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Biomedical subjects

A Klonz

Publications and source records attributed to A Klonz.

13 recordsLinked to original sources
PubMed2006

[Fracture of the distal radius].

Distal fracture of the radius is an injury to a complex joint that is comprised functionally of four partial joints and makes it possible for the hand to move in all directions. The injuries to bone and cartilage and to the stabilizing ligamentous structures and the surrounding soft tissue vary as functions of the impact responsible the mechanism of injury, and any previous illnesses. The objectives of treatment are restoration of pain-free, unrestricted and lasting function of the wrist and lower arm and avoidance of the typical complications. Stable fractures are treated by conservative means, while unstable fractures with fragmentation are realigned in a closed procedure and then stabilized by internal or external fixation. In the case of fractures in bones affected by osteoporosis it is usually not necessary to make good a metaphyseal defect when specially adapted fixed-angel plates are used. Complex intraarticular AO type C3 fractures with multiple fragments frequently require a two-step procedure with primary closed realignment, an external fixator spanning the joint, and subsequent extensive diagnostic examinations to ascertain any concomitant injuries and allow a decision on the definitive treatment that is most suitable for the type of injury present.

Adolescent↗
PubMed2005

[Fracture of the distal radius].

Distal fracture of the radius is an injury to a complex joint that is comprised functionally of four partial joints and makes it possible for the hand to move in all directions. The injuries to bone and cartilage and to the stabilizing ligamentous structures and the surrounding soft tissue vary as functions of the impact responsible, the mechanism of injury, and any previous illnesses. The objectives of treatment are restoration of pain-free, unrestricted and lasting function of the wrist and lower arm and avoidance of the typical complications. Stable fractures are treated by conservative means, while unstable fractures with fragmentation are realigned in a closed procedure and then stabilized by internal or external fixation. In the case of fractures in bones affected by osteoporosis it is usually not necessary to make good a metaphyseal defect when specially adapted fixed-angle plates are used. Complex intraarticular AO type C3 fractures with multiple fragments frequently require a two-step procedure with primary closed realignment, an external fixator spanning the joint, and subsequent extensive diagnostic examinations to ascertain any concomitant injuries and allow a decision on the definitive treatment that is most suitable for the type of injury present.

Fracture Fixation↗
PubMed2005

[The acromioclavicular joint].

Acute or chronic instability and osteoarthritis of the acromioclavicular (ac) joint may cause significant impairment of the shoulder. In this continuing education report, the pathomorphology of acute ac dislocations is described based on the Rockwood classification. Decision making on conservative or surgical treatment is discussed. Surgical techniques are presented as acromioclavicular or coracoclavicular procedures. Persistent complaints may warrant additional surgical therapy after conservative treatment as well as after primary surgical treatment. In these cases, residual instability must be addressed. A modified Weaver-Dunn procedure is presented in detail. In any patient with shoulder pain, osteoarthritis of the ac joint has to be taken into consideration. Resection of the lateral clavicle has proved to be effective in these patients.

Acromioclavicular Joint↗
PubMed2003

[Results after palmar plate-osteosynthesis with angularly stable T-plate in 100 distal radius fractures: a prospective study].

In a prospective study a total of 124 unstable fractures of the distal radius were treated with a fixed angle palmar T-plate (Synthes Ltd., Switzerland). A total of 100 distal radius fractures were evaluated radiologically and clinically after a mean of 10 months after surgery. Loss of correction between postoperative and follow-up radiographs was assessed. The mean loss of the initial volar tilt was 3+/-4 degrees, the loss of radial inclination 0.4+/-2 degrees. The radial shortening was 1+/-1 mm. Flexion and extension of the injured wrist had recovered to an average of 81% of the normal, contralateral side. Radial and ulnar deviation were limited to 84%, pronation and supination reached 91%. Mass grip strength recovered to an average of 74% of the normal side. Using the functional outcome score according to Sarmiento,we obtained 15% excellent,56% good, 28% fair and 1% poor results. The complication rate was 10%. In conclusion, the operative treatment of unstable extra- and intraarticular fractures of the distal radius by fixed angle T-plateosteosynthesis shows good radiological and functional results.

Adult↗
PubMed2003

[Proximal and distal ruptures of the biceps brachii tendon].

Proximal ruptures. Ruptures of the long head of the M. biceps humeri are commonly caused by degenerative changes within the tendon. Non-operative treatment gives good results, the loss of power regarding elbow flexion and supination amounts to only 8-21%. Refixation may be indicated for cosmetic reasons and offers a small but evident improvement of flexion and supination power. Deformity of the slipped muscle can be corrected effectively. Residual complaints after conservative treatment often result from associated subacromial problems. Distal ruptures. Ruptures of the distal tendon should be treated operatively. The loss of power after conservative treatment is evident (30-40% for flexion, >50% for supination). Extra-anatomical tenodesis to the brachialis muscle or anatomical fixation to the radial tuberosity can be applied. Flexion power and cosmesis can be addressed by both techniques. If supination strength is to be restored, the tendon has to be fixed anatomically. Preparation of the tuberosity bears the risk of heterotopic ossification or nerve damage. Mini-open techniques, using only a limited anterior approach, may decrease risks.

