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  • 1
    Electronic Resource
    Electronic Resource
    Der „reversed“ Muculus-biceps-femoris-Lappen zur Defektdeckung am distalen Oberschenkel (1996)
    Springer
    Der Chirurg 67 (1996), S. 1188-1192 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Soft tissue defects ; Biceps femoris flap ; Local muscle flaps ; Osteitis. ; Schlüsselwörter: Weichteildefekt ; M.-biceps-femoris-Lappen ; Schwenklappen ; Muskellappen ; Femurosteitis.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Anhand des Falls einer 30 jährigen Patientin, die im Rahmen eines Autounfalls eine drittgradig offene Oberschenkelfraktur erlitten hat, wird der „reversed“ oder distal gestielte M.-biceps-femoris-Lappen zur Defektdeckung am antero-lateralen, distalen Oberschenkel dargestellt. Zum Zeitpunkt der Verlegung in die Unfallchirurgische Klinik der Universität Bonn, 14 Wochen nach dem Unfall, hatte sich u. a. aufgrund eines Weichteildefekts und einer instabilen Osteosynthese eine posttraumatische Osteitis entwickelt. Nach Infektberuhigung durch die Materialentfernung, Anlage eines Fixateur externe sowie mehrere Débridements wurde zweizeitig ein M.-biceps-femoris-Lappentransfer, in Verbindung mit einer inneren Osteosynthese, durchgeführt. Dank der Defektdeckung und Durchblutungsförderung im Frakturareal durch den M.-biceps-femoris-Lappen kam es zu einer Ausheilung der Fraktur. Die Operationstechnik wird dargestellt.
    Notes: Summary. We report the case of a 30-year-old female patient, who had suffered a grade III open femur fracture in a motor vehicle accident 14 weeks prior to being transferred to the trauma department of the University Hospital in Bonn. Upon admission to our unit, posttraumatic osteitis, an unstable fracture following compression plating, and a soft tissue defect of the anterolateral distal thigh were discovered. Following removal of the hardware and stabilization of the fracture with external fixation, the infection was brought under control. Because the patient refused the time-consuming segmental transport utilizing the callus distraction technique, local muscle transfer and shortening of the femur were carried out. The most lateral of the hamstring muscles, the biceps femoris, was used as a distally based muscle flap utilizing a delay technique. With the help of a reversed biceps femoris flap, the soft tissue defect was closed, the infection subsided and the fracture healed. The surgical technique is outlined.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040050124
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  • 2
    Electronic Resource
    Electronic Resource
    Thoracoscopically assisted ligamentous release of the thoracic spine a cadaver study (2000)
    Springer
    Surgical and radiologic anatomy 22 (2000), S. 143-150 
    Details
    ISSN: 1279-8517
    Keywords: Spine ; Thoracic spine ; Hyperkyphosis ; Anterior longitudinal ligament ; Thoracoscopy ; Anatomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The surgical treatment of thoracic kyphosis frequently requires an anterior release, which can be carried out by an open or endoscopic technique. This study concerns the reference points which are essential from the anatomic view for minimizing the operative risks. Furthermore we wanted to find the most convenient video-assisted thoracoscopic surgery (VATS) technique for transection of the anterior longitudinal ligament (ALL). Transection of the ALL, as well as discectomy, was performed using this technique. The extensive anatomic dissection of 12 fresh cadavers was performed to define possible technical errors and surgical complications. The development of new instruments has made the VATS approach to the ALL a viable alternative to open procedures. With the help of a standardized technique, the isolated thoracoscopic ligamentous transection required less time than the comparable open procedure. The anatomic study showed, that in no case was a ligation of the intercostal or segmental vessels necessary as part of the approach to the spine, once an adequate mobilization of the esophagus and azygos vein had been carried out. The risk of an ischemic lesion of the spinal cord was thereby reduced. The thoracoscopic, limited anterior release consisting of a multilevel transection of the ALL proved to be a rapid and reliable procedure. Our anatomic studies provides suitable the reference points.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00276-000-0143-y
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  • 3
    Electronic Resource
    Electronic Resource
    Compression plating of tibial fractures following primary external fixation (1997)
    Springer
    Archives of orthopaedic and trauma surgery 116 (1997), S. 390-395 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract During the time period from May 1990 to December 1992, a total of 75 tibia fractures were treated in the Department of Traumatology at the University of Bonn. Thirtyeight patients with 40 tibial fractures were managed according to a regimen including primary stabilization, usually using external fixation, soft tissue reconstruction and delayed open reduction and internal fixation using an AO compression plate. The majority of the patients had been involved in motor vehicle accidents, leading to multiple injuries in 24 instances. An open fracture was seen 18 times. The 20% complication rate is comparable to the reports following intramedullary stabilization. Only one infection, following a grade 2 open fracture, was seen after the definitive stabilization. Bony union was achieved after 15.7 weeks. In light of the complications associated with intramedullary nailing, such as fat or air embolism, heterotopic ossification and non- or malunions, use of the tibial plate does not offer just logistic advantages, but is a viable alternative for delayed stabilization of tibial fractures. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00433997
