PubMed Health⌕ Search

Biomedical subjects

B Fromm

Publications and source records attributed to B Fromm.

36 records · Page 2Linked to original sources
PubMed1991

[Secondary arthrosis of the wrist joint in malposition of healed and uncorrected distal radius fracture].

The authors report on long-term results of thirty-five unreduced distal radius fractures with malunion. The mean observation period was 11.5 years (5 to 45 years). It was found malalignment of the carpal articular surface of the radius with a resulting decrease in range of motion of the wrist, well tolerated by the patients and apparently not very painful. Much more evident was pain and decreased motion in the distal radio-ulnar joint for pronation and supination, which paralleled the extent of osteoarthrosis of this joint. This reduced forearm rotation was due to shortening of the radius, leading to incongruency and even dislocation of the distal radio-ulnar joint.

Adult↗
PubMed1990

[Management of unstable pertrochanteric femoral fracture by alloarthroplastic joint replacement].

The treatment of trochanteric fractures of the femur should aim at the reconstruction of the joint function and should allow early weight bearing. In the case of unstable fractures and advanced osteoarthritis of the hip joint the advantages and risks of a total hip replacement have to be compared with different methods of osteosynthesis. We report on 35 patients with trochanteric fractures primarily treated with a total hip replacement. Their perioperative mortality was 9%, the most common complication was a luxation of the replaced hip joint in 3 cases. 1 patient had to be reoperated because of a soft tissue infection. Comparing the literature the primary total hip replacement shows a lower morbidity and mortality rate than complicated methods of osteosynthesis.

Activities of Daily Living↗
PubMed1989

A new operation for the prevention and treatment of amputation neuromas.

A stump neuroma is caused by the disorganised growth of axon cylinders into proliferating granulation tissue, but this is stopped by an undamaged epineural sleeve. We report experiments in the rat in which the epineural sleeve of the stump of the sciatic nerve was freed from nerve fascicles for about 5 mm and then sealed with a synthetic tissue adhesive. Neuroma formation was largely prevented in comparison with the results of other methods. This new technique has been used to treat 68 painful neuromas in 36 patients. All but three of the patients were cured or improved and none were made worse.

Amputation, Surgical↗
PubMed1988

[Pediatric traumatic hip joint dislocation--overview of the topic based on 9 personal, previously unpublished cases].

We report on 8 patients with 9 traumatic hip dislocations in childhood. The follow-up period was between 1 and 21 years. The majority of these rare injuries were caused by major, sometimes, however, by minor trauma. The best prognosis is given by an immediately performed closed reduction in the absence of bony injuries. Five of our patients had associated bony injuries (fractures of the femoral shaft, acetabular fractures). Two of our patients developed an avascular necrosis of the femoral head which needed further surgery; in one case we found a premature closure of the proximal femoral epiphyseal plate, a fourth patient developed premature osteoarthritis due to a concomitant acetabular fracture. Clinical and radiological examination of all other patients showed no residues of the former injury.

Acetabulum↗
PubMed1980

Computer-generated fiscal reports for food cost accounting.

To optimize resource utilization for the provision of health-care services, well designed food cost accounting systems should facilitate effective decision-making. Fiscal reports reflecting the financial status of an organization at a given time must be current and representative so that managers have adequate data for planning and controlling. The computer-assisted food cost accounting discussed in this article can be integrated with other sub-systems and operations management techniques to provide the information needed to make decisions regarding revenues and expenses. Management information systems must be routinely evaluated and updated to meet the current needs of administrators. Further improvements in the food cost accounting system will be desirable whenever substantial changes occur within the foodservice operation at the University of Missouri-Columbia Medical Center or when advancements in computer technology provide more efficient methods for manipulating data and generating reports. Development of new systems and better applications of present systems could contribute significantly to the efficiency of operations in both health care and commercial foodservices. The computer-assisted food cost accounting system reported here might serve s a prototype for other management cost information systems.

Accounting↗
PubMed1979

Risk of respiratory distress syndrome after prenatal dexamethasone treatment.

A prospective double-blind randomized clinical trial was carried out to determine whether glucocorticoid treatment reduces the risk of respiratory distress syndrome (RDS) in prematurely born infants. There were 127 infants born to 122 mothers who received either steroid (dexamethasone phosphate) or placebo. No differences between groups occurred in risk factors for RDS (eg, prepartum asphyxia, male sex, cesarean section). When those who received a full course of dexamethasone therapy were compared with those who received placebo, a significant reduction was found in risk, severity, and deaths due to RDS. An increased incidence of infection in mothers treated with steroid was evident, particularly after premature rupture of membranes. We conclude that steroids are effective in reducing risk of RDS, but safer and more efficacious approaches for the prevention of RDS should be sought.

