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Biomedical subjects

C H Siebert

Publications and source records attributed to C H Siebert.

At least 37 records · Page 2Linked to original sources
PubMed1998

Refixation of femoral anterior cruciate ligament tears combined with a semitendinosus tendon augmentation. Technique and results.

As part of a retrospective study, 76 patients with acute tears of the anterior cruciate ligament who underwent reinsertion and augmentation with the semitendinosus tendon were examined. The follow-up took place on average 4.5 years (range 3-7 years) after surgery. A decreased range of motion upon comparison with the uninjured opposite side was seen in 43 patients. The Lachman test revealed a grade 1 instability in 42 patients, grade 2 in 17 and grade 3 in 2, while 15 patients had a negative test result. The average Lysholm score was 92 points and the Tegner activity score had an average of 7.1 points. KT-1000 measurements showed an identical degree of anterior translation for both knees at 89 N in 25 individuals. The analysis revealed a difference of 2 mm in 15 patients, 4 mm in 19,6 mm in 15 and greater than 6 mm in 2. The radiographic follow-up examination revealed a deterioration of the degenerative change of 1 deg in 17 patients and 2 deg in 4 patients. Isometric testing showed no loss in flexion strength of the operated knee joints compared to the healthy opposite side. The ratio between flexion and extension strength was also identical for both knees. The reinsertion and augmentation with a single strand of semi-tendinosus tendon is not, as this study demonstrates, the appropriate reconstructive technique for the majority of ACL tears.

Adult↗
PubMed1998

Follow-up evaluation of open intra-articular fractures of the calcaneus.

The results of a follow-up evaluation of open intra-articular calcaneal fractures are presented. A modified Merle d'Aubigné functional score and Zwipp radiographic score were used. A retrospective analysis of 35 patients with 36 open intra-articular fractures represents the basis of the study. At the time of follow-up examination (on average 44 months after the injury), 5 amputations of the affected extremity and 4 ankle arthrodeses had been carried out. The 23 patients still able to bear weight on the affected hindfoot and possessing a functional ankle joint were radiographically and functionally evaluated. No excellent results were documented. Only 6 good functional and 2 good radiographic outcomes were noted. In 17 instances, a poor functional or radiographic score was given. Devastating results were seen in the course of treatment of third-degree open joint depression or comminuted intra-articular fractures (n = 15): 9 cases of osteomyelitis, 5 amputations, 1 partial calcanectomy, 1 arthrodesis. An open reduction as part of the primary treatment (n = 6) led to local complications in all instances. The most favorable results were seen after nonoperative fracture management: complication-free course of treatment in 4 of 11 patients. All workmen's injuries led to a permanent disability, and these patients received compensation. The treatment and salvage of the soft-tissue envelope should be paramount in all therapeutic decisions. The fracture treatment must not further jeopardize these tissues. An aggressive operative treatment of local complications, including arthrodesis or amputation, is recommended.

Adolescent↗
PubMed1997

Compression plating of tibial fractures following primary external fixation.

During the time period from May 1990 to December 1992, a total of 75 tibia fractures were treated in the Department of Traumatology at the University of Bonn. Thirty-eight patients with 40 tibial fractures were managed according to a regimen including primary stabilization, usually using external fixation, soft tissue reconstruction and delayed open reduction and internal fixation using an AO compression plate. The majority of the patients had been involved in motor vehicle accidents, leading to multiple injuries in 24 instances. An open fracture was seen 18 times. The 20% complication rate is comparable to the reports following intramedullary stabilization. Only one infection, following a grade 2 open fracture, was seen after the definitive stabilization. Bony union was achieved after 15.7 weeks. In light of the complications associated with intramedullary nailing, such as fat or air embolism, heterotopic ossification and non- or malunions, use of the tibial plate does not offer just logistic advantages, but is a viable alternative for delayed stabilization of tibial fractures. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.

