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Biomedical subjects

D Bettin

Publications and source records attributed to D Bettin.

30 records · Page 2Linked to original sources
PubMed1993

[HIV-screening in bone transplantation].

Tissue transplantation obviously always involves the risk of HIV transmission. Since 1980, the Orthopaedic University of Muenster has conducted careful anamnestic and laboratory screening in 62 donors. Epidemiological investigations show that 90.1% of HIV-positive people in Germany are between 20 and 50 years old. For 25 donors (40%) the results of the HIV antigen test performed in the recipients of the other organs guaranteed HIV negativity. A further 17 donors (28%) were outside the epidemiologic risk group aged between 20 and 50 years. Tissue from all 20 other donors (32%) was subjected to a secondary sterilization method, e.g. fumigation with ethylene oxide or irradiation with 25 kGy.

AIDS Serodiagnosis↗
PubMedDate not supplied

[Long-term treatment outcome in ventral and combined ventrodorsal spondylodesis in the surgical therapy of scoliosis].

We report on 48 patients with a mean postoperative follow-up of 7.7 years. 9 patients underwent simple anterior derotation spondylodesis (VDS), 31 patients were additionally fused with posterior Harrington spondylodesis. In 7 of 8 patients the Dwyer compression spondylodesis (DCS) was completed with the Harrington instrumentation. 2 of 3 scoliosis were idiopathic, the residual cases were mainly neuromuscular. The primary curve (preoperative mean: 69.9 degrees) was initially corrected by 62.8% and sustained a loss of correction of 7.6 degrees resp. 10.9% during long-term follow-up. The long-term loss of correction was maximal after DCS showing 10.4 degrees (14.4%), on the average, and minimal after combined VDS and Harrington spondylodesis showing 6.9 degrees (9.3%). After simple VDS the long-term progression of the curve was 7.0 degrees (12.9%). In this group the initial correction was above-average high showing 76.4%. The main loss of correction occurred during the first 2 years after surgery. The long-term correction stability did not show significant differences between simple VDS and combined antero-posterior instrumentation. After anterior instrumentation of the primary curve the secondary cranial nerve spontaneously straightened up by 30%, on the average, and remained stable in the long-term. The anterior instrumentation of the spine lead to a mean loss of lordosis of 13.6 degrees which in the long-term additionally increased by 6.4 degrees due to the anterior epiphyseodesis effect. In 17 patients (42.5%) 24 fractures of the 3 mm-threaded VDS-compression rod occurred. In case of single rod fractures no higher loss of correction or differences in incidence of pain were observed in comparison to intact implants.

Adolescent↗
PubMedDate not supplied

[The German Society of Orthopedics and Traumatology classification of bone defects in total hip endoprostheses revision operations].

PROBLEM: In revision alloarthroplasty the need for bone allografts increased. The documentation of the defects is not done routinely. METHOD: For better documentation the German Society for Orthopedics and Traumatology (DGOT) developed a new and practical defect classification system. It was tested clinically in the last 6 years. RESULTS: In the acetabulum and femoral shaft seven defect types were distinguished and presented in figures. For the acetabulum: 1 cavitary holes, 2-4 unisegmental, 5 bisegmental, 6 trisegmental, 7 pelvic instability. For the femur: 1 intramedullary 2 trochanter 3 calcar 4 med. shaft 5 lat. shaft 6 part. diaphysis 7 total diaphysis. CONCLUSION: With this classification system we could better compared different reconstruction approaches in endoprosthetic surgery.

Acetabulum↗
PubMedDate not supplied

[Congenital round talus].

The collective consists of 11 patients with a "ball and socket"-anomaly of the talus with a mean age of 13.7 years. All patients demonstrated typical symptoms of the FFU-syndrome with a leg length discrepancy of 4.3 cm (2-20). In 6 patients a close follow-up was done in the early development of the talus form. In the metacarpal region also synostosis of some bones were seen at a mean age of 4.8 years (3.2-5.9). No clinical complaints but a slight reduction of hind foot mobility could been registered. Ball and socket deformity can not been seen as congenital, but as a subsequent deformity after congenital fusions in the metatarsal bones.

Adolescent↗
PubMedDate not supplied

[Organization of a bone and tissue bank].

The regional bone bank offers a good foundation for covering the expanding clinical demands in tumor and revision surgery. Since 1980 the tissue bank of Münster consists of 32 cadaveric and 41 multi organ donors. In the guidelines of the tissue bank the responsibility, organisation form, donor selection, quality control, sterilisation, documentation and all questions of finances are fixed, in accordance to the American Association of Tissue Banks. A fixed staff will be helpful to offer a secure and not expensive donor tissue for the clinical demands.

Bone Transplantation↗
PubMedDate not supplied

[Joint destruction and infection in advanced age].