Clinical Trials as Topic↗
PubMedDate not supplied

Quantitative angioscopy: a novel method of measurement of luminal dimensions during angioscopy with the use of a "lightwire".

PURPOSE: To determine the accuracy and reproducibility of luminal dimension measurements of a newly developed method of quantitative angioscopy. METHODS: A method was developed for quantitation of luminal dimensions during angioscopy, as variation in magnification with lens-object distance and ambiguity associated with identification of corresponding points about the circumference of a given discrete cross-section render subjective estimates unreliable. A transverse ring of fiberoptically transmitted light was emitted from a guidewire or its housing at a known distance from the distal end of an angioscope and discrete cross-sections of interest were observed as the ring of light was reflected from the luminal surface. Caliper measurement of the diameter of the light ring image (< 50 mW at 488/515 nm), obtained on angioscopic video recordings of cylindrical phantom vessels of known dimensions, was performed by three observers on five occasions. RESULTS: The mean absolute difference between measured and known luminal diameter (n = 405 observations) was 65 microns +/- 35 microns and the mean coefficient of variation was 4.2%, and the mean difference between measured and known areas (n = 195 observations) was 0.4 mm2, with a mean coefficient of variation of 6.5%. CONCLUSION: By use of this new lightwire method, luminal dimensions can now be measured in vitro with a high degree of accuracy and reproducibility during angioscopy.

Angioscopes↗
PubMedDate not supplied

[Exchange of endoprosthesis using a proximal femur resection prosthesis].

Total hip arthroplasty (THA) with the use of a Mega prosthesis was performed on 24 patients with significant loss of bone stock in revision THA. A clinical and radiological examination was carried out according to the Enneking evaluation scheme on average 7 years after THA. Pain, active hip motion and strength of hip muscles, walking ability, and activities of daily living rated excellent or good and compared well with the results following conventional THA. Limp and positive Trendelenburg sign were common to all except one after Mega prosthesis implantation and were independent on the type of refixation of the hip abductors. Dislocation of the prosthesis occurred in 16.6% of cases and depended on the type of cup implanted. Remarkable was a periprosthetic callus formation surrounding the stem of the femoral implant.

Aged↗
PubMedDate not supplied

[Demonstration of the blood supply of human cruciate ligaments using the plastination method].

The blood supply of the attachment regions of the anterior and posterior cruciate ligament is demonstrated in 14 cadaver knees by the plastination method. Our findings demonstrate the blood supply by vessels of the synovium. The direct attachment to the bone is free of vessels. Anastomoses between the synovium and the periosteum could be found. In conclusion the surgical coverage of ligament reconstruction and of ligament transplantation by synovium is recommended when ever possible to permit the ingrowth of revascularisation vessels.

Adult↗
PubMedDate not supplied

[Primary osteotomy of the fibula in the treatment of post-traumatic tibial pseudoarthrosis].

In a retrospective study 32 case histories of patients with primary osteotomies of the fibula were evaluated to find out the reliability of this method in the treatment of tibial pseudarthroses. The influence of the osteotomy level and extent was taken into account as well. In 23 cases the pseudarthroses resulted from tibial and fibular fractures. Causative for the pseudarthroses were the blocking effects of healed fibula, tibial infection and loose osteosynthetic materials. 22 tibial pseudoarthroses healed by fibular osteotomy and postoperative immobilisation only, healing time was 25 months on average, in case of proximal fibular osteotomies even longer. The extent of fibular resection was between 5 and 30 mm. In contrast to "modern" methods of treatment, primary osteotomies in the treatment of tibial pseudarthroses take a rather long time to heal.

Adult↗
PubMedDate not supplied

[Aortographic findings in children with myelomeningocele and lumbar kyphosis].

The findings in abdominal aortography performed preoperatively in 21 children with myelomeningocele (MMC), which underwent kyphectomy due to congenital kyphosis of the lumbar spine, are reported. In no case did the aorta follow the kyphotic radius of curvature. It rather seemed to be strung over the kyphosis like a tendon over a bow. An intraoperative lesion of the aorta seems rather unlikely, and this is why we believe, that a routinely performed preoperative abdominal aortography is not necessary. We found a remarkable number of anomalies of the intercostal and segmental arteries, which were only in part associated with deformities of the vertebral bodies. The kidneys seemed to be imbedded in the kyphotic concavity, partially with the inferior pole, partially in whole. In these cases the risk of intraoperative lesion seems higher. We found a number of cases with unilateral agenesis of the kidneys in the patients examined by us. Therefore we suggest the use of noninvasive methods prior to surgery in order to evaluate the presence of malpositions or malformations of the kidneys.

Abnormalities, Multiple↗
PubMedDate not supplied

[Fractures and epiphyseal injuries in children with myelomeningocele].

