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Biomedical subjects

A Rüter

Publications and source records attributed to A Rüter.

At least 73 records · Page 4Linked to original sources
PubMed1993

The role of corticotomy and osteotomy in the treatment of bone defects using the Ilizarov technique.

Posttraumatic bone defects are usually bridged using autogenous or exogenous cancellous bone grafts. These grafts consolidate to form a solid bone structure that is mechanically stiffer than natural bone. Likewise, the procedure of corticotomy and distraction is appropriate for treatment of bone defects. In our experiment, a 2-cm bone defect was created in 25 sheep tibiae. We performed corticotomy or osteotomy of the intact bone, thus creating a bone segment that was drawn across the defect using a specially designed traction device. The limb was stabilized using an external fixator. Four groups were formed for comparison: corticotomy and osteotomy with distraction at a rate of 1 mm/day; corticotomy and osteotomy with immediate transportation of the segment to the docking site. The animals were killed after 4, 8, 12, 16 and 52 weeks. Evaluation of the results was based on standard radiographs. In the two groups involving gradual transportation, spontaneous bone regeneration occurred in all cases whereby after corticotomy the new bone was tubular (around the medulla). Following osteotomy, bone regeneration occurred initially on the dorsal and lateral sides of the tibia leaving a defect on the ventral and medial sides. This defect subsequently closed. At the end of segment transportation, healing was observed at the docking site. In Groups 3 and 4, the bone did not regenerate at all. Therefore, this procedure, immediate transportation, was not investigated further because no clinical success could be expected from its application.

Animals↗
PubMed1993

Indications and results of nonoperative treatment of patellar fractures.

It is uncontested that most patellar fractures have to be treated by open reduction and internal fixation. Nevertheless, there are well-defined types of patellar fractures in which such a procedure is unnecessary because the fracture is stable and the retropatellar surface is congruous. In these fractures internal fixation would constitute overtreatment; conservative treatment yields good results in such cases. In this report, 40 patellar fractures treated conservatively were reviewed (average, 30.5 months after injury). Results were assessed subjectively and objectively. Of the 40 patients, 80% were pain free and 90% had a full range of knee motion.

Adult↗
PubMed1992

[Distal intra-articular humerus fractures in adults. Results of surgical treatment].

Intra-articular fractures of the distal end of the humerus are severe injuries because stable anatomic reduction is difficult to achieve even operatively. They are often accompanied by nerve lesions and often lead to heterotopic para-articular ossifications. Functional recovery is only rarely complete. Follow-up of 54 cases of operatively treated fractures of this kind showed 56% excellent and good late results. In immediate operations we observed fewer infections, less ossification, and better functional results than after delayed operative treatment. We therefore recommend careful examination for nervous deficits, immediate stable internal fixation of the fractures displaying the ulnar nerve, and handling the soft tissue as gently as possible to avoid additional damage. Postoperative physiotherapy should also be started immediately.

Elbow Joint↗
PubMed1991

[Plate osteosynthesis in the treatment of open femoral shaft fractures. Course in 65 cases].

In this study the results of 65 open femoral shaft fractures treated by plating are reported. The follow up of these cases proved that the osteosynthesis by plate is the treatment of choice in most of open femoral shaft fractures. The overall rate of postoperative complications was 23%. There were 5 deep infections concerning third-grade open fractures in two patients. In 10 cases a second operation was necessary because of delayed union; in 8 of these 10 fractures a homologous cancellous bone graft was performed during the first operation. Regarding to these complications an autologous bone transplantation should be carried out after primary plating of open femoral shaft fractures in order to improve vascularity and stability of the fracture. To reduce the unsatisfying rate of infections in III.-grade open fractures the treatment by external pin fixation in these cases should be preferred.

Adolescent↗
PubMed1991

[Modification of the Ilizarov technique].

New bone has been known to form with callus distraction for a long time, yet its first therapeutical application was by Ilizarov. For the stepwise distraction of an osteotomy gap, various systems of fixation and transportation have been developed. The Augsburg and Basel systems, basing on the tubular AO external fixator, require only limited supplementing of implants. The most elegant and "physiological" way is certainly continuous callus distraction using an internal electrical motor, as the Munich intramedullary nail. In the long run, all systems will probably be changed to allow continuous distraction.

Bone Lengthening↗
PubMed1991

[Conservative therapy of fractures of the thoracic and lumbar spine. Indications, treatment regimen, results].

In this study the results of conservatively treated stable fractures of the thoracolumbar spine in 112 cases are reported. The follow-up of these patients was carried out by clinical and radiological examinations. It proved that functional treatment used in 94% of all cases was superior in its results and lack of pain to Böhler the method according of closed correction and immobilization by cast. The radiological examination showed no coherence between narrowing of the verebra after early mobilization and function of the spine. A three point corset in addition to this therapy seems to be without any advantage.

Adult↗
PubMed1991

[Femoral head preserving therapy in medial femoral neck fractures. A clinical study of the effects of treatment method on the outcome].

