Biomedical subjects

F Draijer

Publications and source records attributed to F Draijer.

7 recordsLinked to original sources

PubMed1998

[Pelvic ring injuries].

PURPOSE: Analysis of the trauma patient of fractures of the pelvic ring and classification according to AO/Tile. METHODS: 125 unselected patients (43 females, 82 males) were evaluated retrospectively by conventional x-ray, and CT examinations included follow-studies. RESULTS: Type-A fractures were seen in 36 (29%), Type-B fractures in 58 (46%), and Type-C fractures in 31 (25%) cases. Type-B and Type-C fractures mainly occurred in patients with traffic accidents and falls from great height. Type-A fractures were seen most often in patients with accidents at home or at work. However, in patients with complex fractures a classification concerning Type-B or Type-C fractures was difficult. SUMMARY: Based on CT criterias, in most patients a statement concerning the applied forces, the stability of the pelvic rim and the fracture type can be made.

Fractures, Bone↗

PubMed1997

Quality of life after pelvic ring injuries: follow-up results of a prospective study.

A follow-up after 2 years on average could be done in 43 cases of pelvic ring injuries. Seven were type A, 8 type B and 28 type C lesions. Every type A lesion was treated non-operatively. External fixation and non-operative management were used with type B injuries. As well as non-operative treatment, both internal and external surgical techniques were employed for type C fractures. While group A hardly mentioned pain in the follow-up, groups B and C suffered dorsal pelvic pain of comparable intensity irrespective of the therapeutic measures taken. Anatomic reduction does not guarantee freedom from pain. We also rated hip joint flexibility and ability to walk according to the Merle D'Aubigné score. Because of their pelvic injuries 50% of the type C patients changed their profession. The sequelae of the accident on sports and leisure time activities will be considered as well as the subjective contentment evaluated. Unstable and dislocated pelvic ring injuries permanently interfere to a high degree with the quality of life. It is remarkable that many of the traumatic lesions which interfere with the quality of life are caused by the traumatic violence itself and cannot be influenced by the manner of surgical stabilization.

Adolescent↗

PubMed1995

[Results of follow-up of conservatively and surgically treated injuries of the pelvic ring within the scope of a prospective study].

Follow-up was possible after an average of 23.4 months in 26 cases of pelvic ring injury. These were made up of 7 type A, 8 type B, and 11 type C injuries. Every type A lesion was treated conservatively. External fixation and conservative management were used with type B injuries. Besides conservative treatment both internal and external surgical procedures were applied for correction of type C fractures. While patients treated for type A injuries reported hardly any pain at follow-up, those with types B and C reported dorsal pelvic ring pain of comparable intensity regardless of the treatment given. All patients with a poor outcome following unstable pelvic ring injuries reported dorsal pelvic pain as a principal symptom. Radiological evaluation revealed that the greater the dorsal displacement the more acute the dorsal pain must be expected. An anatomical reduction does not guarantee freedom from pain, however. Besides pain we also rated hip joint flexibility and ability to walk according to the Merle D'Aubigné score. Trauma-related damage and postoperative injuries were distinguished in the neurological evaluation showing a high incidence of lesions of the lateral cutaneous nerve of the thigh following external pelvic fixation. Because of their pelvic injuries 6 patients (23%) were completely or partly disabled and thus unfit for work. The follow-up examinations showed good results in 20 (76%) of the cases. While type B pelvic ring injuries can heal completely when treated by means of a supra-acetabular pelvic fixator, reliable retention cannot be achieved in the case of type C lesions.

Adult↗

PubMed1995

[Injury analysis of pediatric talus fractures].

Fractures of the talus are very rare in children. The present paper analyzes the treatment and long-term follow-up of 11 talus fractures in children over a period of 20 years (1974-1994). There were 5 fractures of the talus neck, 3 flake fractures, 1 depressed fracture of the talus head, and 2 lesions at the trochlea of the talus. Two fractures not previously described in the literature are presented. Treatment was conservative in all nondisplaced fractures. The displaced lesions were treated by compression screws and K-wire fixation of articular surface fractures. In 9 of the 11 fractures healing with good functional results, though arthrosis of the talocalcanean joint was present in 6 and partial necrosis of the talus, in 2. There is no difference between children and adults in the diagnosis and selection for operative treatment.

Adolescent↗

PubMed1994

[Functional treatment of surgically treated empyema of the knee joint].

Knee-joint empyema requires prompt surgical management. After debridement the joint needs to be irrigated for several days. Functional follow-up treatment with electromotive splints according to the CPM concept should begin soon after surgery. Follow-up examination of patients treated in this way for knee-joint empyema showed a protracted course with worse results for empyemas subsequent to arthrotomy, while joint infections after less severe injuries (skin lesions, puncture) healed successfully.

Adolescent↗

PubMed1993

[Pelvic fractures in the Kiel trauma surgery clinic. A one-year evaluation].

48 injuries to the pelvis were treated from January 1991 through December 1991. We found 45 fractures of the pelvic ring with associated acetabular fractures in 15 cases and three isolated acetabular lesions. 19 injuries were caused by car accidents, 18 fractures resulted from a fall, especially in older patients. Isolated fractures of the pelvis occurred in 18 cases. The average total severity of the injuries was 19.7 points according to the Hannover Polytrauma Score (PTS). Every fracture was classified using the Tile-classification. There were 15 (33%) Tile A lesions, 18 (40%) Tile B fractures and twelve (27%) type C pelvic ring injuries. In 18 cases surgery was the method of treatment. Seven out of 18 injuries to the acetabulum were treated with open reduction and internal fixation. In ten patients the unstable pelvic ring was fixed by means of an external fixator. To do so, a pair of 6 mm diameter pins were placed on both sides in the supraacetabular region of the iliac bone directed towards the sacroiliac joints. We used a triangular form of external fixation. An open reduction and internal fixation (ORIF) was necessary in five cases, one injury required a combination of external and internal procedures. There were 14 cases in which we found sacral fractures as an additional dorsal lesion. Nine of 14 sacral fractures were recognized only by CT examination. In eleven cases the conventional radiographs showed simple anterior pelvic ring fractures while the CT examination revealed an additional lesion of the sacroiliac joint in nine of these cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetabulum↗

PubMed1992

[Stabilizing the pelvic ring with the external fixator. Biomechanical studies and clinical experiences].

Experimental studies were performed on anatomic pelvis specimens. In different series of experiments the positioning of the screws and the assembly of the external fixator were changed. We tried fixing the external fixator to the screws at varying distances from the body surface. For stabilisation of the fractured pelvic girdle a self-constructed "bow fixator", fixed to supra-acetabular screws with proximal compression and distal traction showed the best results. Homogeneous distribution of the pressure could be achieved on the unstable dorsal pelvic ring structures. In clinical routine we used the triangular external fixator, which in the experimental situation yielded results close to those of the bow fixator. External fixation of the pelvic girdle has been performed 128 times since 1977, in January 1991 a prospective study was started. For Tile type B injuries the external fixator itself represents an effective, minimally invasive system, but type C fractures often require an additional internal fixation of the dorsal lesion.

Acetabulum↗