oligodactylic hands is made difficult by cutaneous and osseous syndactyly. The operating surgeon should have sufficient experience in plastic surgery to be able to take care of severe adduction contractures of the thumb with constriction of thumb commissure. For aplasia and hypoplasia in the thumb ray the already proven index finger pollizisation is thetherapy of choice. Triphalangeal thumbs are operated according to the same principles. On the other hand in brachyphalangeal thumbs commissure increase and correction of the clinodactylia are of prime importance. Phalangisation is very rewarding in certain forms of synbrachydactyly. In some deformities only the thumb is present. In these cases we recommend an opposition post built out of a tubed flap and autogenous bone graft. Some examples of defective hands surgically treated are shown.

Congenital Abnormalities↗
PubMed1977

[Medial-and simultaneous anterior-transfer of the tibial tuberosity (author's transl)].

Because of the triangular cross-section of the tibia medial transfer of the tuberosity according to Hauser and Roux leads to a backward displacement of the insertion of the patellar ligament accompained by rotation. This mechanically unfavourable effect can be made good by a change in technique of removing the tuberosity. It is not removed as a flat disk of bone but as a bone-block of triganular shape in cross-section and fixed on the medial surface of the tibia with a special flat-headed screw. The technique is described in detail.

Humans↗
PubMed1977

[Replacement of the knee-joint (author's transl)].

Survey of methods. In first part new classification of prostheses. Discussion of some biomechanical problems, mainly on hinge-prosthesis which can only be compromises for various periods. Replacement to be considered only for elderly or very old patients, when conservative treatment offers no chances, other operations are not promising or have failed, arthrodeses cannot be done and pain and loss of function are severe. Indications for hinge- and slide-prostheses are given. In the second part two statistics of results from the literature are discussed and experience with 130 own cases using own model is described. Infection occurred in 3 cases where removal of prosthesis had to be done. Examples of the need for reversal operations are given.

Adult↗
PubMed1976

[Resection arthrodesis in the treatment of bone tumors located near the knee joint (author's transl)].

First of all the authors limit the indications to resection arthrodesis in bone tumors located near the knee joint and present the main features of the procedure. These consist of the technical requirements for a radical operation, the type of osteosynthesis with special supports and the type of compensation for the defect. Based on the well known surgical techniques of Juvara, Merle d'Aubigné and J.Böhler, a precedure was presented which has been clinically tested for 6 years. In this procedure which is based on individual locations of tumors, a homologous bone canal helps to compensate the resection defect. The biological characteristic of the healing of this interponate was described. Finally, recommendations for postoperative aftercare were presented whereby the long support in orthopedic apparatus and the renewed spongiosa accumulation as a result of the removal of the metal were mentioned.

Arthrodesis↗