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Biomedical subjects

D Baranowski

Publications and source records attributed to D Baranowski.

12 recordsLinked to original sources
PubMed1992

[The treatment concept and results of peri-/sub-prosthetic fractures].

The treatment of choice in ipsilateral femoral shaft fractures in patients with hip prosthesis depends on the location of the fracture lines and the observation of loosening of the prosthesis. Either a change of prosthesis, if necessary in combination with refixation of the greater trochanter or simple open reduction with internal fixation (ASIF) along with autologous and/or homologus spongiosa are the used techniques. The rate of complications in peri- or subprothetic fractures is high. Lack of motion in hip and knee joint occurs frequently.

Adult↗
PubMed1991

[Bundle nailing of forearm fractures. Indications and results].

Hackethal developed the nailing procedure named after him in 1959. The rationale of Hackethal nailing is an elastic jamming, which can only be achieved by obeying four rules: jamming of the nails in the cortical window, jamming then in the waist of the medullary cavity, spreading the bunch of nails in the metaphysis and filling up the conus of the medullary cavity with short nails. We confined Hackethal nailing to closed and first-degree open fractures of the 2nd-5th sixth of the shaft of the forearm. If closed reduction and nailing were impossible, we performed a plate fixation (AO), in second- or third-degree open fractures we treated with fixators (Orthofix). In a 13-year period we performed Hackethal bundle nailing in 65 patients with 115 fractures. In 54% patients surgery was performed within the first 8 hours following admission. We used two or three nails passing the fracture and one short nail. Except for 1 case, in which we needed a plaster of Paris, we achieved rational stability. On average, the nails were removed after 11.5 months. The healing and complication rates were assessed by follow-up examination of 49 patients. The results were excellent and good in 71.5% patients, satisfactory 11.4% and poor in 17.1%. Complications consisted of a 2.1% infection rate (osteitis), 3.1% non-union, 2.1% with a synostosis, 1% refracture (during removal of the nails) and 3.1% migration of nails, combined with tendon rupture. We have seen 1 case with metallosis. In conclusion with our confined spectrum of indications Hackethal nailing is a low-risk method, which leads to a rational stability and early bone healing.

Adult↗
PubMed1991

[The radiologic evaluation of osteosyntheses].

Surgeons, orthopedic surgeons, and neurosurgeons employ a wide variety of different osteosynthetic devices in the treatment of fractures and in spinal surgery. In order to assess these instruments correctly, the radiologist should be aware of their purpose and normal appearance. The complications should be identified, such as delayed union, pseudarthrosis, dislocation, device loosening, fracture of the device, osteomyelitis, and re-fracture. To evaluate the fixation device adequately two plain radiographs are mandatory. Normal fracture healing and the most commonly used fixation devices, the abnormalities of fracture healing and their complications are discussed.

Fracture Fixation, Internal↗
PubMed1990

[Modified dorsal approach to supracondylar humerus fractures].

The fracture line in children's supracondylar fractures of the humerus always runs through the olecranon fossa and the radial and ulnar metaphyseal columns. As the articular capsule covers the fossa, all these fractures are intracapsular fractures with haemarthrosis. They require an anatomical reduction and a safe stabilisation in order to avoid a varus deformity. The results after conservative or operative treatment of extension type fractures are only fair, and Magerl found, that 47% of the operated cases suffered a varus deformity. We modified a dorsal approach to the elbow joint, which allows us to overlook the whole joint and the fracture site. Then anatomical reduction is easy. For stabilisation we use two K-wires for the radial and another two for the ulnar column. It is no problem to use twice the number of wires compared with other operative procedures, because the whole fracture region is exposed. Thus we get better stability and avoid secondary dislocation. We used the modified dorsal approach in 13 cases during the last two years. We have obtained excellent results, but a follow-up will be necessary in three to five years.

Bone Wires↗
PubMed1990

[Complementary osteosynthesis and dynamic axial fixation of the distal tibia].

