[Survival following stomach rupture caused by oxygen insufflation].
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
W Noack
Publications and source records attributed to W Noack.
[Ambulatory diagnosis and therapy of gonarthrosis].
AIM OF STUDY: To develop recommendations for appropriate diagnostic procedures and conservative treatment of knee osteoarthritis in outpatients. MATERIAL AND METHODS: Following a consensus conference and expert reviews basic recommendations were developed. RESULTS: While standardized radiographic assessment is mandatory, MRI investigation should be restricted to problems apart from osteoarthritis. Indications for physical therapy, bracing and pharmaco-treatment depend on the severity of the disease. Guidelines for intraarticular injections are presented. CONCLUSION: Effective treatment of knee osteoarthritis must be based on available recommendations and guidelines.
Ambulatory Care↗
[Cryotherapy as analgesic technique in direct, postoperative treatment following elective joint replacement].
The application of crushed ice or hydrogenated silicate, a micro-crystalline substitute has been used as a method to treat posttraumatic and postoperative irritations of the locomotor system for a long time. Closed systems using pumps can be viewed as further development as they enable continuous, water-free cooling of operating areas. The analgetic effect of postoperative cold therapy was evaluated in a prospective clinical trial, including 312 patients after total knee or hip arthroplasty. Conventional cold packs, consisting of microcrystalline silicate were compared to a continuous applicable closed system. Continuous cryotherapy resulted in a depression of skin temperature to 12 degrees C, whereas intermittent cooling only caused a mean temperature decrease of 1 degree C. Clinically continuous cold application leads to a more than 50% decrease of analgetic demands in both, systemic and regional application (p < 0.001). This observation was found in a significant correlation with patient's pain sensation as well as primary range of motion. Intermittent cryotherapy was found to be ineffective in postoperative pain relieve in hip- and adequate in knee arthroplasty patients. We could not report an influence on postoperative blood loss, as discussed in previous reports.
Aged↗
[Significance of the radial compression syndrome for the diagnosis and surgical therapy of so-called epicondylitis humeri radialis (Epic. hum. rad.)].
25 patients with Tennis Elbow were examined after surgery (= retrospectively), 25 before surgery (= prospectively). All of the patients were operated on according to the Wilhelm and Wachsmuth method. 5-18 months after surgery (on average 10), both groups underwent clinical examinations. Those patients who still had symptoms were given neurophysiological examinations. Both groups were compared with each other. The following results were obtained from the comparison: 1) 7 patients (28%) in the retrospective group were dissatisfied with the results of surgery and still had symptoms specific to the disease. In the prospective group, only 2 patients (8%) complained of similar problems. 2) 6 of the above-mentioned 7 dissatisfied patients in the retrospective group agreed to a postoperative neurophysiological examination. This revealed in five out of six patients damage to the radialis nerve. 3) At the clinical examinations of the 25 prospective patients, 17 were suspected of having radial compression syndrome. In 9 patients, this suspicion was confirmed by the neurophysiological findings. A neurolysis of the N. radialis was performed on these nine patients during surgery. All of these patients were satisfied with the results of surgery at the follow-up examination. The above results permit the following conclusions: 1) The failures in surgical treatment of Tennis Elbow can in part be put down to radial compression syndrome. 2) A thorough clinical examination, which in particular takes radial compression syndrome into account, should be carried out on every Tennis-Elbow-patient. 3) The neurophysiological examination of the main extensors of the hand should be an obligatory part of pre-operative preparations.(ABSTRACT TRUNCATED AT 250 WORDS)
Electromyography↗
[Sternocostoclavicular hyperostosis--case reports and differential diagnosis].
Sternocostoclavicular hyperostosis (SCCH) is a disorder related to collagenoses. SCCH is typically characterised by the triad of swelling of the sternoclavicular and/or sternocostal joints of the first or second rib, palmar and plantar pustulosis (PPP), only limited elevation of inflammation indicating laboratory parameters. Till today the etiology is unclear and no causal therapy is known. Symptomatic treatment consists of administration of NSAID and cortisone, irradiation and even limited resection of the clavicle and rib.
Adult↗
[Treatment of progressive axial deformities in children by surgical measures of the growth plate].
Report of the results of 4 surgically treated epiphyseal injuries with progressing deformities in the lower extremities (3 injuries type V, 1 epiphyseal fracture type IV according to Salter and Harris). Our Surgical procedure consisted in a resection of the posttraumatic transphyseal bony bridge with a following interposition of a silastic block to prevent again transphyseal blocking. The indications for such a surgical procedure is explained possibilities leading to failures are discussed. The results of our experimental studies being the basis for such operations are reported.
