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F Herkert

Publications and source records attributed to F Herkert.

7 recordsLinked to original sources

Surgical treatment of humeral shaft fractures--the Basel experience.

One hundred twenty seven patients with fractures of the humeral shaft were treated by open reduction and internal fixation using 4.5-mm dynamic compression plates (DCP). Seventy one osteosyntheses were performed primarily, 36 following attempted closed reduction, and 20 secondarily after a failed conservative treatment of about 8 weeks. A primary radial nerve palsy was present in 19 patients, and appeared subsequently in four additional patients. One hundred two of the 127 patients could be clinically and radiologically examined 1 year after internal fixation: 89 patients (87.3%) had excellent or good results with full functional recovery. Thirteen patients (12.7%) showed a limited range of motion of either the shoulder or elbow or both. This was mostly because of other fractures of the same limb or persistent neurologic impairment. We observed two transitory postoperative nerve palsies, five early failures of internal fixation because of technical errors, two pseudarthroses and four postoperative infections, which healed with one exception by suction drainage and early removal of the plate. We conclude that a correct plate fixation of humeral shaft fractures in a selected group of patients represents an alternative to conservative treatment with the advantage of greater patient comfort.

Adolescent

[Experiences with conservative therapy of humerus shaft fractures].

A well proved method for the conservative treatment of fractures of the humeral shaft is clearly shown by words and pictures. A study of 36 own cases during the years 1985 up to 90 informs on the problems of conservative treatment of these fractures. Even if there is a perfect primary reposition, impossibility of proper retention in the plaster cast may lead to post-primary osteosyntheses (2 cases in 36). Despite correct conservative treatment there are always delayed unions in a certain percentage (6 cases in 34), which you can't recognize before 3 months after injury, but then should bring them to operative treatment. There is quite a high number of pseudarthroses (4 cases in 32). It is still unclear, which type of fracture and which type of patient is going to build up a pseudarthrosis. In conservative treatment, the most important thing is--compared to operative treatment--a very closed and carefully observing aftercare.

Adolescent

[Baumann shoulder reposition].

An untraumatic method for the reposition of dislocated shoulders without any analgesia is presented. That the way of this method must be right, is proved by a short historical view and by case reports; On one side by the inventor of this method and on the other side by a retrospective study from the orthopedic department of the Kantonsspital of St. Gallen. How to do this reposition is clearly described by words and pictures.

Adult

[Can humerus shaft fractures be treated with osteosynthesis?].

The treatment of fractures of the humerus shaft is still controversial. The results of functional treatment (brace) are good, consolidation occurs in most cases within 8-10 weeks, slight malalignment can be accepted, and there is no risk of postoperative complications like osteitis, neurological iatrogenic disorders and technical errors. On the other hand a correct osteosynthesis allows painless functional postoperative treatment, the patient comfort is excellent and a selected group of patients might return to work faster. We present the results of plate fixation of humerus shaft fractures in 127 patients, operated from 1980 to 1988. 102 patients were clinically and radiologically controlled after 1 year: 85 patients (83.4%) presented an excellent or good result with complete functional recovery. 17 patients (16.6%) showed a limited range of motion in shoulder and/or elbow mostly due to other fractures of the same arm or to persistent neurological disorders (plexus or radial lesions). Postoperative complications included 2 postoperative radial palsies recovering completely within months, 5 failures of internal fixation due to technical errors, 2 pseudarthrosis and 4 postoperative infections, healed by reoperation and early removal of the implant with one exception (osteitis). We therefore conclude, that a correct plate fixation of humerus shaft fractures is an alternative to conservative treatment. The main advantage is better patient comfort and shorter disability for a selected group of patients.

Adolescent

[Severe urge incontinence--therapeutic concept].

Basing on our experience with 39 patients with severe urge incontinence (in one-quarter of the cases pure urge incontinence, in one-half of the cases mixed incontinence and in a further quarter of the cases neurogenic bladder disorders) a supervised programme (mictiogram) and a well-tried therapy (especially in the Anglo-Saxon countries) consisting of the triad hospitalisation/bladder training/medication therapy are presented. After an average hospitalisation period of 14 days, we were able to achieve a symptom-free state in 94% of the patients. Cure was achieved on a long-term basis in 76%. Failure of conservative therapy was due especially to severe neurogenic bladder disorders, followed by urethral obstructive insufficiency that cannot be influenced. The superimposed psychic cause of urge incontinence that should not be underestimated and often presents as a transference of unresolved emotional needs (51% of our group are psychologically unstable), is discussed. With these facts in mind, our therapy concept is translated into reality. Hospitalisation brings about a change in surroundings, making the supervision of bladder training and adjustment to medication easier, thus supplying the basis for patient compliance and success of follow-up therapy subsequent to hospitalisation and discharge from hospital.

Adult