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Biomedical subjects

F Grill

Publications and source records attributed to F Grill.

At least 37 records · Page 2Linked to original sources
PubMed2000

Free vascular fibular transfer in congenital pseudoarthrosis of the tibia: results of the EPOS multicenter study. European Paediatric Orthopaedic Society (EPOS).

This paper presents a review of the literature, describes the principal author's (B.R.) personal experience and provides the results of the European Paediatric Orthopaedic Society (EPOS) multicenter study. The objective is to evaluate the present status and future role of free vascular fibular transfer in treating congenital pseudoarthrosis of the tibia. Variables such as the selection of cases, age at operation, technical surgical details and postoperative results will be considered. The data on the EPOS study were incomplete at the time of writing, but the considerable amount of information already amassed is a valuable contribution to this updated report.

Child↗
PubMed2000

Functional results at the end of skeletal growth in 30 patients affected by congenital pseudoarthrosis of the tibia.

From a multicentric study on Congenital Pseudoarthrosis of the tibia (CPT) conducted on 340 patients, we evaluated the functional results on a group of thirty patients who were at the end of skeletal growth (age < or = 16 years). The prognosis of CPT is very much related to the radiologic classification. Crawford type 2 and Crawford type 4 pseudoarthrosis have a worse prognosis, with a lower percentage of fusion at the site of pseudoarthrosis. Crawford 4 patients have the worst functional results. Most of them showed a severe leg length discrepancy, needed a permanent brace, with an ankle joint function fair or poor. The presence of fibula pseudoarthrosis seems to be responsible for most of the worst functional results. The level of deformity caused by either the natural course of the disease or its treatment, is decisive in the evaluation of the functional results.

Adolescent↗
PubMed1999

[Polydactyly of the foot].

Polydactyly may be preaxial or tibial (hallux-side), postaxial or ulnar (side of the little toe) and central (middle toes). The duplication may appear at the distal and medial phalanges or at the whole digit. The metatarsal bone may be part wise or completely duplicated, the accessory toes may share only one metatarsal. Surgical intervention may be indicated in shoe problems, for esthetic reasons or, especially in duplication of the metatarsales, because of secondary deviation of the toes and therefore shoe problems or plantar callosities. Preoperative analysis including x-ray is of great importance to achieve good functional and cosmetic results.

Adolescent↗
PubMed1999

[The childhood ankle joint. Deformities, abnormalities and clinical variations].

The ankle joint unites high functionality with high load on a small surface. Congenital as well as acquired variations lead to a derangement of the complex concerted action of tendons, ligaments and joints. This causes dysfunction and the development of typical deformities. It is necessary to discriminate physiological variants, congenital, posttraumatic and tumoral variations for the differential diagnosis. In most instances this is only possible with the aid of radiological clarification. Congenital malformations in the region of the upper and lower ankle joint are generally rare. One disease is club foot, with malposition and deformity in the upper and lower ankle joint. Extreme malposition can also be found in talus verticalis and congenital hypoplasias and aplasias of fibula and tibia. A rather frequently found disease, which first occurs in the adolescence, is osteochondrosis dissecans.

Adolescent↗
PubMed1999

[Cogenital femoral defect. Indication, therapy and complication management].

Congenital femoral deficiencies remain a surgical challenge. There is no common classification: both radiological and clinical methods are recommended. Depending on the severity of the deformity, reconstructive and lengthening techniques are performed, while accompanying deformations are taken into consideration. In addition, amputation or fusion techniques together with orthotic devices are used. A total of 35 patients (37 extremities) with congenital femoral deficiencies have been treated at the Orthopaedic Hospital Vienna-Speising, from 1982 to 1998. 24 extremities were treated with reconstructive and/or lengthening techniques. Results and complications are reported.

Amputation, Surgical↗
PubMed1998

[Patellar luxation].

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Congenital Abnormalities↗
PubMed1997

[Results of hip ultrasonographic screening in Austria].

The role of hip sonography in neonatal hip screening is still a controversial matter. This paper reports the results of the Austrian ultrasound hip screening program, in which all Austrian babies undergo hip sonography twice: at the birth clinic during the 1st week of life and at an age of 12-16 weeks. Data from all public health insurance companies since 1985 and all ICD data about children hospitalized because of CDH in Austria were collected and analyzed. The rate of sonographically pathological hips was 6.57% (1994). The treatment rate before introduction of hip sonography was 13.16% (1985). The rate of open reduction went down to 0.24 per 1000 newborns, including a high number of unscreened children born abroad and also children with teratological dislocation of the hip. Hip sonography screening proved to be effective in detecting true instability of the hip joint as well as dysplasia. The optimal time for sonographic screening does not seem to be immediately after birth when only "high risk" hips (clinical instability, positive family history, breech delivery) should undergo hip sonography, but at an age between 4 and 6 weeks when the hip has already shown its true nature. Since one sonographic scan appears to be sufficient for screening, a further reduction of costs could be accomplished. Disability owing to DDH can be avoided in a number of cases, and costs for conservative and surgical treatment as well as for later endoprostheses and early retirement can be economized.

Austria↗
PubMed1997

[Late sequelae of coxitis in infants].