Adult↗
PubMed2002

[Technique of distal biceps tendon repair using a limited anterior approach].

From May 1999 to November 2001 an anatomical attachment of a ruptured distal biceps tendon to the radial tuberosity was performed through a limited anterior approach in 8 male patients with an age of 37 to 47 years. Through a small incision in the cubital fossa (3-4 cm) the remaining synovial sheet of the biceps tendon was followed to insert absorbable anchor hooks into the radial tuberosity. The distal biceps tendon then was anatomically reattached. Instruments for arthroscopic Bankart-repair were used. There were no specific complications like neurovascular damage or significant functional impairment. The contour of the biceps muscle was restored in all cases. 3 out of 7 patients developed mild heterotopic ossifications without functional deficits. In our experience the presented technique is a possible minimal invasive procedure of distal biceps tendon repair without major complications and with good functional results.

Accidents, Occupational↗
PubMed2000

[Biceps tendon: diagnosis, therapy and results after proximal and distal rupture].

Ruptures of the long head of the M. biceps humeri are commonly caused by degenerative changes within the tendon. They are associated with pathologies of the subacromial space. The loss of power regarding elbow flexion and supination amounts to 8 to 21% after conservative treatment. Refixation offers a small but evident improvement of flexion and supination power. Especially endurance is improved. The number of cases with remaining light or marked weakness is reduced by more than 50%. Deformity by the slipped muscle can be corrected effectively. Function of the glenohumeral joint can only be improved if associated subacromial problems are identified and treated simultaneously. As complications are uncommon surgery should be recommended to young and active patients and should at least be offered to less active patients. Ruptures of the distal tendon are less common. Thirteen patients were re-examined after operative repair for distal biceps tendon avulsion and 277 reported cases were reviewed. After conservative management (n = 20) the power of flexion will remain reduced by 30%-40%, that of supination by more than 50%. The loss of flexion power, as well as the deformity can be diminished by attachment of the distal biceps to the brachialis muscle (n = 22). The anatomic re-insertion (n = 248) additionally reduces the loss of supination power to 0%-25%, but bears a higher risk of complications. Using the 'double-incision technique' (n = 105 of 248) does not decrease the risk of naval lesions but increases the incidence of radioulnar synostosis. The use of suture anchors provides a nice way of fixation of the tendon but does not facilitate the approach to the tuberosity. The distal biceps tendon rupture should be treated operatively. The adequate method of repair is to be determined individually.

Arm Injuries↗
PubMed1998

[Proximal and distal biceps tendon rupture--an indication for surgery?].

We reviewed 77 conservatively and 164 operatively treated cases of rupture of the long head of the biceps documented in the literature. Refixation offers a small but relatively constant improvement of flexion and supination power and thus reduces the number of cases with remaining light or marked weakness by one third. Deformity by the slipped muscle can be corrected effectively. As complications are uncommon surgery should be recommended to young and active patients and should at least be offered to less active patients. Thirteen patients were re-examined after operative repair for distal biceps tendon avulsion and 277 reported cases were reviewed. After conservative management (n = 20) the power of flexion remains reduced by 30%-40%, that of supination by more than 50%. The loss of flexion power, as well as the deformity can be nicely diminished by attachment of the distal biceps to the brachialis muscle (n = 22). There are no complications documented regarding this procedure. The anatomic reinsertion (n = 248) additionally reduces the loss of supination power to 0%-25%, but bears a higher risk of complications. The double-incision technique (n = 105 of 248) does not necessarily decrease this risk. There are as many nerve injuries reported as with the single-anterior approach. Additionally we are faced with the problem of radioulnar synostosis. The use of suture anchors provides a nice way of fixation of the tendon but does not facilitate the approach to the tuberosity. The distal biceps tendon rupture should be treated operatively. The adequate method of repair is to be determined individually.

Arm Injuries↗
PubMed1996

The marginal blood pool of the rat contains not only granulocytes, but also lymphocytes, NK-cells and monocytes: a second intravascular compartment, its cellular composition, adhesion molecule expression and interaction with the peripheral blood pool.

To leave the blood, leucocytes marginate to the vessel wall. Granulocytes thereby form the so-called marginal pool. It is unclear to what extent such a second intravascular compartment also exists for lymphocytes subsets, NK-cells and monocytes. Samples of the peripheral blood and the marginal pool of the LEW rat were analysed by flow cytometry. In the marginal pool the percentage of granulocytes and monocytes was significantly higher compared to that of the peripheral blood, and the proportion of 'naive' T and B lymphocytes was decreased. The expression of LFA-1 was higher on all leucocyte subsets of the marginal pool except the granulocytes, whereas no differences were seen for the expression of other adhesion molecules (alpha 4-integrins, ICAM-1, CD2, L-selectin, and CD44). In addition, splenectomy influenced the cellular composition of peripheral blood and marginal pool differently and, after injection of blood leucocytes, these cells were found in both compartments showing its characteristic cellular composition. Thus, not only granulocytes, but also B and T lymphocyte subsets, NK-cells and monocytes form a second distinct intravascular compartment. This marginal pool probably influences the cellular composition of leucocyte subsets available for entry into the tissues.

Animals↗