Adolescent↗
[Indications and results of the surgical treatment of distal intra-articular humeral fractures in the elderly].
In this paper we review 16 patients with closed intercondylar fractures of the distal end of the humerus that had open reduction and internal fixation. All patients were older than 60 years of age. Using the classification system of Müller et al. 6 fractures were classified as type C2 and 10 fractures as type C3. The surgical procedures and the types of internal fixation of the fractures allowed early postoperative mobilisation (3rd postoperative day). A rating scale modified according to Cassebaum was used for the results. At a mean follow-up of 4.2 years 3 patients were rated as excellent 9 as good and 2 as fair. No severe complications were registered.
Aged↗
[Treatment of spondylolisthesis in adults using the dorsal approach with the fixateur interne and a special repositioning device].
Fourteen patients with spondylolisthesis were operated in the Orthopaedic Clinic of Ulm (RKU) from October 1984 to December 1986. All patients suffered from low back pain, 13 had symptomes of nerve root compression, 6 had intermittent spinal claudication. All patients were treated by segmental distraction, reduction of the slipped vertebra and a ventral interbody fusion. The operative technique required first the dorsal approach for distraction and reduction using the fixateur interne (Dick) as well as a self developed special instrument for the reduction of the vertebra (repositeur). The ventral interbody fusion was performed in a one-stage procedure. The self developed special instrument (repositeur) is described and its construction principals, mechanics and its applications. Distraction and reduction of spondylolisthesis was achieved totally or nearly complete with this instrument in all but one patient. In one case the transpedicular screw ripped out. Always the foramina intervertebralia were opened to physiological width. Pain and neurological symptomes completely disappeared in all patients and no additional spinal operation was necessary. No infection and no pseudarthrosis did occur. Our clinical results are discussed in regard to other publications. Operative treatment of spondylolisthesis using the fixateur interne and a new developed special instrument for reduction.
Adolescent↗
[Recent aspects of the biocompatibility of carbon fibers. A histologic and electron microscopy analysis].
Twenty out of 36 patients who had been treated with a carbon fiber syndesmoplasty were followed up 12-19 months after surgery. Reoperation was performed on 11 patients, in 3 cases for removal of the material and in 8 because of persistent pain, although the syndesmoplasties were stable in the majority of cases. Histologic and electron-microscopic study of the explanted ligaments revealed a considerable foreign-body reaction to the carbon fibers and insufficient metaplasia of the allogenic material to connective tissue.
Biocompatible Materials↗
[Repositioning injuries of nerve root L5 after surgical treatment of high degree spondylolistheses and spondyloptosis--in vitro studies].
Temporary or persistent paralysis of the fifth lumbar nerve root have been frequently reported as complications following reposition of high degree spondylolisthesis. According to an outcome analysis of sixty-four patients, we found an increased incidence of motor damages after reduction of Meyerding degree four anterolisthesis or spondyloptosis. There were no signs of intradural root compression or nerve injury tracable. In order to detect extraforaminal strictures, the anatomic course of the lumbosacral plexus and its relation to neighbouring structures, especially pelvivertebral connective tissue junctions were recorded in cadavric measurements. Beside an number of variations in origin and course of the iliolumbar ligament complex, we observed a junction between os sacrum and the anterior part of the fifth lumbar vertebrae in 14/30 specimen, constantly running anterior to the fifth lumbar nerve root. In addition the nerve was fixed to the sacral periostium a few centimeters distal this crossing in about 20% of all cases. Pathophysiological effects were measured in reposition trials, using a continuous pressure monitoring system. A reposition of more than 20 mm resulted in a perineural pressure > 30 mmHg. This caused a nerve fiber deformation at the edge of the compressed nerve segment. Increased pressure leads to a nodular displacement of perineural fat as well as intraneural fascicles.
Biomechanical Phenomena↗
[New possibilities in the detection and surgical therapy of synovitis of the hip joint].
Missing pathognomonic clinical and radiological signs, an early diagnosis of hip joint synovitis is often impossible. Ultrasonography and arthroscopy of the hip joint are useful methods to accomplish recognition and exact description of chronic inflammatory hip joint diseases. These new diagnostic methods enable an early adequate treatment. Until today synovectomy of the hip joint is still a rare surgical procedure. Reasons are the difficulties in diagnosis of the synovitis and the insufficient radicality of synovectomy if the femoral head is not luxated temporarily. The semi-arthroscopic synovectomy of the hip joint allows a radical removal of the synovial membrane even in the fossa acetabuli, avoiding the inherent risks of a luxation of the femoral head.
Arthroscopy↗