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Biomedical subjects

W Hackenbruch

Publications and source records attributed to W Hackenbruch.

35 records · Page 2Linked to original sources
PubMed1979

Differential diagnosis of ruptures of the lateral ligaments of the ankle joint.

Ruptures of the lateral ligaments of the ankle joint occur very frequently in young persons and this subject is therefore one which deserves more attention. Once a fracture or avulsion of a ligamentary insertion has been excluded the nature and extent of the ligamentary lesion should be precisely assessed. The only objective criterion of rupture of a ligament is demonstrable instability of the joint. Since the anterior talo-fibular ligament is always found to be torn immediately following supination-inversion injury to the ligaments the talar drawer sign will be demonstratable both clinically and radiologically in such cases. This test causes almost no pain and can be carried out without anesthesia. The radiological visualization of ligamentary instability with the aid of a simple jig which stresses the ankle joint provides diagnostic information which is definitely superior to that obtained from an a-p roentegenogram of the stressed joint. This conclusion was reached by statistical analysis of 384 roentgenograms.

Ankle Injuries↗
PubMed1978

[Juvenile hip pain. 2. Femur head epiphysiolysis, hip dysplasia, tumors].

The early symptom in hip joint diseases in children is pain. Pain is localized in the groin and thight, but mostly in the knee. Other important signs are limping and reduced internal rotation. If a hip disease is suspected it is necessary to take X-rays in two planes. If diagnosis is early and special therapy started immediately, the results are usually excellent without deformation of the hip. Otherwise early osteoarthritis can develop. This is important because osteoarthritis in the hip joint is in 75% of the cases due to hip joint diseases in childhood. The problems of diagnosis and treatment of the most common hip joint diseases in children (transient synovitis, rheumatoid arthritis, osteomyelitis, Legg-Perthes disease, slipped capital femoral epiphysis, dysplasia, tumors) are discussed.

Adolescent↗
PubMed1978

[Juvenile reticulosarcoma].

The prognosis of malignant lymphoma of bone in childhood has been improved. This is due to the modern chemotherapy. Pain in the bones is one of the early symptoms. If these early symptoms are not recognized, diagnosis and therapy may be delayed. The problems of classification, diagnosis and therapy are discussed, 2 case-reports with so-called reticulum cell sarcoma are given.

Adolescent↗
PubMed1978

[Current concepts in the diagnosis of knee injuries].

The exact diagnosis of affections of the knee is most important, especially of the capsulo-ligamentous lesions. To-day more and more younger patients are suffering from knee-instability. The modern possibilities of operative reconstruction lead to excellent results if the operation is performed at an optimal date. During the last years progress also was achieved concerning the knowledge of the mechanics and the pathophysiology of the knee. New methods of clinical investigation and new clinical findings were possible. Specific tests for the diagnosis of instability of the anterior cruciate ligament have to be emphasized. These tests are specially important if there is only an insufficiency of the anterior cruciate ligament which cannot be proven by the other clinical findings. X-ray examination is necessary to search for a fracture or an avulsion of the bone. In all other problems the exact clinical examination leads to the diagnosis.

Humans↗
PubMed1978

[Femoral neck fractures and pertrochanteric fractures due to skiing accidents].

Pertrochanteric and femoral neck fractures are common in elderly patients. These fractures are mostly caused by domestic accidents. Femoral head necrosis and non-union are severe complications. Even if these fractures are not typical skiing-fractures, 101 fractures of the proximal femor were found to be caused by a skiing-accident. The age of the patients averaged 41 years, only one third were female. More than half of all patients participated in a control examination about one year after the accident. All fractures were operated according to the principles of the ASIF. The results showed twice an infection, in 3% dystrophia of the bone and in 3% mild osteoarthritis. There were no necroses of the femoral head, no non-union and no breaking of the implanted material. In 90% the results were good or excellent from the point of view of the patient as well as the orthopedic surgeon.

Adult↗
PubMed1977

[Fracture of the vertebrae due to riding accidents].

Fractures of the vertebral column due to riding accidents are frequent. In most of the cases we observe compression fractures of a vertebral body without compression symptoms of the spinal cord. If fractures of the spine heal with a gibbus deformity degenerative changes of the vertebral joints with severe back pains may ensue. Therefore it seems necessary to treat fractures of the vertebral spine with immediate reposition (ventraler Durchhang) and following immobilisation with a plastic corset Lightcast, Hexcelite). Occasionally operative stabilisation is necessary, especially in fractures of the cervical spine.

Athletic Injuries↗
PubMed1977

[Injuries of the capsular ligament of the ankle joint, so-called "ankle joint distorsion"].

The capsular and ligamentous lesion of the ankle is the most frequent injury and very common in sports. Still these injuries are frequently minimized and not treated properly. Late results are instability, subluxation and finally posttraumatic osteoarthritis. Anterio-lateral instability indicates lateral capsular-ligamentous lesions. Antero-lateral instability can be proved chinically by the anterior drawer-test and radiologically by a standardized stress x-ray in lateral position. The fresh lesion has to be treated by primary ligamentous suture or by plaster cast for 6 weeks. The treatment of chronic instability is secondary reconstruction. Severe osteoarthritis can be treated by an ankle replacement (endoprosthesis) or by arthrodesis.

Ankle Injuries↗
PubMed1977

[Pilon fracture of the skier].

Comminuted intraarticular fractures of the distal end of the tibia have considerably increased. This is due to the modern manner and equipment of skiing. Skiing is the cause of these lesions in about 80%. According to the mechanism of the accident and to the localization of the damage of the bone there are special types of fracture. The diagnosis on the X-ray picture is easy. A great problem is the therapy as the joint is mostly considerably damaged. Today the operative reconstruction with the modern procedure of osteosynthesis accoriding to the principles of ASIF is generally accepted. Even if the operative therapy is optimal the late results are not satisfactory in a high number of cases. A chance for prophylaxis is only expected in the responsible behaviour of the skier.

Adult↗