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E Wallenböck

Publications and source records attributed to E Wallenböck.

16 recordsLinked to original sources
PubMed1998

[Stress fractures of the lower leg and foot].

Stress fractures are caused by overstrain. Depending on their etiology, stress fractures may be categorized as insufficiency or fatigue fractures. A fatigue fracture occurs when repeated axial or rotational force is applied to the bone. In contrast, an insufficiency fracture is observed in bones with altered biomechanical characteristics. In a mixed patient population drawn from the Military Hospital Graz and the Unfallkrankenhaus (Traumatological Hospital) Graz, we were able to corroborate these etiologies. At the former institution, all 21 recruits (mean age, 20.5 years) had fractures of the fatigue type. In the population at the Traumatological Hospital--16 patients with a higher average age of 43.5 years--insufficiency fractures predominated. Diagnosis and differential diagnosis proved difficult in both groups, since plain radiography does not demonstrate the fracture for 2-3 weeks after the occurrence. All stress fractures were treated conservatively. Approximately two thirds of all stress fractures occur in the lower extremities. The main age group at risk is unknown. A sudden change in the activity or training regimen or a change in biomechanics can cause a stress fracture. The absence of individual risk factors makes it difficult to prevent stress fractures.

Adult↗
PubMed1997

Resection of the radial head: an alternative to use of a prosthesis?

Prosthetic substitution of the head of the radius after comminuted fractures has not yielded satisfactory long-term results. For this reason, resection of the radial head is to be preferred in many cases. In the period from 1971 through 1985, 23 resection of the radial head were performed. After a follow-up interval of 17 years, on average, we did a personal reexamination of all patients. Using the Morrey score, we obtained 18 very good, 4 good, and 5 satisfactory results, but not a single poor outcome. On the basis of reports in the literature and our own results, we recommend resection of the radial head, especially in cases in which stable osteosynthesis cannot be achieved, as long as there are no better long-term results of prosthetic substitution of the radial head.

Adolescent↗
PubMed1997

[A break or bend in the unreamed tibial intramedullary nail. Experimental study].

The intramedullary tibial nail with a proximal angle according to Herzog was developed in order to facilitate implantation. However, the modified technique of unreamed nailing also required a shift of the point of insertion; as a consequence the proximal angle required a considerable increase in the force necessary to introduce the nail. In a study using-four cadaver bones and five commercially available unreamed femoral and tibial nails, the authors demonstrate this considerable increase in insertion force and the development of pressure in the medullary cavity. The measurements made with our experimental setup clearly show that the proximal angle of the unreamed tibial nails available for our series does not have a favourable influence on insertion behaviour. As it appears, it results in an increase in the force required for insertion of the nail, thus also causing a greater strain on the bone and an increase in pressure in the medullary cavity. In contrast, the continuous bend of the nail results in a much smoother course of pressure development in the medullary cavity, which does not reach the same high values as with the unreamed tibial nails, despite the fact that less time is required for insertion of the nail. In our opinion, modification of the axial shape of the nail would result both in better implantability and easier removal. We therefore advocate such a modification of the axial shape of intramedullary tibia nails.

Biomechanical Phenomena↗
PubMed1996

[Solitary calcaneal cyst].

Differential diagnosis of solitary calcaneal cysts extends from benign cysts to malignant tumours. In all, 10-50% of these cysts are located at the centre of the calcaneal body in the form of intraosseous lipomas. Among our patients treated over a period of more than 20 years, there were four who underwent surgery for calcaneal cysts; the respective histological findings showed three lipomas and one tuberculoma. The average age of these patients corresponded to that of Milgram's study. It should also be remarked that all four patients came from a region in which mining was of central economic importance. Our experience has shown that such cysts should be surgically removed and filled with plastic spongiosa material in order both to check whether the cysts are benign or malignant and to avoid an imminent spontaneous fracture of the heel bone.

Adolescent↗
PubMed1995

Stress in the Achilles tendon during a topple-over movement in the ankle joint.

The achilles tendon is one of the strongest tendons in the human body, and a healthy tendon will only rupture under very severe conditions. Experiments and statistics show a high probability of tendon rupture in the case of a person trying to make a quick start and thereby toppling over in the ankle joint. Toppling over means a quick overturning in the lower ankle joint as it may occur when starting out of the sagittal plane. Based on a verified model of the achilles tendon, of M. Gastrocnemius and M. Soleus (Hatze, H. (1980) IEEE Trans. Automatic Control 25, 375-385; Hoy et al. (1990) J. Biomechanics 23, 1185-1198.), the stress in different tendon fibres during such a movement is investigated. The results of this simulation show that the expected extreme stresses in the lateral tendon fibres are a possible starting point for a rupture.