In view of the problems encountered with fractures of the distal tibial shaft, with or without damage to the ankle joint, we have developed a regimen of our own. We reconstruct the fracture by means of simple techniques (K-wires or one to three screws), taking the greatest possible care to avoid damage to the soft tissues. The length and axis of the lower leg are maintained by means of a unilateral fixator, which can also be used for decompression of the ankle joint in a joint-bridging modification. The two components of our regimen complement each other, and we have therefore coined the phrase "complementary osteosynthesis". Evaluation of data in 15 patients who had suffered trauma at least 1 year earlier and in whom the follow-up period was a mean of 86.8 weeks showed that results classified as good or fair can be achieved even in these problematic fractures.

Adult↗
PubMed1989

Genu recurvatum due to partial growth arrest of the proximal tibial physis: correction by callus distraction. Case report.

The formation of a genu recurvatum after partial growth arrest of the proximal tibial physis is uncommon. This contribution deals with the case of a 16 years old male patient who after a direct injury to the proximal tibia four years ago showed a genu recurvatum of 18 degrees. An incomplete upper tibial corticotomy was performed and a hinge type de Bastiani fixator applied. The deformity was corrected at a distraction rate of one millimetre a day. The corticotomy gap filled with callus during the distraction process. The advantages of this concept are omision of iliac crest grafts, maintainance of a full range of knee motion with partial weight bearing during distraction and determination of the final degree of correction with the aid of proper radiographs.

Adolescent↗
PubMed1989

[Current indications for intramedullary bundle nailing].

Hackethal developed the nailing procedure named after him in 1959. The original method consisted in two steps: a non-sterile step in which mechanical reduction was performed with a traction device and a sterile step, i.e. nailing. The rationale of Hackethal nailing is an elastic jamming, which can only be achieved by obeying four rules: jamming of the nails in the cortical window, jamming then in the waist of the medullary cavity, spreading the bunch of nails in the metaphysis and filling up the conus of the medullary cavity with short nails. Hackethal believed it was possible to achieve an elastic jamming in all transverse and short oblique fractures of the shaft. He used his technique in fractures and non-unions of femur, tibia, humerus, radius and ulna. Extensive indications led to overuse of the method and resulted in a major rate of complications. Meanwhile, plating of shaft fractures has proved to involve an unexpectedly high rate of complications, and locking nails and new types of fixators have enlarged the surgeon's armamentarium for stabilization of fractures. Therefore, it seemed important to determine the present indications for Hackethal nailing. We confined Hackethal nailing to fractures of the middle third of the shaft in the upper extremity. All second- and third-degree open fractures were treated with fixators. In a 13-year period we performed Hackethal nailing of the humerus in 53 cases, of the radius in 20, of the ulna in 17, and in both of the forearm simultaneously in 12 cases. Plating and Hackethal nailing were combined for the treatment of forearm fractures in 10 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Plates↗
PubMed1988

[Principles of intramedullary nailing of the femur and tibia].

The interlocking nail technique is a perfected method to stabilise even complex shaft fractures of tibia and femur. There are some advantages of this technique compared with Küntscher's intramedullary nailing, such as avoidance of telescoping and rotation of the fragments. In view of the principles of interlocking nailing and some hints on indication, as given here, the orthopaedic surgeon will obtain good results in the treatment of shaft fractures when proceeding as described.

Femoral Fractures↗
PubMed1986

[Supracondylar upper arm fracture in childhood].

For the last 28 years condylar upper arm fractures have been treated at the Department of Surgery of Erlangen University mainly via the extention after Baumann. 182 cases out of 306 were followed up clinically. Extension treatment after Baumann is a technically simple procedure and offers the possibility of continual control and correction of repositioning. Treatment results are good. We could not observe Volkmann's contraction among our patients. Operation does not decisively improve the results, whereas the risk is increased. It should remain restricted to those cases only which cannot be successfully treated by conservative measures.

Casts, Surgical↗