Adult↗
PubMed1996

[Reversed musculus biceps femoris flap for covering a defect of the distal thigh].

We report the case of a 30-year-old female patient, who had suffered a grade III open femur fracture in a motor vehicle accident 14 weeks prior to being transferred to the trauma department of the University Hospital in Bonn. Upon admission to our unit, posttraumatic osteitis, an unstable fracture following compression plating, and a soft tissue defect of the anterolateral distal thigh were discovered. Following removal of the hardware and stabilization of the fracture with external fixation, the infection was brought under control. Because the patient refused the time-consuming segmental transport utilizing the callus distraction technique, local muscle transfer and shortening of the femur were carried out. The most lateral of the hamstring muscles, the biceps femoris, was used as a distally based muscle flap utilizing a delay technique. With the help of a reversed biceps femoris flap, the soft tissue defect was closed, the infection subsided and the fracture healed. The surgical technique is outlined.

Adult↗
PubMed1996

[Plate osteosynthesis management of humerus shaft fractures].

During the period from 1 May 1990 to 30 November 1994, a total of 62 humeral shaft fractures were treated in the Department of Traumatology of the University of Bonn. In 42 instances the fracture was internally stabilized primarily, while in 13 instances the humeral shaft fractures were treated according to a regimen including primary stabilization, usually in an external fixateur, soft tissue reconstruction and delayed open reduction and internal fixation using an AO plate. The delayed stabilization was carried out 9.1 days, on average, after the injury. Seven pseudarthroses were treated electively. The indication for surgery was in 28 cases the associated injuries, 18 times the fracture type or form, 7 times a primary neurological deficit, 7 times a pseudarthrosis and twice the underlying systemic disease. A majority of the patients were involved in a motor vehicle accident. An open fracture was seen 6 times. Of the 19 primary radial palsies, 79% were associated with fractures of the distal diaphysis. The complication rate of 11% is comparable to that reported following intramedullary stabilization. No infection, pseudarthrosis or long-term radial palsy was observed. In three instances, twice following the revision of a pseudarthrosis, a temporary radial palsy was noted. All these neurological deficits resolved by the 6th postoperative day. Bony union was achieved after 16.2 weeks. If the surgeon adheres to the proper indications for open reduction and internal fixation, the compression plating of the humeral shaft fracture is a viable alternative to other forms of stabilization.

Adolescent↗
PubMed1995

[Bilateral apophyseal rupture of the tibial tuberosity in the athlete].

The fracture through the apophysis underlining the tibial tuberosity remains an infrequent traumatic lesion. The simultaneous bilateral occurrence of this injury is rare. A 16-year old athlete suffered an Ogden type 1B fracture on the left and a type 1B injury combined with a Salter II lesion on the right side during the acceleration phase of a high jump. Open reduction and internal fixation were carried out bilaterally on the day of the injury. Hardware removal was performed after 12 weeks. Full range of motion and return to athletic activity was obtained 20 weeks after the injury. A modification of the Ogden classification is suggested.

Adolescent↗
PubMed1995

Surgical treatment of ruptures of the Achilles tendon: a review of long-term results.

The rupture of the Achilles tendon is frequently sports-related. In the time from 1 January, 1978 until 31 December, 1988, we treated 358 men and 54 women with such an injury at the Staatliche Orthopaedische Klinik in Munich. The average age of these patients was 43 years. The site of the rupture was generally located between 3-5 cm proximal of the distal insertion of the tendon. In the follow-up examination of 122 patients with surgical treatment of tendo calcaneus ruptures 85% showed 'good' to 'very good' subjective results. Of the operated patients 97% would choose the same treatment under similar circumstances. The isokinetic studies demonstrated a loss of static and dynamic strength in plantar flexion of the ankle joint of 9.1%, and 16.7% respectively, when compared to the healthy contralateral side. The ultrasound examination revealed a thickening of the tendon and of the dorsal paratenon with changes in the internal structure of the injured Achilles tendon. In spite of these favourable results, the high complication rate of 15.1% shows the need for new and extensive studies regarding the various alternative treatment forms, such as functional, non-operative options, to finally resolve the debate about the optimal treatment of Achilles tendon ruptures.

