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Biomedical subjects

B G Ochs

Publications and source records attributed to B G Ochs.

5 recordsLinked to original sources

[Post-traumatic shoulder instability in adolescence].

BACKGROUND: Post-traumatic shoulder instability in adolescence represents a very rare condition. However, most of these patients develop recurrent shoulder dislocations over time. METHODS: We report about a retrospective study, which included 32 patients younger than 16 years of age. The mean follow-up was 5 years. Our evaluation focussed on patients' age at the time of first shoulder dislocation, type of injury, and the results after conservative and operative treatment. RESULTS: After the first dislocation, all shoulders were immobilized for 3 weeks and were treated with physiotherapy afterwards. Of these 32 patients, 30 (94%) developed recurrent shoulder dislocations. Eight patients remained in a conservative regimen (age <15 years) and 21 patients were operated for persistent shoulder instability (age >15 years). The recurrence rate was 8 of 21 patients (36.5%) in the operative group and 4 of 8 patients in the conservative group. At the time of follow-up, 4 of 8 conservatively treated patients had returned to their former sports activities and 15 of 21 (71%) in the operated group. CONCLUSIONS: Our results on post-traumatic shoulder instability in adolescence show high recurrence rates in both conservative and operative groups. After adolescence, including ossification of the glenoid, operative treatment is able to decrease the recurrence rate and to increase the sports ability of these young patients.

Adolescent↗

[Fixed posterior subluxation with lateral rotation of the knee joint caused by congenital dislocation of the patella in combination with aplasia of the posterior cruciate ligament. Case report and review of the literature].

Congenital dislocation of the patella is very rare. In this anomaly, the patella is dislocated to the side of the lateral femoral condylus and cannot be repositioned manually. Diagnosis is often made by clinical examination and observation of an abnormal gait. We describe the long-term course of treatment in a young girl with fixed posterior subluxation with lateral rotation of the knee joint caused by congenital dislocation of the patella in combination with aplasia of the posterior cruciate ligament. These anomalies of the knee joint were corrected incrementally. First, recentralization of the patella was performed by open surgery. Subsequently, distraction of the shortened ischiocrural muscles and the posterior capsules and ligaments was conducted. This is the first case to be described, to the best of our knowledge, of a patient with congenital dislocation of the patella in combination with aplasia of the posterior cruciate ligament. We describe the successful treatment of such a fixed posterior subluxation and lateral rotation of the knee joint.

Child↗

[Improving microbiological diagnostics in septic orthopaedic surgery. Comparative study of patients receiving systemic antibiotic therapy].

MATERIAL AND METHODS: This prospective study included 63 patients with confirmed infections of soft tissue, joints, bones or implants. During 110 surgical interventions, 124 swab and deep tissue sample pairs were taken and analysed microbiologically using standard procedures. RESULTS: In 40 patients who had not received prior antibiotic treatment, 57 sample pairs (swabs/tissue) were taken. In 70%, growth of microorganisms could be observed in both swabs and tissue samples. Growth in tissue sample only was observed in 14% and in 14% no growth could be detected. In 67 sample pairs taken from 23 patients who had received systemic antimicrobial treatment prior to surgery, microbial growth in both specimens was detected in 40%. Growth in tissue sample only was observed in 22% and 34% of the samples remained without detectable growth. The overall sensitivity of the tissue samples (70%) was significantly higher than in swab samples (44%) for the pretreated group. CONCLUSION: The use of intraoperative tissue samples for microbiological diagnostics in septic orthopaedic surgery must be considered a "gold standard". The higher sensitivity of intraoperative tissue samples is particularly important in patients receiving systemic antibiotic therapy prior to surgical interventions.

Anti-Bacterial Agents↗

[Shoulder dislocation in the newborn. Report of 12 cases and review of the literature].

Shoulder dislocation in the newborn is a rare entity. Therefore, a therapeutic regimen does not exist. This retrospective clinical study (1967-2003) includes 9 newborns with 12 dislocations of the shoulder. The data focus in particular on the therapeutic strategy and its success. The position of the joint and its functionality were monitored with a questionnaire. Publications from 1904 to 2003 were reviewed and served for comparison. Results of calculations showed that 0.018-0.07% of newborns suffer from shoulder dislocations. The diagnosis was made on average at the age of 22 days. Our data include four cases each of congenital and paralytic and two cases each of spastic and traumatic shoulder dislocations. All of them were initially treated conservatively, but because of inadequate results one patient finally had to be operated. In the follow-up of 19.4 years, none of them developed a redislocation and all shoulder functions were suitable for daily life. We propose that patients primarily be treated conservatively; however, if therapy fails, surgery has to be performed.

Birth Injuries↗

[Experience in operations for scoliosis in patients with cerebral palsy].

AIM: Experiences in operation of scoliosis in cerebral palsy are very different. Therefore a therapeutic regiment does not exist. In this study we want to report our experiences. METHODS: This retrospective-clinical study (1986-2003) includes 46 patients with cerebral palsy who had been operated for scoliosis. The data focus in particular on the therapeutic strategies and its success and complications. Publications from 1946 to 2003 were reviewed and served for comparison. RESULTS: 28 female and 18 men during one period by median 3.4 years were after-observed. The post office-operationally reached correction of the curvature of all operation procedures was appropriate for median between 51 and 68 % depending upon localization of the curvature. In the last re-examination median a correction loss of 3-25 % existed. A fusion to S1 corrected a thoraco-lumbale or lumbale scoliosis significantly better than a fusion to L5. The posterior and the combined posterior-anterior operation procedure showed comparable correction results. The total complication rate was with 35 %. CONCLUSIONS: Due to good correction successes and smaller complication rate we favor a posterior-anterior operation procedure. A fusion to S1 is indicated with thoraco-lumbale and lumbale fusion. Altogether complication rate was reduced in patients with scoliosis and cerebral palsy after operation at the spinal column in the last years.

Cerebral Palsy↗