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Biomedical subjects

A Zauner-Dungl

Publications and source records attributed to A Zauner-Dungl.

10 recordsLinked to original sources
PubMed2001

Short segment stimulation of the anterior transposed ulnar nerve at the elbow.

OBJECTIVE: To determine whether short segment stimulation after anterior subcutaneous transposition of the ulnar nerve reaches normal values and correlates with postoperative clinical findings. DESIGN: Comparative cross-sectional study. SETTING: Outpatient clinic of a university department of physical medicine and rehabilitation. PATIENTS: Nineteen patients (15 men, 4 women) with 21 surgically treated ulnar neuropathies at the elbow; and 19 healthy controls (11 men, 8 women) with 24 measured nerves. INTERVENTIONS: Assessed motor function of ulnar innervated muscles and staged into 4 categories; used questionnaire to assess clinical course of the nerve lesion and graded into 5 categories; took electrophysiologic recordings to measure motor conduction velocity and compound muscle action potentials; and studied short segment stimulation across elbow and lower arm. MAIN OUTCOME MEASURES: Mean +/- standard deviation of ulnar short segment conduction time across the elbow, amplitude and motor conduction velocity; grading of ulnar nerve lesions; grading of the course of disease after surgery; and logistic regression and correlation (Spearman's correlation coefficient) for electrophysiologic and clinical parameters. RESULTS: Sixteen nerves showed focal conduction slowing in patients. No significant correlation between the course of disease and electrophysiologic parameters was seen. For stepwise logistic regression, there was a significant effect between grade of nerve lesion and amplitude, but no significant effect between the course of disease and electrophysiologic parameters. CONCLUSION: A focal conduction slowing across the elbow after anterior subcutaneous transposition does not correlate with postoperative clinical findings.

Adolescent↗
PubMed1998

Sliding door technique for the repair of midline incisional hernias.

We describe a technique that enables the autologous repair of large midline incisional hernias by restoring the functional musculoaponeurotic support of the abdominal wall. Unlike other methods of hernia repair, the essential step of the sliding door technique is the complete release of the rectus abdominis muscles from the anterior and posterior layers of their sheaths. The released muscles are thus overlapped and sutured together without tension. Another step of the technique is the release of both rectus sheaths by incising the aponeuroses of the external oblique muscles. We report on the use of this technique in 10 patients with midline incisional hernias (mean size of the abdominal musculofascial defect 14 x 11 cm). The patients were examined 14 months to 5.5 years after hernia repair. Two postoperative complications occurred: one marginal skin necrosis and one subcutaneous seroma. Recurrences were not observed. Ultrasound examination showed that the rectus muscles maintained their overlapped position postoperatively. Clinical muscle testing indicated that the strength of the released rectus muscles provides functional support to the reconstructed anterior abdominal wall.

Abdominal Muscles↗
PubMed1998

[Cold and cryotherapy. A review of the literature on general principles and practical applications].

Cryotherapy increases the threshold of pain and induces physiological changes. It influences hemodynamics (reduction of skin- and muscle temperature through vasoconstriction), metabolism (reduction of ischemia due to hypoxia), and neural control (reduction of nerve conduction velocity and muscle tone). Cryotherapy is indicated mainly in locomotor system related pain. Such pain can be induced by degenerative changes, postoperatively, and during mobilisation of contracted joints. Cryotherapy may be used as short term therapy (less than 15 min) as well as long term therapy (more than 20 min). For maximal efficacy the intensity of application as well as the application medium must be considered. Due to biorhythm, cold application seems to be more effective in the afternoon.

Circadian Rhythm↗
PubMed1995

Donor-site morbidity of the gracilis flap.

To determine whether there is a specific donor-site morbidity inherent in the elevation of the gracilis flap, we retrospectively examined 42 patients who underwent elevation of their gracilis muscles. We found, on dynamometric measurement, that the adduction strength of the hip joint was decreased by 11 percent when the gracilis muscle was elevated. This decrease in strength was not noticed by the patients. We also found an area of hypesthesia corresponding to the cutaneous territory of the obturator nerve in 40.5 percent of the patients. In addition, many patients were dissatisfied with the aesthetic appearance of the donor site, and a contour deformity of the thigh was present when a myocutaneous flap was elevated. Therefore, we conclude that the gracilis flap has a low but definite rate of donor-site morbidity. The advantages of the flap outweigh by far, however, the sequelae at the donor site.

Adult↗
PubMed1995

Quantification of functional deficits associated with rectus abdominis muscle flaps.

