PubMed Health⌕ Search

Biomedical subjects

B Isler

Publications and source records attributed to B Isler.

12 recordsLinked to original sources
PubMed2000

The outcome of revision hip arthroplasty in patients older than age 80 years: complications and social outcome of different risk groups.

Between December 1995 and June 1996, we reviewed 53 consecutive patients who were at least 80 years old and had undergone a revision of a hip prosthesis between June 1988 and June 1995. Three patients (6%) had died after the operation in the hospital. Thirty-five patients were still alive with a mean follow-up of 4.0 years (range, 1.0-7.3 years). At follow-up, 15 patients had died, with a mean survival period of 25 months. Thirteen of the 15 (89%) belonged to American Society of Anesthesiologists' (ASA) group 3. Of 50 patients, 40 (80%) returned to their original social environment. Admission to a home for elderly people or to a nursing home was unrelated to the procedure in 9 of 10 cases. Complications occurred in 27 patients (51%). Major complications occurred only in high-risk patients, classified as ASA 3 according to the physical status classification of the ASA.

Age Factors↗
PubMed1996

Classification of pelvic ring injuries.

Advances in the operative stabilization of pelvic ring injuries, particularly by the development of special surgical techniques and implants, call for clear indications. These require the thorough analysis of the injury and its classification. Classification systems facilitate communication and the comparison of treatment concepts and results. Although a number of classification systems have been proposed, none of them has found universal acceptance. The following is a proposal for a comprehensive classification of pelvic ring injuries which, at the same time, accommodates the requirements of the AO/ASIF classification guidelines. The proposal is based primarily on radiographic morphology and secondarily on certain deductions made from it pertaining to the pathomechanics of the injury. To accommodate the extremely wide variety of possibilities, an open system was created by dividing the pelvic ring into anterior and posterior ring segments. Lesions of both segments can be freely combined for the definition of any given pelvic ring injury.

Fractures, Bone↗
PubMed1993

[Follow-up and prognosis of neurologic sequelae of pelvic ring fractures with involvement of the sacrum and/or the iliosacral joint].

The extent of neurological lesions following an injury of the pelvic ring is often not initially recognized, as interest is then focused on the treatment of the pelvic ring fracture. Once the fracture has healed, the patient suffers from the sequelae of the neurological injury. Our series of 323 pelvic ring injuries includes 161 sacral fractures and 12 complete disruptions of the sacroiliac joint. Twenty-three patients sustained an injury of the lumbosacral plexus, and 20 patients were examined retrospectively. The different parts of the lumbosacral plexus showed variable recovery potential. An important or complete recovery was noted in 8 of 9 patients suffering from a motor deficit of the lumbar plexus, the obturator nerve, the superior gluteal nerve or the inferior gluteal nerve. Four out of 8 patients with a motor deficit of the sacral plexus had an important or complete improvement. In contrast to these results was the poor recovery of lesions of the lumbosacral trunk. Eight out of 11 patients showed no or only minor recovery, although the pelvic ring was stabilized by operative means in 9 patients. In 2 patients the lumbosacral trunk was directly decompressed by a dorsal approach. In both cases the recovery was complete. In 6 patients the sphincter function was damaged. Recovery was dependent on the localization of the sacral fracture. If the fracture traversed the sacral canal, no neurological improvement was noted.

Adult↗
PubMed1991

[Cervico-acetabular impingement after femoral neck fracture].

Six cases of femoral neck-acetabular impingement following fracture of the femoral neck are reported. To our knowledge, this complication has not previously been described in the literature. A bony prominence at the level of the former fracture site following primary or secondary valgus position of the femoral head showed a conflict with the acetabular rim causing pain and limited motion. In four patients this impingement was posterior, between the femoral neck and the acetabulum in extension with external rotation, and in two patients it was anterior in flexion with internal rotation. A detailed description of the symptoms, diagnostic procedures and treatment options is presented.

Acetabulum↗
PubMed1990

Lumbosacral lesions associated with pelvic ring injuries.

