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Biomedical subjects

E Euler

Publications and source records attributed to E Euler.

31 records · Page 2Linked to original sources
PubMed1992

[Pelvic girdle fractures--must they be stabilized?].

Osteosynthesis can only be successful in the pelvis if one has a biomechanical understanding of the physiological flux of force from the neck of the femur via the acetabular fossa to the sacroiliac joint. The sacroiliac ligaments have a particularly important support function here. For assessing stability and classifying the traumatic patterns it is helpful to use Pennal's classification, which takes the direction of the action of force into account. Three basic forms can be distinguished: anteroposterior compression, lateral compression and vertical avulsion. Depending on the extent of the traumatic pattern one can distinguish three subtypes. Type 1 is treated conservatively while types 2 and 3 require surgical treatment. The traumatic patterns and treatment techniques applied are described clearly and with good illustrations.

Biomechanical Phenomena↗
PubMed1991

[Traumatology in the elderly. Problems exemplified by femoral neck fractures].

The most frequent complications in response to a fracture of the femoral neck, a typical injury of the elderly, are necrosis of the head of femur and pseudoarthrosis of the femoral neck. Only the around dressed down fracture can be conveyed to conservative treatment. The classification of AO takes these problems into consideration. One possibility to preserve the femur head is by operative insertion of a dynamic hip screw (DHS). Specific problems of the diverse types of fracture and their surgical details are taken into special account.

Aged↗
PubMed1991

[Injuries of the pelvis and retroperitoneal organs].

About 50% of all patients with pelvic fractures present with associated injuries. Diagnostic and therapeutic guidelines follow the step-by-step regimen used in polytraumatized patients. Whereas lifesaving emergency operations are rarely necessary, most associated injuries are operated on after completion of the first diagnostic phase in order to preserve organ function. Injuries of the pancreaticoduodenal system and ruptures of the digestive tract are particularly difficult to diagnose. Stabilization of pelvic fractures will take place in the phase of delayed reconstruction, usually several days after the accident.

Abdominal Injuries↗
PubMed1990

Ewing's sarcoma of the hand: localization and treatment.

Ewing's sarcoma of the hand is rare. Only 20 cases of Ewing's sarcoma of the hand have been reported in the literature. Although Ewing's sarcoma of the hand is rare and highly malignant, modern combinations of treatment are possibly curative due to the tumors surgical accessibility and apparent restricted involvement of only tubular bone. This case study illustrates currently accepted combination therapy consisting of chemotherapy, radiation therapy, and surgical tumor reduction. In spite of the advances of adjuvant therapy, surgical removal of the tumor still remains the most effective treatment.

Adult↗
PubMed1990

[Arthrographic imaging of ganglions of the hand].

In the genesis of ganglions synovial herniation is discussed with an existence of a valve mechanism which prevents the synovial fluid from returning into the joint space. Arthrography of the wrist was performed in 34 patients with suspicion of ganglions on the dorsal and volar aspect of the wrist. By injection of contrast medium in 6 cases directly into the ganglion no connection with the carpal joint cavity was seen. On the contrary, wrist arthrography with examination of the midcarpal and radiocarpal joint showed regularly a communication by a torturous narrow duct between the midcarpal joint and the dorsal ganglion and the radiocarpal joint and the volar ganglion. Other pathologic findings were seen, like tears of the scapholunate ligament and of the triangular fibrocartilage. The consequences for surgical therapy and conclusions for the aetiology of the ganglions are shown.

Adolescent↗
PubMed1990

[Nerve compression syndromes of the elbow and hand].

The importance of nerve compression syndrome in the upper extremity for making a diagnosis or differential diagnosis in orthopedics, surgery, especially hand surgery, and neurology is evident. We review the characteristics of this entity, demonstrate the pathophysiological findings, and stress their importance on the diagnosis, therapy, indications for operation, and operative techniques in our patients. With special regard to the topographic anatomy each of these nerve compression syndromes of the elbow and the wrist region is demonstrated systematically and consequences are discussed for surgical therapy.

Carpal Tunnel Syndrome↗
PubMed1990

[Reconstructive surgery of malunited joint fractures of the hand].

Malunion of fractures, joint fractures and pseudoarthroses leads to therapy-resistant pain during function and loading, especially in the wrist, with a risk of early arthrosis. In spite of the extraordinary adaptability of the hand, malunion in the axis and rotation can lead, for example, to cross-finger malfunction. Because of the relatively thin layer of soft tissue, secondary operations to correct the axis, rotation and the length of the phalanx are possible. Each reoperation on the hand diminishes the blood flow, and the anatomical structures change with cicatrices. Thus, the risk of damaging blood vessels or nerves is increased. Operative correction of the position, arthroplasties, joint prostheses, arthrodeses, arthrolyses and denervation are all part of the operative repertoire. It is necessary to repair the joint surface as well as the capsule-ligament structures. Furthermore, we also express our opinion regarding the indications and contraindications of secondary operations. We discuss the risks and complications during operations and especially stress the aspect of having enough patient information. Finally, we describe the operative techniques in special cases. The necessity for reconstructive secondary operations is increasing as more and more replantations are being done and hand lesions in polytraumatized patients are being neglected. To date, not enough attention has been given to these problems in the scientific literature.

