Biomedical subjects
Publications and source records attributed to D Träger.
Two-dimensional spatial solitonic lattices are generated and investigated experimentally and numerically in a Sr(x)Ba(1-x)Nb(2)O(6):Ce crystal. An enhanced stability of these lattices is achieved by exploiting the anisotropy of coherent soliton interaction, in particular the relative phase between soliton rows. The manipulation of individual soliton channels is achieved by the use of supplementary control beams.
In this retrospective study we analyse the results of primary anterior cruciate ligament (ACL) sutures, primary ACL plasties and secondary ACL plasties 5 years after operation. All operations were performed with an additional PDS augmentation. Follow-ups of 100 of 130 patients could be done (80 male and 20 female). The average age at time of operation was 29.2 years. ACL rupture in 81 patients occurred due to a sport accident. In 26 patients a primary ACL suture was performed, in 59 patients a primary ACL plasty and in 15 patients an ACL plasty due to instability. There was no difference between the primary and secondary plasty groups, but there was between the suture and the plasty groups. In all, 92% of the suture group and 69% of the plasty group were satisfied with the surgical results. The pivot shift, Lachman and anterior drawer sign were less frequent in the ACL suture group, and the Lysholm score was higher. Primary suture combined with a PDS augmentation seems to represent an adequate treatment of acute proximal ACL ruptures.
5-9 years follow-up results following 26 out of 37 operated injuries of the ligaments of the knee are reported. While 18 patients described the result of the operation as very good and good, the objective findings presented only 5 stable knees.
Analysis of 100 consecutive arthroscopies in patients with traumatic hemarthrosis of the knee joint demonstrates the importance of arthroscopy in diagnosis and therapy. In 48 cases injuries of the anterior cruciate ligament, isolated and in combination with lesions of other structures, were found. In 47 cases an operation was necessary. In 21 cases the reason for the hemarthrosis was luxation of the patella, in 6 cases with a flake fracture. Isolated lesions of one of the menisci were found in 11 cases and treated arthroscopically in all cases (2 meniscopexies, 1 total meniscectomy , 8 partial meniscectomies). Only in 8 cases unimportant injuries or lesions were found to have caused the hemarthrosis.
From June 1976 to June 1981, 71 isoelastic total hip endoprostheses were implanted. In a 5-to 7-year follow-up study, all but one of the hips that had been operated upon could be evaluated. In 10 cases reoperation was performed because of loosening of the stem (3 infections, 7 aseptic loosenings). In the remaining 51 endoprostheses in 45 patients, 2 were described as in poor shape. In 3 cases, an X-ray film demonstrated potential loosening of the stem. Because there is a 9.8% loosening rate of the stem, the indication for implantation has been restricted. We had no problems at all with the RM acetabular components.
Ender-nailing is a proved method in the treatment of sub- and pertrochanteric fractures in old people. In special cases Ender-nailing can be useful in the treatment of other types of fractures. 3 cases of Ender-nailing of femoral shaft fractures in childhood are reported.
This is a report on findings of an ulna defect in a small girl, due to a haematogenous infection in her right arm, which was successfully treated and healed with a bone graft using a portion of the 6th rib. The last x-ray examination, three years after the operation, showed a definite consolidation of the rib ulna transplantation and clinically good mobility of the elbow joint and underarm.
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Since June 1979 we implant the RM isoelastic total hip endoprosthesis in younger patients (average age 53 years). Up to now 391 endoprostheses have been implanted. A follow-up examination of 60 operated hips in 55 patients 3 and 4 years after the implantation of the endoprosthesis was possible. In 46 hips there was no pain at all, in 12 hips a light or medium pain and in 2 hips a severe pain. 35 hips showed a range of motion of more than 90 degrees and between 30 degrees and 90 degrees. All patients were able to walk, 37 patients more than 1 hour. The patients declared the results of the operation in 50 hips to be very good or good, in 4 hips to be fair and in 6 hips to be poor. 5 times a potential loosening of the stem could be found.
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17 patients with chronic fibular instability of the ankle had been operated on using autologous corium for reconstruction. Follow up examinations on an average of 1 year are reported; advantages and disadvantages of the operation technique are described.
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It is reported about follow-up examinations in 26 patients with chronic fibular instability of the ankle, who had been operated on using the Watson-Jones and Evans technique. 19 Patients described the results as excellent or good, 7 patients as fair, 22 patients would agree to undergo an operation in the same technique again.
It is reported of 77 patients with fractures of the proximal femur who have been treated with internal fixation using Ender-nails. The average age was 76 years. The mortality rate was 16.9%, the infection rate 2.6%. In 79.2% there were no complications at all. The average hospitalisation period was 35 days. After an average period of 2 1/2 years a follow-up study was possible (24 patients). In 62.5% there was no pain, in 25% patients had light pain in the knee and in 8.3% they felt light pain in the hip. An important disturbance of movements in hip or knee was never to be seen. Only one patient was not able to walk. 58.3% walked without help, 37.5% with the help of a walking stick. In 54.2% there was a rotation failure of the femur, in 25% more than 20 degrees.
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The risks associated with blood transfusion can be minimized using autologous blood. The efficiency of preoperative blood deposit, preoperative acute-hemodilution spinal anesthesia, controlled hypotension and intra and postoperative autotransfusion in reducing homologous transfusion has been demonstrated. In a prospective study the effectivity of this concept is demonstrated. 141 patients scheduled for total hip arthroplasty were divided in three groups: group I--total hip arthroplasty without cement (n = 55); group II--total hip arthroplasty with cement (n = 52); and group III total hip revision arthroplasty (n = 34). The mean quantity of the donated blood was 900 mL. The donation was not associated with serious complications. In group I 52 patients (94.5%), in group II 40 patients (77%) and in group III 14 patients (41.2%) did not require homologous transfusion. The difference between group I and II was significant (p < 0.05). Under the conditions studied, preoperative autologous blood deposit, acute hemodilution, spinal anesthesia and controlled hypotension are effective for decreasing the application of homologous transfusions in hip arthroplasty. The efficiency of preoperative hemodilution alone is limited. Preoperative deposit of autologous blood is a simple, effective, economical, and low-risk method of reducing homologous transfusion. Autotransfusion with a cell separator can save approximately 50% of the erythrocytes lost during revision total hip arthroplasty.
A case of the rare Freeman-Sheldon Syndrome combined with a high luxation of the left hip is reported. The importance of differential diagnosis to arthrogryposis multiplex congenita is explained.