Achilles Tendon↗
PubMed1995

[Secondary plate osteosynthesis of open fractures of the lower extremity--still a therapeutic alternative!?].

During the time period from May 1, 1990 to July 31, 1993, a total of 102 tibial and 144 femur fractures were treated in the Department of Traumatology of the University of Bonn. 45 patients with 25 open tibial and 22 open femur fractures were treated according to a regimen including primary stabilization, usually in an external fixator, soft tissue reconstruction and delayed open reduction and internal fixation using an A0-plate. A majority of the patients were involved in motor vehicle accidents, leading to multiple injuries in 26 instances. The complication rate of 17% is comparable to the reports following intramedullary stabilization. Only three chronic infections, following one grade two open femur fracture, one grade two and one grade three open tibial fracture, were seen. Bony union was achieved after 24 weeks. It is shown that the use of the A0-plate in the treatment of open fractures of the femur and tibia offers not only logistic advantages but represents a viable alternative for the delayed stabilization of these injuries.

Adult↗
PubMed1993

Surgical treatment of dislocations of the acromioclavicular joint in the athlete.

The treatment of the sports related dislocation of the acromioclavicular joint remains controversial. This study was carried out to determine whether or not a combined surgical procedure consisting of repair and polydioxanone (PDS)-cord augmentation of the coracoclavicular ligaments, fixation of the acromioclavicular joint with a single Kirschner wire as well as the repair of the acromioclavicular ligament permitted return to athletic activity. Athletes were examined with regard to their range of motion, pain and their ability to return to the performance level achieved before the injury. During the period 1986-1989, 21 athletes were treated. Follow-up averaged 22 months. Return of athletes to previous performance level was related to their original degree of activity. Two recreational once-a-week athletes did not return to this level, 19 patients, including five competitive athletes, continued their previous activities. There was no correlation between coracoclavicular ossification or post-traumatic arthritis and a good or excellent result. We recommend the operative treatment of acromioclavicular separations in athletes.

Acromioclavicular Joint↗
PubMed1993

[Secondary management of tibial fractures with plate osteosynthesis--applications of an old, but reliable procedure].

During the time period from May 1990 through October 1992, a total of 70 tibia fractures were treated in the Department of Traumatology of the University of Bonn. 35 patients with 37 tibial fractures were treated according to a regimen including primary stabilization, usually in an external fixateur, soft tissue reconstruction and delayed open reduction and internal fixation using an AO-plate. A majority of the patients were involved in motor vehicle accidents leading to multiple injuries in 22 instances. An open fracture was seen 16 times. The complication rate of 19% is comparable to the reports following intramedullary stabilisation. Only one infection, following a grade 2 open fracture, was seen. Bony union was achieved after 15.7 weeks. Considering the complications associated with nailing such as fat or air embolism, heterotopic ossification and non- or malunions, the use of the tibial plate seems not only to offer logistic advantages but is a viable alternative for the delayed stabilization of tibial fractures.

Adult↗
PubMed1993

[Local and systemic trauma in plate osteosynthesis of femur shaft fracture].

Compression plating of fractures of the femur has a number of logistic advantages over intramedullary stabilization techniques though it is equally demanding for the surgeon. In this retrospective study of 77 cases, we try to show that compression plating of fractures of the femoral shaft is still a viable alternative to intramedullary fixation, especially in the light of local complications, postoperative systemic implications for the patient with multiple injuries, and the time required to achieve bone union. The data relating to all three of these aspects permit the conclusion that the results reached with compression plating of both simple and comminuted femoral shaft fractures are comparable to those reported following intramedullary nailing. Our treatment regimen does not involve a higher risk to the patient.