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  • 4
    Electronic Resource
    Electronic Resource
    Refixation of femoral anterior cruciate ligament tears combined with a semitendinosus tendon augmentation (1998)
    Springer
    Archives of orthopaedic and trauma surgery 117 (1998), S. 68-72 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract As part of a retrospective study, 76 patients with acute tears of the anterior cruciate ligament who underwent reinsertion and augmentation with the semitendinosus tendon were examined. The follow-up took place on average 4.5 years (range 3–7 years) after surgery. A decreased range of motion upon comparison with the uninjured opposite side was seen in 43 patients. The Lachman test revealed a grade 1 instability in 42 patients, grade 2 in 17 and grade 3 in 2, while 15 patients had a negative test result. The average Lysholm score was 92 points and the Tegner activity score had an average of 7.1 points. KT-1000 measurements showed an identical degree of anterior translation for both knees at 89 N in 25 individuals. The analysis revealed a difference of 2 mm in 15 patients, 4 mm in 19, 6 mm in 15 and greater than 6 mm in 2. The radiographic follow-up examination revealed a deterioration of the degenerative change of 1 deg in 17 patients and 2 deg in 4 patients. Isometric testing showed no loss in flexion strength of the operated knee joints compared to the healthy opposite side. The ratio between flexion and extension strength was also identical for both knees. The reinsertion and augmentation with a single strand of semitendinosus tendon is not, as this study demonstrates, the appropriate reconstructive technique for the majority of ACL tears.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00703445
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  • 5
    Electronic Resource
    Electronic Resource
    Compression plating of tibial fractures following primary external fixation (1997)
    Springer
    Archives of orthopaedic and trauma surgery 116 (1997), S. 390-395 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract During the time period from May 1990 to December 1992, a total of 75 tibia fractures were treated in the Department of Traumatology at the University of Bonn. Thirtyeight patients with 40 tibial fractures were managed according to a regimen including primary stabilization, usually using external fixation, soft tissue reconstruction and delayed open reduction and internal fixation using an AO compression plate. The majority of the patients had been involved in motor vehicle accidents, leading to multiple injuries in 24 instances. An open fracture was seen 18 times. The 20% complication rate is comparable to the reports following intramedullary stabilization. Only one infection, following a grade 2 open fracture, was seen after the definitive stabilization. Bony union was achieved after 15.7 weeks. In light of the complications associated with intramedullary nailing, such as fat or air embolism, heterotopic ossification and non- or malunions, use of the tibial plate does not offer just logistic advantages, but is a viable alternative for delayed stabilization of tibial fractures. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00433997
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    Paper (German National Licenses)
    Fulltext
  • 6
    Electronic Resource
    Electronic Resource
    Refixation of femoral anterior cruciate ligament tears combined with a semitendinosus tendon augmentation (1997)
    Springer
    Archives of orthopaedic and trauma surgery 117 (1997), S. 68-72 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract As part of a retrospective study, 76 patients with acute tears of the anterior cruciate ligament who underwent reinsertion and augmentation with the semitendinosus tendon were examined. The follow-up took place on average 4.5 years (range 3–7 years) after surgery. A decreased range of motion upon comparison with the uninjured opposite side was seen in 43 patients. The Lachman test revealed a grade 1 instability in 42 patients, grade 2 in 17 and grade 3 in 2, while 15 patients had a negative test result. The average Lysholm score was 92 points and the Tegner activity score had an average of 7.1 points. KT-1000 measurements showed an identical degree of anterior translation for both knees at 89 N in 25 individuals. The analysis revealed a difference of 2 mm in 15 patients, 4 mm in 19, 6 mm in 15 and greater than 6 mm in 2. The radiographic follow-up examination revealed a deterioration of the degenerative change of 1 deg in 17 patients and 2 deg in 4 patients. Isometric testing showed no loss in flexion strength of the operated knee joints compared to the healthy opposite side. The ratio between flexion and extension strength was also identical for both knees. The reinsertion and augmentation with a single strand of semitendinosus tendon is not, as this study demonstrates, the appropriate reconstructive technique for the majority of ACL tears.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00703445
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    Paper (German National Licenses)