Between February 1971 and February 1988, 947 children with myelomeningocele were treated at the Model Center of Heidelberg University Orthopedic Clinic. In 82 of these children, a total of 224 osseous lesions were seen. Metaphyseal and diaphyseal fractures were far more common than epiphyseal lesions, among which epiphysiolysis dominated. Diagnostically important symptoms included swelling, local hyperthermia, and high temperature. Owing to the paralysis, pain is of no value in diagnosing fractures. Protruding periosteal detachments are a common feature of lesions, and if this special form of healing of such fractures is unknown they may cause problems in differential diagnosis. Fractures in children with spina bifida should be treated conservatively, except for fractures of the femoral neck and epiphyseal lesions, which are treated with transcutaneous Kirschner wiring. Immobilization in plaster, postoperatively and during treatment of the injury, is the most common cause of osseous lesions in spina bifida children. Immobilization in plaster should therefore be minimized.

Adolescent↗
PubMedDate not supplied

[Intraspinal anomalies in myelomeningocele].

This study reports the results of MRI analysis of the spinal cord in 83 patients with myelomeningocele. 63 patients had a "tethered cord" or a "suspected tethered cord". In 14 cases we found a "hydro-/syringomyelia". In only 2 cases there were no pathological findings. The influence especially of the "tethered cord" and the "hydro-/syringomyelia" on the development of deformities of the locomotor apparatus is discussed. Concerning this problem the experience reported in the literature is not sufficient enough to make final statements. However, in cases of deterioration of the neurological status in patients with myelomeningocele the influence of intraspinal anomalies should be considered giving rise to further diagnostic examinations.

Adolescent↗
PubMedDate not supplied

[Results of surgical therapy of knee flexion contractures in patients with myelomeningocele].

This study reports the results of 98 operations for correcting knee-flexion-contractures, which were performed between 1972 and 1989 in 60 patients with myelomeningocele. 13 knees had hamstring lengthening and 85 knees had radical flexor release. In 4 patients, who had flexion-contractures of more than 50 degrees, the soft tissue release was combined with supracondylar extension osteotomy. 58 patients had additional hip-flexion-contractures and 39 patients had feet deformities. The average age at time of surgery was 8 years, 3 months. The average follow-up-period was 65 months with a minimum of 1 year and a maximum of 13 years. In 92 knees a permanent extension ability could be achieved. In 6 knees a recurrence of flexion-contracture occurred making a second surgery necessary. The main problem in the postoperative period were 13 skin necroses, which were seen mainly after an s-shaped incision. As a conclusion a perpendicular midline incision is recommended. After surgery 11 patients could be provided for the first time with an orthoses. In the remaining the upright body position or the erection of the orthoses could be improved.

Adolescent↗
PubMedDate not supplied

[Spinal surgery on patients with myelomeningocele. Results 1971-1990].

Between 1971 and 1990 33 kyphectomies were performed at the Orthopaedic Hospital, University of Heidelberg. The average age at time of surgery was 5 years/5 months; the follow-up period was 5 years. The best results were obtained in the group with congenital rigid kyphosis. A marked postoperative deterioration was considered in patients with a flexible paralytic kyphosis, probably due to a too short area of fusion. In 19 patients the correction of the kyphotic deformity was the prerequisite for being provided with orthotic devices. The most serious complication was the intraoperative death of 3 patients. It can be presumed, that after transection of the spinal cord a non-functioning CSF-shunt lead to an acute elevation of the intracranial pressure. Therefore an adequately functioning shunt must be secured preoperatively.

Adolescent↗
PubMedDate not supplied

Routine withholding of digitalis for heart rate below 60 beats per minute: widespread nursing misconceptions.

OBJECTIVE: To describe the nursing practice of withholding digitalis solely on the basis of a heart rate less than 60 beats/min and to determine the rationale for this practice. DESIGN: Non-randomized survey. SETTING: Five hospitals in a midwestern metropolitan area, ranging from affiliates of a university medical center to a private community-based hospital. SUBJECTS: Two hundred twelve nurses, 53% from critical care units, 19% from step-down units, and 28% from nonmonitored units). RESULTS: Eighty-one percent of respondents either withheld digitalis unnecessarily or administered the drug without correctly indicating why they did so. Nurses with CCRN certification were more likely to answer correctly than those who were not certified (p = 0.0001). Categories for incorrect rationale were (1) incorrect understanding of the drug's mechanism of action (46%), (2) deference to physician's decision-making (28%), (3) adherence to hospital policy (18%), and (4) adherence to guidelines taught in nursing school (6%). CONCLUSIONS: The results document the need to correct widespread misconceptions regarding the mechanism of action for digitalis and subsequent nursing practice.

Arrhythmias, Cardiac↗