The main problem with fractures of the femoral neck is the high incidence of avascular necrosis and non-union. While the rate of pseudarthroses has been lowered by treatment with stable compression screws, no effect of this technique on the incidence of head necrosis is evident. The reasons for this are rupture of vessels, wide dislocation of fragments and diminution of blood supply owing to intracapsular hematoma. Since 1982 we have been using a defined indications and therapy schedule for these fractures, which is based on the main principle of open operative treatment in younger patients. This procedure is the only one that makes accurate reduction and stable internal fixation of fragments possible. With the opening of the capsule and evacuation of the hematoma pressure on the blood vessels is relieved. The analysis of data recorded in 81 patients treated with open reduction and stable internal fixation revealed that poor functional results and avascular necrosis occur especially in fractures of Garden's stages III and IV that are operated on longer than 6 h after the trauma is sustained. Therefore, the operation should be performed as soon as possible as an emergency procedure to reduce the likelihood of such severe complications.

Femoral Neck Fractures↗
PubMed1989

[Method of treating femur head dislocation fractures].

The fracture and dislocation of the head of the femur is still an uncommon accident, however, involving many complications. To avoid secondary damage a closed reduction should be obtained as soon as possible and with great care. Osteosynthesis of the femur head fragments is desireable for congruency of the joint surfaces and to prevent post traumatic arthrosis. Only this treatment allows for functional physical therapy. Type 3 fractures in patients over 65 and also multiple fractures of the femur head should be treated with a prosthesis implant. In young people primary reconstruction of the joint should be attempted in every case.

Adult↗
PubMed1986

[Collection of autologous bone transplants].

For the collection of autologous cancellous bone transplants normally the anterior and posterior parts of the Os ilium are used. With proper techniques the conture of the pelvis and the muscle insertions can be conserved. All other collection places should only be used in unexpected situations and need of only small amounts of transplant. Serious complications are fractures and nervous lesions, which can be avoided by a careful procedure.

Bone Transplantation↗
PubMed1984

Differentiation of granulocytes in Pappenheim stained blood cell smears using standardized cytophotometric analysis.

The well-known problems of the low reproducibility of peripheral blood smear analysis have for some time stimulated endeavours to automate blood cell classification. In the cytophotometric standardized color measurement and analysis, the computed color characteristics for the first time refer to an internationally accepted color system, allowing not only an international comparison of the computer color measurements but an unproblematic mutual interchange of color information between man and machine based on both the human visual color impressions and the conventional morphological color attributes of the white blood cells. The discriminatory power of the method is demonstrated by differentiating the cytoplasm granulations in basophil, eosinophil and neutrophil granulocytes.

Color↗
PubMed1984

Evaluation of preoperative diagnosis and surgical management of thyroid tumors.

The difficulty of obtaining an accurate diagnosis in nodules of the thyroid gland without operation and histologic examination is well documented. Surgical intervention has therefore been recommended, though opinions differ concerning the indications for surgery. Experience from 276 patients operated on for thyroid gland nodules is reported in the present paper. The decision to operate was based on a standard schedule with relatively wide indications for surgery. Complete hemithyroidectomy was performed in all surgically managed cases. The accuracy of preoperative diagnosis was evaluated against the histologic findings. Experience of hemithyroidectomy as the standard procedure is also reviewed. The incidence of malignancy with this active policy was 9% in the series as a whole and 12% in solitary adenoma of the thyroid. Total thyroidectomy was routinely performed when malignancy was demonstrated; 24% of the malignancies were bilateral. Although fine-needle biopsy and clinical evaluation were entrusted only to experienced investigators, the results confirmed earlier reports that no hitherto available diagnostic procedure can adequately distinguish malignant from benign thyroid lesions without surgery. The value of scintigraphic thyroid scan in the preoperative assessment seemed to be insufficient to warrant its use. No persistent complications arose from hemithyroidectomy. Complete hemithyroidectomy is always the operation of choice in such cases since, should be histologic examination show malignancy, the requisite additional surgery will not involve a thyroid lobe with previous surgical interference.

Adult↗
PubMed1983

[Colorimetric and cytophotometric study of a modified Papanicolaou staining method in cervical cells].

The staining patterns of a modified Papanicolaou staining method and of its components are compared with those from the common Papanicolaou method. The staining results are investigated by the CIE-DIN-standardized color analysis. The medical investigator is able to discriminate more colors than this cytophotometric method, but this method is superior in the exact determination of colors. For neither of the both Papanicolaou staining methods it is possible to indicate one or two wavelengths for cytophotometric measurement using narrow-band filters which allows an optimal automated separation of nuclei, cytoplasms and background of all cell types. Keeping to this usual color analyzing method there is a better evaluation of the common Papanicolaou staining patterns. More saturated colors in the cyanophilic cytoplasms with the Papanicolaou staining patterns and in the eosinophilic cytoplasms with the investigated modified Papanicolaou staining patterns would be desirable. Since the resulting color patterns are similar from both stains, the modified Papanicolaou method has to prefer if it proves to be more reproducible.

Cell Nucleus↗