To evaluate the deficits in trunk flexion due to partial or complete unilateral rectus abdominis muscle flap transfer in reconstructive surgery, 27 patients (11 females, 16 males) with rectus abdominis muscle flap transfer dating back at least 3 years, clinically healthy at the time of testing, and 22 controls (10 females and 12 males), comparable in age and body mass index, were compared. For clinical assessment of power of the straight and oblique abdominal muscles, Janda's test of muscle function was used, and torque (in N.m) of isometric trunk flexion at 0, 5, 10, 20, and 30 degrees was determined with the TEF Modular Component, an auxiliary unit of the Cybex 6000. Results were analyzed for males and females separately. Relative torque (N.m/kg) of operated male and female patients was significantly lower (p < 0.05) as compared with controls. Differences were more pronounced in males than in females. Clinically, there were no significant between-group differences in the power of the straight and oblique abdominal muscles. In conclusion, trunk flexion deficits following rectus abdominis muscle flap transfer can be compensated for satisfactorily in most cases, supporting the use of this muscle in reconstructive surgery, if patients are selected carefully.

Abdominal Muscles↗
PubMed1995

[Functional deficits following transfer of rectus abdominis muscle].

Functional deficits after raising of a rectus abdominis muscle flap in reconstructive surgery were evaluated retrospectively in 27 patients (11 female, 16 male) and compared to 22 healthy control individuals. To test the torque of trunk flexion, the Cybex 6000 (TEF modular component) was used and subjects tested in a defined position allowing isolated sagittal flexion. For the rectus and oblique abdominal muscles, the Janda muscle function test was applied. For comparison of patients and controls, the Man and Whitney test was applied, and subgroup analyses were performed for men and women, respectively. The peak torque (relative to bodyweight) was significantly lower in patients as compared to controls, the differences being greater in men than in women, whereas clinical examination did not reveal a significant difference between either group. After autologous transplantation of the rectus abdominis muscle flap, compensation is obviously restricted to a certain degree, although the remaining deficit does not seem to represent a handicap in normal life. Thus the use of rectus abdominis muscle flaps in reconstructive surgery may be beneficial for the patient, provided the indication is precise and long-term control is possible.

Adult↗
PubMed1994

[Physical therapy of idiopathic spinal disorders].

In Physical Medicine and Rehabilitation structural and functional disorders in the genesis of back pain are of great importance. From an epidemiological point of view this has great consequences. Active and passive forms of physical therapy are available. Assuming that the intradiscal pressure has an influence on the origin of back pain, the aim of physiotherapy has to be that any movement of the vertebral column has to be controlled with a minimum of muscular contraction. Passive forms of physical therapy like heat and cold, electrotherapy or mechanotherapy have a reflective reaction beside a physical effect. Sometimes a combination of active and passive forms are of benefit. Every treatment concept has to pay regard to the actuality of pain, the load of every day life and the physical and social situation of the patient. Last but not least one has to learn to cope with the pain.

Biofeedback, Psychology↗
PubMed1994

[Functional follow-up of combined musculocutaneous tensor fasciae latae and rectus femoris flap repair. Supplementary information on the Handchir. Mikrochir. Plast. Chir. 21 (1989) 315-317 contribution].

As a supplement to our publication in the Journal Handchirurgie, Mikrochirurgie, Plastische Chirurgie 21 (1989) 315-317, we would like to report a five-year follow up of a patient with recurrent sigmoid carcinoma, infiltrating all layers of the abdominal wall. Treatment was by radical tumor excision and reconstruction with a combined tensor fasciae latae and rectus femoris flap. Abdominal wall, hip, and knee functions were evaluated by gait-analysis (Motion Analysis Corporation AMTI) and dynamometry (Cybex 6000). The dynamometry of knee motion showed a slight deficit of the operated side regarding the parameters of strength-endurance as well as work-recovery. All other parameters (peak-torque) were equal for both sides corresponding to the activities of daily living of the patient. Gait-analysis showed a reduced rotation of the pelvis as well as a functional deficit of extension of the knee during stance and swing phase. We can document a good functional result in all motions without major impairment of every-day activities.

Abdominal Muscles↗
PubMed1990

[Evaluation of shoulder function after removal of the latissimus dorsi muscle for surgical flap].

The latissimus dorsi muscle is frequently used in reconstructive surgery. The present study was undertaken to determine the post-operative function of the shoulder girdle with respect to dominance in 26 patients following latissimus dorsi flap transplantation mainly for soft tissue coverage in the lower leg. The patients were interviewed and examined, with special attention being paid to shoulder mobility, dexterity and muscular strength. On interview, a considerable majority felt that very good results had been achieved. Raising the latissimus dorsi flap did however influence shoulder retroversion, particularly when surgery was performed on the non-dominant side. The influence of dominance was further noted as regards inward rotation of the shoulder and the ability to lead the hand backward over the shoulder. Dexterity was determined by a modified tapping test in the sagittal plane. Other than a minor correlation with age, post-operative function depended on whether the latissimus dorsi flap had been raised from the dominant or non-dominant shoulder. No effect of operation or dominance was observed in terms of isometric muscular strength, measured with an electronic device (Hottinger-Baldwin-Messtechnik). We believe that the function of the latissimus dorsi muscle can be compensated for by synergistic muscles. Yet, in rehabilitation, particular attention must be paid to the function of the non-dominant shoulder since it is used less in daily activity.

Adolescent↗