Arthrodesis↗
PubMed1989

Nonsuture microsurgical vessel anastomosis using an absorbable cuff.

The nonabsorbable cuff used for nonsuture anastomosis can cause residual vessel stenosis as well as regional wall rigidity. Resulting disturbances in laminar flow promote the development of irregularities in the intimal endothelial vessel lining distal to the anastomosis. Using absorbable cuffs, the degree of stenosis can be appreciably reduced, thereby diminishing thrombogenic flow turbulence. The absorbable cuff can thus facilitate clinical application of nonsuture microsurgical vessel anastomosis.

Anastomosis, Surgical↗
PubMed1989

Thermotoxicity of palacos cement. Clinical observation.

In total hip joint replacement with cemented prostheses, Palacos (polymethyl methacrylate, PMMA) involves a high perioperative risk for the patient, on account of the effects on both the systemic and the pulmonary circulation. Data were assembled retrospectively from the records of 203 patients who underwent hip joint operation with Palacos implantation in the Inner City Surgical Clinic and the Surgical Polyclinic of the University of Munich from 1982 to 1986. In the hemiarthroplasty series, hemiarthroplasty was performed in 61% of patients in risk group III, whereas in the risk groups I and II it was done in 31% of cases. The mortality following hemiarthroplasty was greater than that following implantation of total prostheses in risk groups I and II. In risk groups II and III the mortality was 17% with surgery on the day of injury, lower, at only 10%, when the operation was performed on the day after injury, and markedly higher, at 31% and 38%, respectively, when surgery was postponed to the 2nd or 3rd day. It has been shown in burn research that the prostanoid levels in the plasma of untreated animals show a typical curve with two peaks, the first on the day of the injury and the second on the 3rd day after injury. Our observations support the assumption that the effect of trauma and surgical treatment are complementary.

Aged↗
PubMed1989

[Changes and progress in surgical treatment of fractures of the pelvic ring and acetabulum].

The diagnosis and treatment of pelvic fractures and dislocations demand that the pelvic girdle and the acetabulum be examined separately. Fractures of the pelvic girdle are present in more than 60% of cases but have to be stabilized only in 9%, in contrast to acetabular fractures, which need to be reduced and internally fixated in 55%. Combined fractures need surgical management in 66% of cases. Fractures of the pelvic girdle are best diagnosed by means of plain radiograms and computed tomograms to distinguish posterior instability. These techniques are the basis of the treatment plan for external or internal fixation. External fixation is an effective method from the aspect of hemorrhage control but not sufficient to avoid postoperative pain. Early open reduction and internal anterior and posterior fixation is the treatment of choice if good rehabilitation is to be achieved. Acetabular fractures occur mostly in young patients. Only accurate articular reduction of displaced fractures can bring about a good functional result, as this minimizes posttraumatic arthritis. Radiological evaluation is done with three standard views: 1. A. P. X-ray of the pelvis; 2. oblique view of the obturator; 3. oblique view of the ilium. When those are considered in combination with a CT scan, acetabular fractures can be classified. The Letournel classification is extremely important for reduction and fixation, as no one surgical approach has been found that is satisfactory for all acetabular fractures. Internal stabilization is provided with single screws and plates.

Acetabulum↗
PubMed1989

[Skier's thumb].

Over a period of 9 years (1979-1988), more than 1000 patients have been seen in the Department of Hand Surgery with a tentative diagnosis of skier's thumb or a painful metacarpophalangeal of the thumb. Most injuries were treated conservatively, but 562 operations on the ulnar collateral ligament were done during this period. An X-ray Film was taken in all cases to exclude a fracture. The indications for an operation depend on the clinical symptoms. Swelling, pain just over the ulnar collateral ligament, and instability of the joint with a widening of the ulnar aspect of the joint of more than 30 degrees in comparison to the other hand are typical clinical symptoms, which together with the widening in the flexion position, prove a rupture of the collateral ligament. As part of our standard examination we take X-ray films of the hand in two projections to exclude a fracture, followed by abducted stress views in comparison to the other side. The best results were obtained when surgical therapy was performed within the first 8 days. Fractures of the base of the proximal phalanx of the thumb were operated on by pin wire fixation of the bone fragment in the anatomically correct position along with temporary transarticular pin wire arthrodesis. In ligamentous ruptures, periostal sutures together with a temporary arthrodesis were carried out. Old injuries without sufficient regeneration of the ligament and capsule necessitated plastic surgery using the long pulmar tendon or a PDS wire. In each case the joint was immobilized with a cast for 5-6 weeks, followed by active physiotherapy.

Adolescent↗
PubMed1987

Nonsuture microsurgical vessel anastomosis.

An alternative microsurgical method for achieving vessel union without applying sutures is presented. The basic principles of the technique involve the creation of an extraluminal cuff that permits exact adaptation of both endothelial layers, without intraluminal damage or application of foreign material. When used for microsurgical procedures, the method can be further simplified by using a Teflon cuff secured by means of a mini-clip. The anastomosis can be accomplished quickly, in an uncomplicated and precise fashion. On the basis of preliminary experiments, this method appears to offer a wide range of applications, particularly if absorbable material is used.

Anastomosis, Surgical↗