In pelvic ring injuries, an anterior lesion is usually combined with a lesion of the posterior ring segment. A fracture of the sacrum is the most common type of posterior lesion. Its severity ranges from a stable minimal compression fracture of the ala of the sacrum to a displaced fracture with complete loss of stability. The fracture line commonly involves the first and second sacral foramina, exiting the bone distally through its free border and proximally just lateral to the articular process of S1. This study shows that in a number of cases the proximal fracture line passes through or medial to the articular process of S1. Consequently, displacement of the involved hemipelvis causes no damage to the lumbosacral junction if the fracture line passes lateral to the articular process of S1. However, any displacement of the mobile hemipelvis must injure the lumbosacral junction with the latter fracture pattern if the fracture line passes through or medial to the articular process of S1. We found an injury of the lumbosacral junction in 6% of all of our pelvic ring injuries and in 38% of those with an unstable vertical sacral fracture. One kind of these lesions, the locked dislocation of the L5/S1 joint, was shown to inhibit reduction of a displaced sacral fracture. Furthermore, these lesions may be responsible for some of the lumbosacral pain frequently persisting after pelvic ring injuries.

Fractures, Bone↗
PubMed1990

Pelvic fractures and traumatic lesions of the posterior urethra.

We report on the retrospective analysis of 61 traumatic lesions of the posterior urethra in a fractured pelvis. In collaboration with the orthopedic surgeons, 44 cases could be classified with regard to the nature and mechanism of the pelvic fracture. No direct relationship between the structural integrity of the dorsal ring segment and the urological pathology could be established. However, the mechanism of injury in 35/44 cases with pelvic girdle injuries and urethral pathology appears to be a predominantly lateral compression force. Ten of the 44 patients received a surgical stabilization of the fracture and open splinting of the urethra at the same time. An infection in the area of surgery developed in only one of these patients; however, this cleared up completely under antibiotic therapy and closed suction irrigation. The primarily conservative treatment of urethral lesions (27/61) is compared with primary open splinting or reanastomosis (34/61), which we prefer, with regard to the number of reoperations and late results. The joint conclusion of urologists and orthopedic surgeons concerns a primary simultaneous surgical treatment both of the urethral lesion and the pelvic fracture.

Fracture Fixation↗
PubMed1990

[Surgical measures in metastatic lesions of the extremities and pelvic bones].

Two factors--generally increased life expectancy with a higher risk of malignant disease and improved survival rates among cancer patients--have led to a steady increase in the incidence of metastatic bone disease over the past 20 years. There is little controversy about the need for ORIF in the case of pathological fractures, but special techniques are necessary to achieve immediate and lasting stability in the presence of frequently extensive bone destruction. Metastatic bone lesions that involve the risk of fracture should preferably be stabilized prophylactically before further treatment in the form of radiation or chemotherapy. Special techniques of composite osteosyntheses for the long bones and particularly for composite reconstructions of acetabular lesions are listed.

Bone Neoplasms↗
PubMed1990

[Classification of pelvic girdle injuries].

Advances in the operative stabilization of pelvic ring injuries, particularly through the development of special surgical techniques and implants, call for clear indications. A prerequisite for these is a comprehensive classification system. Correct placement of any injury within such a system requires a thorough analysis of the injury, and at the same time comparisons of different treatment concepts and their results are facilitated. Although a number of classification systems have been proposed, none of them has found universal acceptance. Our own attempt at completeness has resulted in a new classification, which is based primarily on the X-ray morphology and secondarily on certain deductions made from it pertaining to the pathomechanics of the injury. To accommodate the extremely wide variety of possibilities we created an open system by dividing the pelvic ring into an anterior and a posterior ring segment. Lesions of both segments can be freely combined. As in the ASIF classification of fractures, lesions of the posterior pelvic ring segment are divided into three types, and each of these again into three groups. Lesions of the anterior ring segment are classified in subgroups. The principle of increasing severity represented by morphological complexity, the difficulty of treatment, and the prognosis is strictly adhered to. The proposal is based on the analysis of 283 pelvic ring injuries.

Fractures, Bone↗
PubMed1984

Internal fixation technique in pathological fractures of the extremities.

More often than not, the standard methods of internal fixation are insufficient to meet the demands of treatment of pathological fractures. In malignant diseases with improved survival rates, durability of the osteosynthesis is needed. The seemingly convenient prosthetic replacement therefore has to be regarded with caution. Good results without complications cannot be expected unless the fixation of the components is in healthy bone. In the younger patient with a curable disease, late complications have to be considered. We describe methods of internal fixation that satisfy these particular requirements, and pertinent clinical examples elucidate the techniques.

Adult↗
PubMed1984

Chiari's osteotomy. A note on technique.

Direct joint distraction of the hip facilitates the performance of Chiari's osteotomy on a standard operating table as opposed to the classic procedure on the traction table. Some useful modifications of the original technique include a guide wire to control the direction of the osteotomy, insertion of an additional bone graft to provide better anterior coverage of the head, and internal fixation of the osteotomy.

Adolescent↗