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Biomedical subjects

W Mutschler

Publications and source records attributed to W Mutschler.

At least 127 records · Page 7Linked to original sources
PubMed1992

[Computerized tomography of intra-articular calcaneus fracture. Comparison: radiomorphologic result--clinical result].

In 55 patients with intraarticular fracture of the calcaneus computed tomography of the fractured bone was performed immediately after the accident and 6-12 months later. We recorded the fracture type according to the classification established by Essex-Lopresti. We evaluated the degree of bony destruction, deformation of the calcaneus and the extent of articular bursting. We recorded the severity of the fracture with reference to a 10-point scale and compared this with the clinical outcome after surgery or conservative therapy. The clinical results were according to a 18-point scale devised by Merle d'Aubigne. Changes between the initial and follow-up CT were also recorded. There was a good correlation between radiological findings and clinical results.

Adolescent↗
PubMed1992

[Surgical therapy of metastases of the proximal femur and acetabulum].

An analysis of indications and operative techniques was carried out in 166 patients with skeletal metastases of the proximal femur and acetabulum. Complications as well as functional and oncological results clearly show advantages and disadvantages of different methods such as osteosyntheses, standard hip prostheses and tumour prostheses referring to the tumour's localization and extent.

Acetabulum↗
PubMed1991

[Surgical therapy of leiomyosarcoma of the veins. A case report].

Among the rare soft tissue sarcomas the leiomyosarcoma of the veins is only to be found in very few cases. On the basis of a case report the procedure of surgical treatment concerning this tumour is described; usually, in addition to the resection of the compartment a vascular reconstruction is required.

Adult↗
PubMed1991

Post-traumatic radioulnar synostosis after forearm fracture osteosynthesis.

One hundred sixty-seven forearm fractures treated with plate osteosynthesis were analyzed for synostosis occurring between the radius and the ulna. Eleven cases (6.6%) were found, in 7 of which both bones of the forearm had been fractured, while the other 4 were cases of isolated radial or ulnar fracture. Overall there were 89 cases of fracture of both bones; of the 65 cases treated utilizing the two-incision approach, cross-union was seen in only 1, while in a comparable group (12 cases) in which the fractures were stabilized using the Boyd approach, there were 5 synostoses. In 38 cases of isolated ulna fracture, only 2 synostoses were seen one associated with severe soft-tissue trauma and the other arising after treatment with a modified Boyd approach. Among 40 isolated radial fractures, 2 radioulnar synostoses occurred, one in an open fracture and the other after fixation via the Boyd approach. These results emphasize the importance of using two approaches for fractures of both forearm bones. The highest risk of post-osteosynthetic synostosis appears to be in fractures of the proximal third of both radius and ulna.

Adolescent↗
PubMed1991

[Cervical spinal injuries in craniocerebral trauma: their x-ray diagnosis on the day of the accident].

To investigate cervical spine injuries and to evaluate cervical radiography 100 patients were reviewed who were referred to computed tomography of the head because of blunt head trauma. 15 sustained cervical injury, 11 were located at the lower level of the cervical spine. Six fractures of the lower cervical spine were detected by additional radiographs. The diagnosis was established by computed tomography in three cases. To rule out cervical injuries in patients with incomplete visualisation of the lower cervical spine, cervical computed tomography should be performed in addition to lateral, anterioposterior, and open-mouth views.

Adult↗
PubMed1991

Compartment syndrome of the foot after intraarticular calcaneal fracture.

Seventeen patients with a total of 21 intraarticular calcaneal fractures were examined at up to 30 days after trauma for the development of tissue pressure in the central plantar muscle compartment. Twelve patients had a significant increase in tissue pressure with values greater than 30 mmHg because of primary fracture hematoma or interstitial fluid accumulation. This increase in pressure persisted for three to five days after trauma, so that ischemic damage to the short plantar foot muscles had to be suspected. Plantar muscle scarring and claw-toe formation were observed in seven patients with a total of 11 fractures during a mean observation period of 18 months. The plantar aponeurosis, which forms the constricting fascial envelope of the plantar muscles, is the anatomic structure responsible for the compartment syndrome that may develop after calcaneal fracture. Therefore, to avoid functional deficit, plantar compartmental pressures should be regularly measured after calcaneal fracture. Significantly increased plantar tissue pressure greater than 30 mmHg should be relieved by longitudinal incision of the plantar aponeurosis, preferably by a plantar incision as soon as the diagnosis is made.

Adolescent↗
PubMed1990

Detection of local recurrent disease in musculoskeletal tumors: magnetic resonance imaging versus computed tomography.

A 2 1/2-year prospective study of surgically treated malignant mesenchymal neoplasms showed magnetic resonance imaging (MRI) to be superior to computed tomography (CT) in sensitivity for local recurrent disease measuring less than 15 cm3. Larger masses were detected with similar sensitivity; specificity and predictive values did not differ. The presence of areas of high signal intensity on T2-weighted images proved to be a reliable criterion except in fibrous neoplasms. However, differentiation between non-hemorrhagic fluid collections, cross-sectioned veins or bowel contents and small tumor nodules cannot be made simply by signal intensity, but has to be based upon the evaluation of gross morphologic criteria.

Bone Neoplasms↗
PubMed1990

[Surgical treatment of spinal metastases].

