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Biomedical subjects

A Kröpfl

Publications and source records attributed to A Kröpfl.

At least 19 recordsLinked to original sources
PubMed1999

Intramedullary pressure and bone marrow fat extravasation in reamed and unreamed femoral nailing.

This study was designed to investigate whether intramedullary pressure and embolization of bone marrow fat are different in unreamed compared with conventional reamed femoral nailing in vivo. In a baboon model, the femoral shaft was stabilized with interlocking nailing after a midshaft osteotomy. Intramedullary pressure was measured in the distal femoral shaft fragment at the supracondylar region. Extravasation of bone marrow fat was determined by the modified Gurd test (range: 0-5) with blood samples from the vena cava inferior. Data were monitored in eight unreamed and eight reamed intramedullary femoral nailing procedures. Intramedullary pressure increased in the unreamed group to 76 +/- 25 mm Hg (10.1 +/- 3.3 kPa) during insertion of 7-mm nails and in the reamed group to 879 +/- 44 mm Hg (117.2 +/- 5.9 kPa) during reaming of the medullary cavity. Insertion of 9-mm nails after the medullary cavity had been reamed to 10 mm produced an intramedullary pressure of 254 +/- 94 mm Hg (33.9 +/- 12.5 kPa) (p < 0.05). Fat extravasation in the unreamed group was recorded with a score of 2.9 +/- 0.4 for the Gurd test during nailing with 7-mm nails, whereas in the reamed group significantly more fat extravasation was noticed during the reaming procedures, with a score of 4.6 +/- 0.1. Liberation of fat during insertion of 9-mm nails after reaming was recorded with a score of 3.5 +/- 0.4. In both groups, a positive correlation of fat extravasation with the rise in intramedullary pressure was found (reamed group: r(s) = 0.868; unreamed group: r(s) = 0.698), resulting in significantly less liberation of bone marrow fat in the unreamed stabilized group than in the reamed control group (p < 0.05). The data indicate that fat embolization during nailing procedures after femoral osteotomy increases with increasing intramedullary pressure and occurs in a lesser degree in unreamed than in reamed intramedullary femoral shaft stabilization.

Animals↗
PubMed1997

Intramedullary pressure and bone marrow fat intravasation in unreamed femoral nailing.

OBJECTIVE: To investigate whether intramedullary pressure and bone marrow fat embolization are different in unreamed compared with conventional reamed femoral nailing. The null hypothesis is that there is no difference between the two techniques. DESIGN: A prospective consecutive nonrandomized clinical trial. METHODS: Intramedullary pressure was measured in the distal femoral fracture fragment at the supracondylar region. Bone marrow fat intravasation was measured by means of the modified Gurd-test. Monitoring was carried out in 31 unreamed and eight reamed intramedullary femoral nailing procedures. RESULTS: Intramedullary pressure increased in the unreamed group to 82 +/- 11 mm Hg during the insertion of 9-mm and 10-mm nails and in the reamed group to 396 +/- 85 mm Hg during reaming of the medullary cavity. Insertion of nails after reaming led to an increase in intramedullary pressure of 79 +/- 13 mm Hg. A positive correlation between fat intravasation and intramedullary pressure was found in each group (rs = 0.73), resulting in less liberation of bone marrow fat in the unreamed group than in the reamed group. CONCLUSIONS: Intramedullary pressure increased significantly in the reamed more than in the unreamed group. Bone marrow fat intravasation depended on the rise in intramedullary pressure, and occurred less frequently in unreamed than in reamed intramedullary femoral fracture stabilization.

Adolescent↗
PubMed1996

[Technique, results and risks of endoscopic carpal tunnel release].

Endoscopic carpal tunnel release was performed in 168 cases of carpal tunnel syndrome using the two-portal technique described by Chow. There were 164 cases of idiopathic carpal tunnel syndrome and four cases following a wrist trauma. Sensory symptoms improved within few days in 113 patients (67%) and in 141 cases within eight weeks (84%). Nighttime pain relief was achieved immediately in 87% of the patients and in 94% within eight weeks. Grip strength increased to preoperative values within eight weeks and pinch strength reached preoperative levels within six weeks. In four cases an iatrogenic injury of the superficial palmar vascular arch occurred. In another four patients, open revisional surgery had to be performed. Three of these patients presented an incomplete release of the retinaculum flexorum and in one patient a remaining part of the palmar fascia led to further compression of the median nerve despite complete dissection of the carpal ligament.

Adult↗
PubMed1995

Unreamed intramedullary nailing of femoral fractures.

Seventy-five patients with 81 femoral shaft fractures were treated with unreamed antegrade intramedullary nailing using a titanium alloy implant (AIM femoral nail, ACE Medical) with static interlocking. There were 73 closed fractures and 8 open fractures. Six patients had bilateral femoral shaft fractures. In two cases there was an ipsilateral fracture of the femoral neck, two patients had an ipsilateral intertrochanteric fracture, in one case there was a concomitant subtrochanteric fracture, and four patients had sustained an ipsilateral fracture of the acetabulum in addition to their femoral shaft fractures. In 43 cases (53%) the fracture of the femoral shaft was a comminuted type fracture. Thirty-nine patients (52%) had suffered multiple injuries; the mean Injury Severity Score was 41.2. Sixty-nine fractures were stabilized primarily within 8 hours after admission and 12 fractures were treated secondarily, in a mean of 5.8 days after injury. Closed intramedullary nailing was performed in 73 femora and open nailing with cerclage wiring was done in 8. All 81 nails were implanted unreamed and static was used in every case. The diameters of the nails used were 9 mm (n = 68) and 10 mm (n = 13). Proximal interlocking was distally directed in 76 cases and proximally directed in 5 cases. Two patients died of severe head injuries and one patient died of multiple organ failure. The infection rate was 0%, and uneventful consolidation of the fractures was seen in all cases within a mean of 3.8 months. Neither in the case of nails nor in the case of interlocking bolts did an implant failure occur.