Septic arthritis of the hip joint is a condition that can often lead to partial or complete destruction of the hip joint, causing severe functional disability. Reports in the literature indicate that optimal management of these patients is unclear. Our report presents a follow-up of 37 patients (44 hips) who had septic arthritis during infancy or childhood. In general, patients at follow-up had a poor anatomical appearance radiographically, although pain and activity restriction were minimal. Results suggest that surgical efforts should be directed primarily at correcting limb length discrepancy and malalignment of the mechanical axes. In general, patients with a hip deformity of type I-III had a good functional outcome, whereas patients with hip deformity type IV with an instable hip joint had an unsatisfactory outcome. Any indication for hip replacement in these patients should be based not only on radiological findings, but also on the functional situation.

Adolescent↗
PubMed1996

Treatment of congenital pseudarthrosis of tibia with the circular frame technique.

We treated nine patients with congenital pseudarthrosis of the tibia consecutively by a modification of the Ilizarov (circular frame) technique. Seven patients had had several previous operations, and two patients had had none. After resecting of the pseudarthrosis and the surrounding pathologic periosteum, we performed acute shortening and compression at the level of resection, together with simultaneous lengthening of the proximal tibia. Union was achieved in all cases. With this technique, not only the mechanical but also the biologic problems are addressed. As compared with other methods, the circular frame technique also offers the possibility of correcting angulation and limb length discrepancy.

Adolescent↗
PubMed1996

[Clubfoot].

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Child↗
PubMed1995

Bilateral nonunited femoral neck fracture in a child with osteopetrosis.

We report a case of osteopetrosis with bilateral nonunited femoral neck and coxa vara in a 7-year-old boy. There was a history of traumatic transcervical left femoral neck fracture unsuccessfully treated by internal fixation. We performed a bilateral subtrochanteric valgus osteotomy. K-Wire fixation failed on the right side due to hardness of the bone. Finally, internal fixation with an angular plate after predrilling of the femoral neck offered stability. Bone union was achieved on both sides, resulting in full recovery of normal physical activity.

Bone Plates↗
PubMed1993

[Results of surgical repositioning of congenital hip dislocation].

The authors submit an analysis of the results of surgical treatment of inborn dislocation of the hip joint in children from the age of one year to completed growth. Decisive for inclusion into this group was surgical reposition. The operated patients were divided into the following three groups by age at the time of operation: 1. first year up to 17 months; 2. 18 to 48 months; 3. patients older than 4 years up to 15 years. Between 1978 and 1992 96 children with inborn dislocation of the hip joint were operated (103 hip joints). Complete documentation was available for 59 hip joints of 54 patients. The follow up period varies between 1 and 14 years after operation. In the first group 24 hip joints of 21 patients were checked, the average age at the time of operation being 8 months. In 17 hip joints at the same time subtrochanteric osteotomy with abbreviation was performed. In these operated hip joints surgical reposition was preceded by distraction either using the "overhead" system or the Pavlanský's method. All hip joints in this group were operated from an anterolateral approach according to Scaglietti's principles. In the second group 19 hip joints of 16 patients were checked, the mean age at the time of operation being 28 months. A standard component of the operation was in addition to surgical reposition also pelvic osteotomy according to Salter's method, in 16 cases at the same time derotation varus osteotomy was performed. The third group comprises 16 hip joints of 15 patients operated at an average age of 9 years and 8 months. Fourteen of the hip joints had been operated previously at least once by different methods. In acetabular dysplasia different techniques were used, most frequently Chiari's osteotomy. The surgical reposition proper was preceded in four instances of high iliac dislocation by preoperative distraction by external fixation. For evaluation of the results clinical and radiological parameters were used, essentially identical with Severin's classification. X-ray evaluation was supplemented y values of the distance between the head and Köhler's protrusion. The best clinical and X-ray results were achieved in the first group; wih the number of previous operations and advancing age the perspective of excellent results declines. In the group as a whole five, i. e. 8.5%, avascular necroses were recorded. From the total number of operated patients good radiological results were achieved in 83%, 17% of the results are considered satisfactory.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1991

[Ultrasound screening of the neonatal hip: results and experiences].

1291 newborn were examined sonographically between May 1986 and June 1987. Some of them were followed up radiologically until February 1989. The schedule of examination and treatment is given below. Neonatal examination suggested the immediate treatment of 3.25% of the newborn (1.97% of all hips), either Pavlik harness or abduction brace. The mean duration of therapy was 4.3 months. At the end of therapy type I was always in evidence. Patients with severe dysplasia (Graf type IIc or worse) were followed up radiologically at the end of the 2nd year of life. An avascular necrosis of the femoral head was not observed; in one case there was an acetabular index of 30 degrees; the remaining hip joints showed normal findings. We conclude that ultrasound examination in the neonatal period is a worthwhile procedure.

Female↗
PubMed1991

Lengthening for congenital short femur. Results of different methods.

We have reviewed the results in 37 patients with unilateral congenital short femur (Pappas classes III to IX), treated by different lengthening procedures. The increase in the length of the femur varied from 15.6% to 142%, excellent or good results being obtained in 32 patients (86%). There was an average of 1.9 complications per case, most being seen earlier in the series when the Wagner technique was used. With the Orthofix and the Ilizarov techniques, we used callus distraction in all cases. We found that the proximal diaphysis of the congenitally abnormal femur healed less well, and we now prefer to perform corticotomy and callus distraction of the distal metaphysis. The Ilizarov method gave the best results, offering the possibilities of the simultaneous use of a Hoffmann fixator across the hip and the treatment of knee dislocation and instability.

Adolescent↗