Biomedical subjects

D Rikli

Publications and source records attributed to D Rikli.

5 recordsLinked to original sources

PubMed2003

[Osteosynthesis of combined radius head and capitulum humeri fractures with mini-implants].

INTRODUCTION: Combined injuries of the capitellum humeri and the radial head are rare. Most of them show combined osteocartilaginous lesions and collateral ligament lesions. Recommendations for treatment of these fatal injuries of the elbow are missing. TYPE OF STUDY: Five cases were investigated in an retrospective analysis. The same approach was used for the osteocartilaginous lesion of the capitellum as well as the injury of the radial head. Internal fixation was done with mini-titanimplants, three of them combined with resorbable pins. PATIENTS AND METHODS: Between 1996-1999 five patients (four men, one woman) with combined injury of the radial head and the capitellum were stabilized. The average age was 34 years (31-40 years). All fractures were stabilized by a direct radial approach with 1.5 mm or 2.0 mm lag screws partly with resorbable pins. All patients were evaluated radiologically and clinically according to the Mayo-elbow-performance score. RESULTS: All patients were personally examined after an average period of 12.8 month (8-24 month) by an independent investigator. 4/5 patients were assessed for their satisfaction. No radiological signs of avascular necrosis of the capitellum or arthrosis were found. Three patients showed periarticular calcifications. The range of motion was averagely 124 degrees (extension 5-30 degrees, flexion 110-145 degrees), in three of five cases a secondary intervention for improvement of joint mobility was necessary. The Mayo-elbow-performance score rated for 85 points in average (range 70-100 points). CONCLUSION: Direct screw fixation with mini-implants, eventually combined with resorbable pins allows to use the same approach for anatomic reconstruction and fixation of the capitellum humeri and radial head. Transarticular fragment fixation of the capitellum allows for safe compression. Therefore early functional rehabilitation is possible postoperatively. Secondary interventions for improve joint motion were necessary in three of five cases.

Absorbable Implants↗

PubMed2000

[Intramedullary nailing of humeral shaft fractures--initial experiences with an unreamed humerus nail]].

Interlocking intramedullary nailing has become the preferred method of internal fixation for diaphyseal fractures of the lower extremity. In shaft fractures of the humerus however open reduction and internal fixation with plates and screws is still considered the gold standard for operative treatment. The unreamed humerus nail (UHN) is a new implant for interlocking intramedullary nailing, which allows for stable fixation of humerus shaft fractures and immediate functional after treatment. The UHN could thus become an equal alternative to plate osteosynthesis. From this point of view we analyzed retrospectively 19 shaft fractures of the humerus, which have been treated at our institution with an UHN. Infections and iatrogenic nerve lesions did not occur. One patient with a rotational malalignment of 45 degrees underwent a secondary procedure. In two out of ten fresh fractures the bone healing failed and resulted in a non-union. In all cases of pathological fractures a good palliation could be achieved. With exception of two patients the range of motion of the shoulder and elbow was symmetric. We conclude that the UHN is a real alternative to plate osteosynthesis. Compared with most series of plate osteosynthesis published in the literature the risk for iatrogenic lesions of the radial nerve appears to be lower. Even in this small series we found however a rather high rate of non-unions.

Adult↗

PubMed1999

[Distal radius fractures].

Fractures of the distal end of the radius are the most common fractures in humans. The variants of type of fracture and associated injuries are numerous, depending on the mechanism of injury, the amount of energy absorbed and the quality of the bone. Treatment concepts evolve as our understanding of the physiopathology of this heterogeneous group of injuries increases. It is now commonly accepted that extraarticular anatomy and joint congruency, as well as ligamentous integrity, should be restored to obtain a good functional result. This paper provides an overview of current knowledge and discusses possible future trends.

External Fixators↗

PubMed1995

The unstable shoulder girdle: early functional treatment utilizing open reduction and internal fixation.

The unstable shoulder girdle--a combination of a scapular neck fracture with a clavicular fracture, acromioclavicular dislocation, or sternoclavicular dislocation--represents a rare and often underestimated injury. Sufficient treatment to permit early function is necessary to avoid a frozen shoulder as well as to treat concomitant thoracic injuries. This is possible only by open reduction and internal fixation. In most cases this can be achieved by a sole osteosynthesis of the clavicular injury. We retrospectively analyzed 12 cases and classified the results according to the Constant Score. This analysis showed excellent functional results in nearly all cases.

Acromioclavicular Joint↗

PubMed1987

The coronal suture, a useful bony landmark in neurosurgery? Craniocerebral topography between bony landmarks on the skull and the brain.

In the present study the variation of the localisation and the course of the coronal suture (CS) was examined on the lateral skull X-ray. The study shows a variation of the localisation and course of the CS from the average position within +/- 4 mm in 65-77% and extreme differences between minimum and maximum values between 16 and 21 mm. The CS has also a considerable variation in its localisation relative to the precentral gyrus. Additionally the craniocerebral relationships and the localisation of the precentral gyrus and pyramidal tract are altered by the lesion or the space occupying process itself. A more exact localisation of the precentral gyrus, respectively the pyramidal tract can be obtained with CT and intraoperative cortical stimulation of the motor strip.

Brain↗