Adolescent↗
PubMed1995

[Donor site morbidity following radial forearm flap].

The results concerning morbidity of the fasciocutaneous radial forearm flap donor site of 20 patients are presented. The review was carried out with an average time of 4.4 years after raising the flaps, ranging from ten months to eleven years. Range of motion of the wrist joint was limited in extension in two patients with 15 degrees and in one patient with 30 degrees. Pinch and grip strength was found normal in 13 patients and was limited in five cases to 88% of the strength of the opposite limb. Dysesthetic areas were found in three patients on the radial border of the donor site and reduced sensation of the radial nerve was present in four patients.

Adolescent↗
PubMed1994

[Epiphyseal growth after replantation in childhood].

Long-term results in 17 patients with 19 replanted parts of the upper extremity after replantation during childhood are presented. Regarding longitudinal epiphyseal growth, three patients had normal growth. In 15 cases, average length of the replanted digits attained 88.6% of normal and one patient gained overgrowth of 118% of normal. In every case, consolidation of the fracture was seen. Four patients developed a deviation of the replanted finger in the frontal plane. The cause of deviation in every case was incorrect primary reposition and not a disturbance of growth of the replanted epiphysis.

Adolescent↗
PubMed1991

[Value of plate osteosynthesis in treatment of radius fractures at a typical site].

In the past, distal radius fractures tended to be treated conservatively. Recently, however, unsatisfactory anatomical and functional results have led to an increase in their surgical treatment. Our preferred method of treatment has been percutaneous pin fixation after closed reduction. In our opinion, open reduction and internal fixation with an A0-plate is indicated for Smith fractures (B3 A0-classification), and for any fractures which cannot be ideally reduced (usually C1 to C3 fractures). From 1972 until 1989, 84 patients with distal radius fractures underwent surgical treatment in the Unfallkrankenhaus Salzburg. The procedure was usually performed under brachial plexus or Bier block, and we preferred a palmarly positioned plate for internal fixation. Follow-up of 42 patients showed good results, the functional and subjective results earning higher marks than the X-ray findings.

Adult↗
PubMed1989

[Malunion and growth disorders following fractures of the condylus radialis humeri in children].

Basing on the results of 46 fractures of the lateral humeral condyle in children possible mal-unions and disturbances of growth after conservative and operative treatment are shown. Varus-tendency of the elbow axis was observated in 23% after conservative treatment of undisplaced fractures and in 37.5% after open reduction and Kirschner wiring of displaced fractures. Fish-tail deformity was seen both after conservative treatment and fixation with Kirschner wires; only open reduction and osteosynthesis with small-fragment screws could avoid this two disturbances of growth. One non-union was seen after conservative treatment.

Adolescent↗
PubMed1989

[Surgical treatment of forearm shaft fracture].

Between 1977 and 1987 at trauma hospital in Salzburg 142 patients with shaft fractures in the middle third of forearm have been treated by open reduction (altogether 730 forearm fractures in the same period). Among other things post surgical complications are examined. Functional results and reported troubles of patients are demonstrated by 66 cases which have been reviewed.

Adolescent↗
PubMed1989

[Comparative study of arthroscopic and open meniscus surgery].

In this paper we compared two groups of 80 patients each with meniscal tears. One group was treated by Arthrotomie and partial meniscectomie and the other group by an arthroscopic procedure also with partial meniscectomie. All patients were seen at a follow up between six and 18 months postoperatively. According to the Gaudernak scale we found in both groups 98% of very good and good results. The duration of hospitalisation and sickleave was reduced by 50% after the arthroscopic operation, which showed a significant difference.

Adult↗
PubMed1989

[A rare combination injury in Alpine skiing].

This is a report on the incidence of associated osseos lesions in Achilles tendon ruptures. From 1967 to 1984 630 patients underwent treatment for closed Achilles tendon ruptures. In 49 cases (7.7%) associated osseos injuries were discovered. In 42 cases (6.6%) fractures of the malleolus medialis were found. Two patients with a rare combination (primarily treatment of osseos lesions, with delayed diagnosis of tendon rupture) deserve special attention. Concerning fractures of the lower leg with associated tendon rupture. Chronology and pattern of the injury are analyzed.

Achilles Tendon↗
PubMed1965

[Chylothorax].

Explore the source record for details and available documents.

Chylothorax↗
PubMedDate not supplied

[The diagnostic value of double contrast CT in shoulder dislocation].

The article reports of the indication, technique and results of the shoulder joint double-contrast-computertomography. It discuss its diagnostic value in comparison to other examining methods. As alternative preoperative diagnostic procedures only arthroscopy, arthrography and MRI can be considered. Also discussed are the therapeutic consequences resulting from the nature of the pathological lesions (rupture of the limbus glenoidalis, Hill-Sachs-defect, reversed Hill-Sachs-defect). Especially for the first traumatic dislocations of the shoulder joint, we consider this investigational method an eminent enlargement of the diagnostic spectrum. Therefore, we are generous with its indication, attempting to prevent reluxations by primary diagnostic and therapeutic procedure.

Adult↗