Because of degenerative joint diseases and the reduced resistance in older patients the correct diagnoses of joint-empyema is difficult. In 29 pat (> 60 y) the mean delay of diagnoses was 5.1 months. First location of the infection have been: urinary tract 12, pneumonia 6, skin infection 10, and decubitus 3. Risk factors have been diabetes 4, polyarthritis 3, gout 3 and tuberculosis 3. The species were: s. aureus 12, s. albus 2, streptococcus 2, diphtheroid 2, e.coli 2, pseudomonas 2, proteus 4, enterobacter 3 and salmonella 1. 8 patients demonstrated mixed infections. The high mortality (3 pat.) and the frequent general sepsis (5 pat.) underline the importance of a missed joint-empyema in the elderly.

Aged↗
PubMedDate not supplied

[Allograft transplantation in pelvic instability following prosthesis exchange].

The collective consists of 19 patients with 21 operations after multiple revision operations with complete pelvic instability. The reconstruction was done with tibia (11x) and femur allografts (6x). The bridging was reached by pressfit contact. The junction side was supplemented with autologous bone chips. The allografts were fixed with screws or plates. In all patients a good primary stability was achieved. Partial weight bearing was gained within 10.1 week and full weight bearing in 15.1 weeks. We notice one allograft fracture after 4 months and one infection after 3 months. The reoperation rate was 4. The clinical results are encouraging. No lytic lines were seen between the acetabulum cup implant and the allograft within 20.1 months time.

Acetabulum↗
PubMedDate not supplied

[Ultrasonographic measurement of leg length and leg length differences].

A new diagnostic method for measuring the leg length and the leg length difference by means of ultrasound is presented. A special device for holding and moving the ultrasound transducer was constructed. The measuring points on the hip, knee and upper ankle can be visualised by means of a 5- or 7.5-MHz linear scanner. The measuring device gives the distance of the points in cm so that the difference correspond to the length of the leg, femur and tibia. Tests conducted on corpes and clinical examples show that ultrasound in combination with our special device is an ideal method for determining the exact lengths of the leg. The ultrasound measuring of the leg length offers a reliable, non invasive and easily performed method. Because ultrasound is not limited by radiation hazards, our technique can be used for clinical screening.

Adolescent↗
PubMedDate not supplied

[Long-term results of Judet's cementless total endoprosthesis of the hip joint].

AIM: Control of the long term results of the Judet-TEP. METHODS: From 1980-1985 124 Pat. have been operated. The follow up was done in the same collective of 83 patients after 2-6 years and > 6 years. RESULTS: The intraoperative complications have been fractures of the femur (19.3%) and the trochanter major (3.6%) and luxation (1.9%). In the follow up time the clinical results declined. The patients complained increasing pain in the thigh (26.5%) and the groin (13.2%). Radiological loosening of the acetabulum occurred especially in the medio-caudal area (61.5%) and in the proximal femur (32.5%). Cranial movement of the cup (31.3%) and varus deviation in the femur (40.9%) predominated. 28 prostheses were revised. After 11 years the cumulative success rate was 55.1%. CONCLUSIONS: The long term results are disappointing.

Adult↗
PubMedDate not supplied

[The diagnostic value of wound secretion analysis].

Wound exudation is commonly produced by damaged tissue particles after surgery and by repairing mechanisms initiated by the body. The early postoperative analysis of normal visual, chemical and corpuscular composition of wound exudation reveals a characteristic distribution in normal wound healing. Typical changes in the visual aspect and the corpuscular distribution permit a sooner recognition of wound infection. Thus, instant special management becomes possible being frequently decisive for the final outcome. Our results show a positive correlation between the prolonged decrease of the white blood cell concentration in the wound exudation and established wound infection. The serum analysis of CRP and ESR does not show unequivocal changes. The visual and corpuscular analysis of wound exudation is an important contribution to early diagnostics of wound infection. By means of chemical analysis admixtures to wound exudation can be clearly identified, e.g. the presence of liquor is recognized by the determination of total wound exudation protein.

Blood Proteins↗
PubMedDate not supplied

Congenital ball-and-socket anomaly of the ankle.

We present the clinical and radiographic appearance of 11 patients with a ball-and-socket ankle joint with an average follow-up of 13.7 years. Ten patients demonstrated parallel symptoms of the femur-fibula-ulna syndrome (FFU) associated with a mean leg-length discrepancy of 4.3 cm (range, 2-20). In six patients, an annual follow-up of talar development was possible. Radiographically the patients showed an additional tarsal coalition at a mean age of 4.8 years (range, 3.2-5.9). This earlier fusion could be detected by an arthrographic examination. All patients had no clinical complaints except a slight reduction of hindfoot mobility. The ball-and-socket ankle joint is presumably not congenital itself but secondary to congenital conditions in the peritalar region.

Ankle Joint↗