An analysis of indications, techniques, results of decompression and stabilization in 164 spinal metastasis was carried out. Actual possibilities of rigid stabilization from the anterior and posterior approach are demonstrated.

Adult↗
PubMed1990

[Late vascular damage after unilateral leg amputation].

The higher incidence of infrarenal aortic aneurysms in war-veterans with above knee amputations indicates that leg amputation besides arteriosclerotic risk factors constitutes a relevant pathogenetic factor for the late development of an abdominal aortic aneurysm. A retrospective study of 25 mainly young patients with above knee amputation showed that already one year after leg-loss a typical adaptive narrowing of the pelvic and leg arteries with significant reduction of the flow volume of 37% on the amputated side could be registered. Unilateral flow reduction resp. interruption causes an asymmetric flow pattern at the aortic bifurcation. The changed hemodynamics are probably the main cause for late damage to the aorto-iliac vessels. The clinical importance of these results is that patients with unilateral leg amputation should have regular follow up investigation in order to detect late sequelae on the aorto-iliac vessels and to perform elective surgery for abdominal aortic aneurysm. Ipsilateral occlusive arterial disease as well as abdominal aortic aneurysms must be regarded as secondary late damage after leg amputation justifying obligatory indemnification.

Adolescent↗
PubMed1990

[Reconstructive surgery of malunited elbow fractures].

Fractures of the elbow may result in deformity, pseudarthrosis and arthritis, which lead to painful and restricted use of the joint. The operative treatment of these late complications includes osteotomies, surface reconstruction, arthrolysis, arthroplasty, alloarthroplasty and arthrodesis. Indications, operative techniques and results are described and discussed.

Adolescent↗
PubMed1989

[Intra-articular juvenile calcaneus fractures in skiing].

Calcaneal fractures are extremely rare in children with intraarticular fractures occurring between 8 and 14 years. This report refers to two cases with displaced intraarticular fractures of the calcaneus sustained from skiing. Results of surgery were proven to be excellent. As essential prerogatives of successful treatment elaborate diagnostics including computerized tomography, experience in doing surgery on the calcaneus and knowledge about the special entities of the growing skeleton are mandatory.

Adolescent↗
PubMed1989

[Radiomorphologic classification of central chondrosarcomas].

A retrospective study of 50 exostotic chondrosarcomas of the trunk reveals statistically significant correlations of histological grading and growth pattern as well as bone destruction pattern as general hallmarks of the degree of malignancy. No correlation between presence and type of matrix mineralisations was found. A radiomorphological classification derived from the CT appearance of mineralisations allows a distinction of 5 types that are important for diagnostic specificity and recurrence detection. MRI provides sensitive detection of early local recurrences due to high-contrast display of chondroid tissue irrespective of mineralisations. However, the specificity is low.

Adult↗
PubMed1989

[The value of CT and MRT in the diagnosis of cartilage-forming tumors].

Accuracy in the assessment of lesion extension, specificity for histologic type and tumour status were reviewed in MRI and CT scans of 27 chondrosarcomas, 18 osteochondromas and 10 enchondromas and compared with the results obtained by plain radiography. No significant differences in the description of the lesion were found in chondrosarcomas and enchondromas between MRI and CT. In osteochondromas cartilage caps smaller than 5 mm and isodense to muscle were missed or not adequately delineated in CT. The specificity for the primary benign and malignant forms was equally high for CT and plain films, while MRI implies a much lower specificity due to the low sensitivity for matrix mineralisations. The criteria for malignant transformation of osteochondromas are visualised to better advantage by MRI. Solid ossified and small unmineralised recurrences of chondrosarcomas are detected by MRI with a higher sensitivity and specificity than by CT.

Bone Neoplasms↗
PubMed1989

[Carbon fiber reinforced polysulfone implants for tumor surgery of the spine].

Anterior tumor removal, cord decompression and spinal stabilization gain in significance in surgical treatment of vertebral tumors. An implant system, consisting of a basket as vertebral body replacement, plates and screws, was developed using carbon fibre reinforced polysulfone. This system allows to perform individually shaped, stable and short-distance spine fusions from an anterior approach. Moreover its radiolucence facilitates postoperative care and irradiation. Operative technique and clinical experience are demonstrated in two patients.

Bone Plates↗
PubMed1989

[Malignant tumor (including metastasis) as a cause of pathologic fracture].

Pathological fractures due to primary malignant bone tumors are extremely rare. The first step in their treatment is biopsy and stabilization with external or internal fixation including bone cement. The tumor is then typed, graded and staged. A multimodal therapy follows. In cases of bone metastases the tumor is immediately removed and internal fixation or endoprostheses are used for stabilization. Operative procedures and results are demonstrated in patients with metastases of the proximal femur.

Bone Neoplasms↗
PubMed1988

[Advantages in the diagnosis and classification of intra-articular fractures of the calcaneus using computed tomography].

The superiority of CT over conventional radiography in demonstrating intra-articular fractures of the os calcis was demonstrated in 34 patients. The advantages consist in being able to demonstrate the joint without superposition and the exact demonstration of the position, size, shape and number of fragments. Shortening or widening of the os calcis can be easily recognized, as well as fractures of the medial or lateral cortex. At the same time it is possible to evaluate soft tissues, particularly the peroneal ligament. The conventional classification of calcaneal fractures has been newly evaluated in the light of the ability to recognize involvement of the joint and the course of the main fracture lines.

Adolescent↗