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Biomedical subjects

F Magerl

Publications and source records attributed to F Magerl.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Osteotomy of the first ray in the treatment of hallux valgus].

An osteotomy of the first row for the treatment of hallux valgus is indicated for younger patients with minor to moderate valgus deformation and only minor arthritic changes in the first metatarsophalangeal joint. The osteotomy has two prominent goals: Correction of the deformity and restoration of muscle function and muscular balance. Especially the later seems to be essential for preventing failures in the long term. Osteotomies can be carried out on os cuneiforme mediale, metatarsal bone (proximal, shaft, subcapital) and phalanx. The cuneiforme osteotomy isn't recommended because of alterations in the joint between the medial and intermedium cuneiforme. Osteotomies of the proximal metatarsal bone are rarely performed and mostly combined with an arthroplastic procedure of the metatarsophalangeal joint. The disadvantage of a shaft osteotomy (Ludloff's osteotomy) is the long time for healing of the osteotomy of diaphysis of the metatarsal bone. Subcapital osteotomies are most frequently performed. With a subcapital osteotomy you can correct more deformities than with the other osteotomies. The phalangeal osteotomy is indicated just in special cases. The combination of a subcapital and a phalangeal osteotomy is recommended by Magerl in order to reduce the failure rates.

Hallux Valgus↗
PubMed1990

[Conservative treatment of classical radius fractures].

In Colles' fractures of the radius the distal fragment is slanted dorsally and radially, dislocated dorsally and radially and supinated. The radius is shortened. Furthermore a comminution-zone of the dorsal cortex is found. In closed reduction the fracture is unwedged and reduced by recreating the mechanism of trauma in neutral position, rather a light dorsiflection is maintained to check secondary dislocation of the distal fragment and shortening of the radius. The cast should push the carpus slightly palmwards and hold the hand in light ulnar-duction. Immobilization is retained for four to six weeks. Radiologic review is performed 4, 8, 12 and 16 days post reduction so that timely change to a different form of fixation is possible in case of secondary dislocation.

Casts, Surgical↗
PubMed1990

[Which distal radius fractures can be treated conservatively?].

Roughly 80% of distal radial fractures can be treated conservatively. To decide which fractures should be treated surgically and which can be treated conservatively we divide them into four categories; metaphyseal bending-fractures, epiphyseal buckle-fractures, avulsion-fractures of the articular rim and fractures of the growing skeleton. Metaphyseal bending-fractures with dorsal inclination of the distal fragment (Colles' fracture) can generally be treated conservatively, those with palmar slanting of the distal fragment (Smith's fracture) must be stabilized surgically. The intraarticular fractures (avulsion-fractures and epiphyseal buckle-fractures) must be reduced anatomically and stabilized by osteosynthesis. In the growing skeleton Aitken 0 and I respectively Salter I and II fractures can be treated conservatively.

Casts, Surgical↗
PubMed1990

Congenital fusion C0-C2 associated with spondylolysis of C2.

This is the report of a very rare malformation at the cranio-cervical junction, including congenital occipito-cervical fusion C0-C2, spondylolysis of C2, and hypoplasia of the right vertebral artery. The malformation itself is part of a Klippel-Feil syndrome with sensory-neural hearing loss on the left side, congenital high thoracic scoliosis, rib agenesis on the right side, and kidney malformations on both sides.

Axis, Cervical Vertebra↗
PubMed1989

[Peri-prosthesis fractures in total hip endoprostheses].

Periprosthetic fractures after total hip arthroplasty (THA) were found in 0.77% (33 fractures in 4280 THA). At the time of fracture the prosthesis was loose in about one-third of the cases. In most cases (63%), the fracture was located at the distal end of the prosthesis. Fractures at this location were transverse or short oblique; those situated more distally were spiral. Whereas those located along the prosthesis shaft were long oblique. Open reduction internal fixation was performed immediately for all fractures. Thirty patients were followed an average of 2.7 years (1 year-11 years) after fracture. In 28 cases stabilization was obtained using a plate. In 2 cases the prosthesis was changed at the same time as plate stabilization. 1 case the lossened prosthesis was converted to a Girdlestone. A primary change in the prosthesis without osteosynthesis was performed in 2 cases. One year after operation all fractures were healed. We recommend a large DC plate for fractures distal to the tip of the prosthesis (spiral fractures). In cases of stable THA, we stabilized the fracture at the level of the tip of the prosthesis or along the shaft of the prosthesis itself, using a wave plate with corticocancellous bone graft. Fractures along the loosened prosthesis but with good bone stock are treated by implantation of a long-stem prosthesis. If bone stock is poor, we recommend the fracture be stabilized using a plate. Only after the fracture is healed do we revise the prosthesis.

Aged↗
PubMed1988

Total posterior vertebrectomy of the thoracic or lumbar spine.

A total vertebrectomy in the thoracic or lumbar spine via a posterior approach can provide optimal neural decompression in certain severely compromised terminal patients affected with a malignant metastatic spinal lesion. The Arbeitsgemeinschaft für Osteosynthesefragen (AO) internal fixator, accompanied by methyl methacrylate reconstruction of the anterior vertebral column, provides sufficient stabilization so that immediate ambulation with minimal external support is possible. This single operative procedure allows reduction of the iatrogenic trauma by avoiding an additional anterior exposure. Total posterior vertebrectomy has been performed successfully in a total of nine cases in this study. In three early cases the spine was stabilized with posterior transpedicular plate fixation. The six most recent cases in which the AO internal fixator was used have verified the effectiveness of this fixation system. A modification of this technique may be applied to certain primary benign or malignant spinal lesions by allowing appropriate tumor resection margins and anterior corticocancellous bone graft reconstruction.