Adult↗
PubMed1992

Tumoral calcinosis of the ischium.

The authors report on a case of tumoral calcinosis of the ischium in a 63-year-old female. By means of this particular case a general review of the literature on pathogenesis, histological characteristics, the possible way of treatment and the prognosis of tumoral calcinosis is presented.

Bone Diseases↗
PubMed1992

Sports-related epiphyseal injuries of the lower extremity. An epidemiologic study.

Sports-related epiphyseal injuries in children and adolescents have been becoming more prevalent during recent years. We report 85 patients with epiphyseal fractures of the lower extremity treated in our hospital during the last twenty years, of which 60 were males and 25 females with an average age of 12.6 years (range 4 to 17 years of age). The injuries were sustained during soccer in 28% and during alpine skiing in 26% of the cases, of which the former was responsible for most of the injuries reported in males and the latter for those in females. The most frequently seen localizations were in the distal tibial epiphysis (31 cases), followed by the distal fibula (17) and the proximal tibial epiphysis (15). Of the reported 85 epiphyseal fractures 30 were Salter-Harris type I injuries, 25 type II, 8 type III and 11 were type IV fractures, while 11 were avulsion fractures. Of these patients, 56% were treated surgically, while conservative treatment was chosen for 44% of the patients. Of the 49 patients available for follow-up, complications were documented in 9 instances, including 3 leg length discrepancies, 4 axis deviations, one avascular necrosis of the femoral head and one case of osteomyelitis, of which 6 required corrective surgery.

Adolescent↗
PubMed1991

Indications for and results of operative treatment of spondylitis and spondylodiscitis.

We present a retrospective follow-up study of 24 patients with spondylitis or spondylodiscitis whose treatment included surgical intervention. Tuberculous spondylitis was diagnosed in 14 patients and 10 suffered from non-specific spondylitis. The average age of the patients was 50.2 years and average follow-up was 3 years. All patients were asymptomatic at the time of examination and showed radiographic evidence of solid fusion. We recommend radical debridement and spinal fusion through a ventral approach in patients with destruction of the ventral vertebral body, progressive neurological impairment, septicaemia and antibiotic-resistant, symptomatic infections of the spine. In the elderly patient, even in reduced states of health, early surgical intervention can be particularly valuable. Although surgical intervention should be reserved for specific indications, we were able to document favourable results in all 24 patients treated with debridement and spinal fusion.

Bone Transplantation↗
PubMed1991

Sports-related two-plane fractures of the distal tibia. Report of two cases.

Two cases of sports-related two-plane fractures of the distal tibia, their operative treatment and the result of therapy after hardware removal are reported. The incidence and mechanism of this type of fracture in adolescents are shown as well as the indication for surgical reconstruction depending on the gap in the joint surface of the distal tibia.

Adolescent↗
PubMed1991

Paragliding injuries.

Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during starting procedures and nine during flight. The mean patient age was 29.6 years. There were 34.9% spinal injuries, 13.4% upper extremity injuries and 41.3% lower limb injuries. Over half of these injuries were treated surgically and in 54 instances permanent disability remained. In paragliding the lower extremities are at greatest risk of injury during landing. Proper equipment, especially sturdy footwear, exact training in landing techniques as well as improved instruction in procedures during aborted or crash landings is required to reduce the frequency of these injuries.

Adolescent↗
PubMed1990

Destructive changes of the spine in magnetic resonance imaging.

Twenty-nine patients were examined by magnetic resonance imaging for various lesions of the spine. The results of these scans were compared with those of plain radiographs, computertomographs, and radionuclide bone scans. The findings were substantiated by intraoperative or histological findings in 18 cases. The MRI scans proved to be very sensitive in the detection of a wide spectrum of morphological changes of the bone marrow of vertebral bodies. Characteristic changes of the signal patterns for inflammatory and tumorous lesions were not observed. The differentiation of these lesions will presently continue to have to be based on morphological criteria.

Adolescent↗