Achilles Tendon↗
PubMed1995

[Experiences with using the soft cast in injuries of the fibular ligament of the upper ankle joint].

From June 1993 until October 1994, 75 persons with recent ruptures in the region of the fibular ligament at the ankle joint were treated with a Softcast at our hospital. The patients were divided into a surgical and a conservative group: 33 patients were operated on and 42 were treated conservatively; 49 persons were male, 26 female. Both groups were initially treated with a conventional cast, and after the first week a Softcast was used. Surgery was performed whenever X-ray examination showed a difference of more than 10 degrees in supinatory subluxation between the unstable ankle and the intact one or anterior instability of more than 10 mm. In 55 of these patients follow up by clinical and X-ray examination was possible after an average period of 14.5 months after trauma and treatment. For the clinical follow-up the 100-point Pförringer-Stolz score was used (6), and the X-ray examination was performed under constant conditions by means of these standardized conditions, excellent and good results were achieved in more than 95% of the patients. The authors recommend the semi-rigid immobilization with Softcast in both operatively and conservatively treated patients with ruptures of the lateral ankle ligaments.

Adult↗
PubMed1995

[Initial experiences with hip joint arthroscopy. Report based on 2 cases].

In order to put the value of hip joint arthroscopy into correct perspective we report that among over 500 operations undertaken in the hip region annually-cases of readjustment osteotomy, osteosynthetic and prosthetic surgery-at the Graz Hospital for Accident Surgery there is about one case of hip joint osteotomy. Arthroscopy of the hip joint is a technically sophisticated examination which is only performed for the strictest indications. After reviewing data from the relevant literature we present two cases and discuss the indications for and technique of this operation.

Adult↗
PubMed1994

[Experiences with internal fixation of isolated fractures of the head of the radius].

The advantages of internal fixation of fractures, with the possibility of immediate resumption of the function of the fractured bone, are in contrast to the well-known complications described in the literature. These complications and our own unsatisfactory results after surgical treatment of fractures of the head of the radius induced us to carry out a randomized prospective study of primary functional treatment of such fractures without external or internal stabilization. From December 1991 through December 1992, a total of 70 patients were treated according to a strict treatment protocol at the Graz Hospital for Accident Surgery, and CT was used for observation of the healing process. The positive early results, which in 91% of all cases were classified as very good or good, the lack of complications that sometimes follow surgical treatment, the markedly earlier recovery of the patient's working capacity, and the clearly shorter--albeit somewhat more expensive--treatment period required have led us to continue using this method at our hospital and also to recommend its use elsewhere.

Adult↗
PubMed1994

[Prosthesis of the head of the radius in long-term follow-up--vitallium versus silastic].

At the Graz Hospital for Accident Surgery, seven Vitallium prostheses were implanted in the period from 1964 to 1968, and nine Silastic prostheses in the period from 1984 to 1991. In January 1993 we were able to do control examinations in eleven patients. Five of them with fractures of type B2.3, five of B3.3 and one of C3.3 according to the AO-Classification. Secondary treatment was done in four patients by prosthetic substitution. All patients had to wear a cast postoperatively for two to eight weeks. Our results--like those already described in relevant literature--clearly confirm the markedly poorere outcome of secondary treatment by prosthetic substitution of the head of the radius. On the basis of our results we therefore recommend in all cases where resection seems to be unavoidable to perform primary atraumatic resection with complete removal of all bone splinters and subsequent prosthetic substitution of the head of radius, if it is not possible to an osteoynthetic operation without immobilisation. We did not find any correlation to the classivication of the fracture types.

Adult↗
PubMed1994

[Is there a surgical indication for fracture of the os naviculare pedis?].

In the period from 1986 through 1991 121 patients with injuries of the os naviculare pedis were treated at the Graz Hospital for Accident Surgery. The paper describes our experiences with the diagnosis and surgical management of such lesions. Only 7% of all fractures received surgical treatment. In the overwhelming majority of these cases drill wire osteosynthesis with subsequent plaster cast immobilization proved to be the method of choice, splintered fractures with a tendency to shortening of the limb had to be treated by spongiosa osteoplasty. Follow-up examinations (on average 42.6 weeks after primary management) using the score according to Gainor et al. showed very good and good results in 7 cases and only one negative result. Rotational X-ray examination is indispensable for establishing the diagnosis. Whenever possible, the exact extent of the injury should also be determined by CT.