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  • 7
    Electronic Resource
    Electronic Resource
    Destructive changes of the spine in magnetic resonance imaging (1990)
    Springer
    Archives of orthopaedic and trauma surgery 109 (1990), S. 133-138 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twenty-nine patients were examined by magnetic resonance imaging for various lesions of the spine. The results of these scans were compared with those of plain radiographs, computertomographs, and radionuclide bone scans. The findings were substantiated by intraoperative or histological findings in 18 cases. The MRI scans proved to be very sensitive in the detection of a wide spectrum of morphological changes of the bone marrow of vertebral bodies. Characteristic changes of the signal patterns for inflammatory and tumorous lesions were not observed. The differentiation of these lesions will presently continue to have to be based on morphological criteria.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00440573
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  • 8
    Electronic Resource
    Electronic Resource
    Indications for and results of operative treatment of spondylitis and spondylodiscitis (1991)
    Springer
    Archives of orthopaedic and trauma surgery 110 (1991), S. 78-82 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We present a retrospective follow-up study of 24 patients with spondylitis or spondylodiscitis whose treatment included surgical intervention. Tuberculous spondylitis was diagnosed in 14 patients and 10 suffered from non-specific spondylitis. The average age of the patients was 50.2 years and average follow-up was 3 years. All patients were asymptomatic at the time of examination and showed radiographic evidence of solid fusion. We recommend radical debridement and spinal fusion through a ventral approach in patients with destruction of the ventral vertebral body, progressive neurological impairment, septicaemia and antibiotic-resistant, symptomatic infections of the spine. In the elderly patient, even in reduced states of health, early surgical intervention can be particularly valuable. Although surgical intervention should be reserved for specific indications, we were able to document favourable results in all 24 patients treated with debridement and spinal fusion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00393878
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  • 9
    Electronic Resource
    Electronic Resource
    Follow-up evaluation of open intra-articular fractures of the calcaneus (1998)
    Springer
    Archives of orthopaedic and trauma surgery 117 (1998), S. 442-447 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The results of a follow-up evaluation of open intra-articular calcaneal fractures are presented. A modified Merle d’Aubigné functional score and Zwipp radiographic score were used. A retrospective analysis of 35 patients with 36 open intra-articular fractures represents the basis of the study. At the time of follow-up examination (on average 44 months after the injury), 5 amputations of the affected extremity and 4 ankle arthrodeses had been carried out. The 23 patients still able to bear weight on the affected hindfoot and possessing a functional ankle joint were radiographically and functionally evaluated. No excellent results were documented. Only 6 good functional and 2 good radiographic outcomes were noted. In 17 instances, a poor functional or radiographic score was given. Devastating results were seen in the course of treatment of third-degree open joint depression or comminuted intra-articular fractures (n = 15): 9 cases of osteomyelitis, 5 amputations, 1 partial calcanectomy, 1 arthrodesis. An open reduction as part of the primary treatment (n = 6) led to local complications in all instances. The most favorable results were seen after nonoperative fracture management: complication-free course of treatment in 4 of 11 patients. All workmen’s injuries led to a permanent disability, and these patients received compensation. The treatment and salvage of the soft-tissue envelope should be paramount in all therapeutic decisions. The fracture treatment must not further jeopardize these tissues. An aggressive operative treatment of local complications, including arthrodesis or amputation, is recommended.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050289
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  • 10
    Electronic Resource
    Electronic Resource
    The quadriceps tendon cyst: an uncommon cause of chronic anterior knee pain (1999)
    Springer
    Knee surgery, sports traumatology, arthroscopy 7 (1999), S. 349-351 
    Details
    ISSN: 1433-7347
    Keywords: Key words Knee pain ; Quadriceps tendon ; Chronic anterior pain ; Ganglionic cyst
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract The causes of knee pain are manifold. One of the uncommon causes of chronic anterior knee pain are cysts and ganglia. Magnetic resonance imaging not only reveals the intra-articular pathology but also accurately depicts such cystic structures about the knee. As part of this case report, a cyst of the lateral border of the quadriceps tendon is presented as a cause of such discomfort. Although cystic lesions around the knee are a common clinical problem, the described location is rare. After surgical revision of the lateral border of the quadriceps tendon and excision of the cyst, the patient was found to be asymptomatic.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001670050178
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