Adult↗
PubMed1987

Comparative study of the stability of anterior and posterior cervical spine fixation procedures.

Both posterior and anterior procedures of stabilization are used for operative immobilization of unstable functional units of the cervical spine. The primary stabilizing effect of each procedure was examined and the two were compared in an experimental study. To this end the functional units C-5 and C-6 were removed from ten fresh cervical spines, the discoligamentous structures being preserved, and C-6 was embedded in methacrylate. As a result of a tensile force in a vertical direction applied to the base of the spinous process of C-5, a flexion bending load was introduced into the unit, the main component of which was measured with the aid of one vertical- and two horizontal-displacement transducers. The respective tilting angle alpha and the translation were calculated on the basis of these values. Each individual functional unit was measured with and without the discoligamentous lesion. This posterior instability was then stabilized with an H-plate, a hook plate, sublaminar wiring, and various combinations of these. Our results lead to the following clinically relevant conclusions: With isolated posterior instability, posterior fixation with the hook plate appears to bring about exercise stability. With complete discoligamentous instability, the combined procedures certainly produce exercise stability, from a biomechanical point of view, the posterior hook, plate alone being capable of guaranteeing secure fixation. Exclusive posterior wiring with complete discoligamentous instability may, without external immobilization, result in permanent subluxation in the functional unit. Exclusive anterior H-plate fixation with complete discoligamentous instability requires additional external immobilization in the postoperative stage in order to prevent flexion.

Biomechanical Phenomena↗
PubMed1987

[Patellectomy as a salvage operation].

One hundred seven patients were examined who had undergone patellectomies between 1965 and 1983 (113 patellectomies). The mean follow-up time was 10.5 years (3-17.5 years) and the average age of the patients 42.6 years. There were three distinct groups of operative techniques: (1) the purse-string technique in 40 patellectomies; (2) the vastus medialis technique in 24 patellectomies; (3) other techniques in 49 patellectomies. The indications for patellectomy were: chondromalacia, 56 cases; comminuted patellar fractures, 32 cases; arthritis, 17 cases; recurrent patellar dislocations, 8 cases. The patients were examined for pain, rage of motion, giving way, swelling, quadriceps strength, activity and cosmetic results (interview, physical examination, Cybex and radiographic study). In the purse-string technique group, 81% of the cases ended up with good or excellent results; in the vastus medialis group there were 79% and in the third group only 73% good or excellent results. Among the patellectomies for comminuted fractures, 75% had excellent results. The clinical outcome of patelletomy for arthritis is fair, for recurrent dislocation favorable, and for chondromalacia variable and not predictable.

Adolescent↗
PubMed1987

[Surgical stabilization of C1 and C2 fractures].

We present operative procedures for the stabilization of fractures of C1 and C2. As is the case for fractures of the extremities, a direct approach to the injury should be attempted in order to avoid the inclusion of intact segments in the spondylodesis. The aim of the three presented techniques - direct screw fixation of fracture of the dens axis and traumatic lysis of C2 - is to active anatomical reconstruction by optimal stabilization. The new technique of transarticular screw fixation of C1-2 developed by Magerl allows unisegmental three-dimensional stabilization in cases in which at least a three-level fusion would have previously been considered necessary.

Bone Screws↗
PubMed1987

[Dorsal spondylodesis of the cervical spine using a hooked plate].

The hook plate is a new device for achieving dorsal fusion of the lower cervical spine (C2-T1). Using the dorsal approach, this technique guarantees independent stability that is sufficient even in cases without anterior stabilization. It satisfies the three main requirements for dorsal implants, i.e. a tension band, independent stability and the possibility of distraction. Except in cases with direct anterior compression of the neural structures (such as herniated discs) the dorsal approach allows, in most cases, direct repair of the injury or luxation. The technique and the results obtained are described and discussed.

Bone Plates↗
PubMed1987

[Refractures].

Explore the source record for details and available documents.

Adult↗
PubMed1985

[Therapeutic results in spinal tumor metastases involving neurologic deficit].

Between 1976 and 1982 primary or secondary intraspinal malignant lymphomas and metastases of solid tumours with neurologic defects were found in 118 hospitalised patients. A total of 126 episodes of spinal and caudal compressions were observed. Nearly half of all tumour diagnoses were breast and prostatic carcinomas. Segments Th 3-6 were mainly involved. Symptoms of compression were the first objective hints of malignant disease in every third patient. Local and (or) radicular pains were reported as first symptoms by 80% of patients. Therapeutic success was considered satisfactory (group A) if patients were able to walk freely 3 months after initiation of treatment or isolated loss of sensitivity or defects of urination or defaecation could not be demonstrated any longer. Results were classified as unsatisfactory (group B) if the above-mentioned aims of treatment could not be achieved within this time. After individualised carefully monitored treatment, survival of patients of group A was significantly longer after 12 and 24 months than in patients of group B. Probability of survival is mainly influenced by rapid response to treatment, by tumour histology, by severity of neurologic defects and by the chosen treatment regime.

Aged↗