Adult↗
PubMed1994

[Follow-up results of complications in tibial intramedullary and interlocking nailing].

Faults in the technique of tibial nail locking and possibilities of complications thereafter are numerous, showing that this procedure is also not foolproof. On the basis of the results of follow-up examinations carried out in 42 cases with perioperative and postoperative complications out of a total of 229 patients on whom tibia nail locking was performed in the period from 1987 through 1992, we were able to state that in the learning curve for the initial period the overall rate of complications amounted to as much as 25.5%. After we-like other authors--made routine use of the method of static nail locking the overall rate of complications dropped to 5.6%. Although we cannot confirm an increase in the occurrence of the compartment syndrome on account of static nail locking, we deem it advisable to point to the possibility of this postoperative complications, as well as to the chance of avoiding incomplete healing by early decompression.

Adolescent↗
PubMed1993

[Late results of surgical treatment of chronic anterolateral instability of the proximal ankle joint].

In the literature more than 30 methods of syndesmoplastic surgery are described for the treatment of chronic ligament instability in the ankle. The aim of our investigation was, on the basis of long-term results, to determine which surgical method has the least complications, which offers the best chances from the viewpoint of exercise and sports, and whether degenerative changes in the joint can be avoided by restitution of stability. By means of isokinetic testing with 36 patients we were able to determine differences in the long-term results of various surgical methods, viz. syndesmoplasty using the peroneus brevis muscle as modified by Evans and Watson/Jones, respectively, and periosteal syndesmoplasty. In the period from 1980 through 1990, at the Graz Hospital for Trauma Surgery we performed 77 syndesmoplastic operations on 75 patients suffering from chronic ligament instability in the ankle joint. Of these cases, 45 were followed up for 6-136 months after the operation. On the basis of the results of these postoperative examinations we recommend periosteal syndesmoplasty for management of chronic ligament instability in the ankle, as this method is relatively easy to perform, prevents post-traumatic arthrosis, ensures maximum stability, which consequently means a low complication rate, and shows favorable final results in isokinetic testing.

Ankle Injuries↗
PubMed1993

[Rupture of the patellar ligament--a late complication after removal of a bone-tendon-bone transplant as cruciate ligament replacement].

Ruptures of the patellar ligament have been observed in surgery for complete substitution of the knee joint and with application of the operation method according to Roux and Goldwilde; ruptures of this ligament after removal of a graft cruciate ligament substitution have been described very rarely. Since 1990 we have been practicing the method of autologous substitution of the cruciate ligament by using material from the median part of the patellar ligament. In one patient treated by this method who had displayed no complications during 10 months after the operation a new adequate trauma resulted in rupture of the patellar ligament at its tibial insertion. As far as we can assess on the basis of available technical literature, such injury might be due to problems of paraligamentary blood supply, partial or complete resection of the infrapatellar fatty tissue additionally contributing to lasting vascular damage.

Adult↗
PubMed1993

[Tarsal tunnel syndrome after non-dislocated fracture of the outer ankle joint (case report with review of the literature)].

The authors are going to report on the case of a 32-year-old female patient suffering from a non-dislocated external ankle fracture which was submitted to conservative treatment. This treatment was complicated by the occurrence of a tarsal tunnel syndrome which required surgical revision. The cause of this complication may be seen in the development of a minor local hematoma in the course of the tibial nerve as well as in a convolution of varicose veins located in the region of the internal ankle. By describing this case the authors wish to point out that development of a tarsal tunnel syndrome may not only be due to ankle fractures treated by osteosynthetic management (as described in relevant literature) but also to relatively uncomplicated and almost non-dislocated external ankle fractures receiving conservative management.

Adult↗
PubMed1992

[Complications after surgical management of radial head fractures].

As surgical management of fractures of the head of the radius unfortunately does not always yield satisfactory results, we performed a detailed study of these complications with special regard to several criteria. Over a period of five years, 44 cases of fractures of the head of the radius received surgical treatment at the Graz Hospital for Accident Surgery. Correlating with the literature known to us we found a relatively high rate of complications (17 of 44 cases, nine of the 17 cases required reoperation). If, however, we consider cases with a loss of mobility of up to 30 degrees in bending and stretching and rotation of the forearm still as satisfactory, of our 44 patients who were operated on for fractures of the head of the radius 37 showed satisfactory results and only seven poor ones.

Adult↗