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Biomedical subjects

G Hierholzer

Publications and source records attributed to G Hierholzer.

At least 19 recordsLinked to original sources
PubMed1999

Fixation technique influences osteogenesis of comminuted fractures.

Comminuted fractures most often are associated with compromised soft tissue conditions and diminished vascularization leading to a reduced osteogenesis. In contrast to stable fixation by compression plating with lag screws, the less stable but also less invasive techniques of external fixation, unreamed nailing, or bridging plates have become increasingly popular. The aim of this study was to compare the bone healing and osteogenesis of these fixation techniques. A triple wedge osteotomy of the sheep tibia was used as a bone healing model. Internal compression plate fixation of all fragments with lag screws was used in one group. In the other three groups, only the main proximal and distal fragments were fixed by external fixation, unreamed interlocking nail, or bridging plate. The sheep with compression plate fixation and lag screws showed the worst results after 12 weeks. The periosteal and endosteal osteogenesis and the apparent density of the newly formed bone in the fracture gaps were significantly lower than those seen in the sheep in the other three technique groups. The best results were found for the bridging plate and external fixator. From these results, it can be concluded that compression plate fixation should be avoided for treatment of comminuted fractures.

Animals↗
PubMed1998

[New methods for effective prevention of thromboembolism in surgical medicine exemplified by trauma surgery].

Under conventional prevention (pharmacological and physical) of thromboembolism 30-40% of surgical patients develop deep vein thrombosis (DVT). Mechanical methods significantly increase the efficacy of prophylaxis for thromboembolism: these include intermittent pneumatic compression, A-V impulse systems and ankle motion devices. For all trauma patients it is advisable that conventional prophylaxis of thromboembolism be supplemented with elements of mechanical prophylaxis in order to reduce the continuing high thrombosis rate significantly.

Anticoagulants↗
PubMed1997

High stability of the Ilizarov ringfixator in a metacarpal fracture of an Arabian foal.

In a case of I degree open multifragmentary metacarpal fracture of a 4-week-old Arabian foal, an osteosynthesis with the Ilizarov ringfixator was performed. Immediate full weight-bearing (100 kg) was possible, demonstrating the high stability of the Ilizarov ringsystem. After 12 weeks, sufficient bony union was achieved, and the fixator could be removed. At that time, the body weight of the foal was 170 kg. In our opinion, this case proves the high stability and efficiency of the ringsystem under difficult and unusual conditions.

Animals↗
PubMed1996

[Ultrasound diagnosis of acute rupture of the anterior cruciate ligament. An experimental and clinical study].

In an experimental study on 20 cadaver knee joints we found examined the ventral translation of the tibial head, which is otherwise shown by the Lachmann test, by dorsal sonography. These examinations were performed in knees in which arthroscopical examination had confirmed intact ACL. After endoscopical partial and complete rupture of the ACL the examinations were repeated. Radiological examination was performed as a reference method. In a sonographically standardized clinical study of 243 traumatized knee joints the ventral translation of the tibial head was evaluated. In all knee joints examined an arthroscopy or arthrotomy was performed. In 56% a rupture of the ACL was verified. There was a positive correlation between translation of the tibial head by 3 mm or more compared with the non-injured side and a rupture of the ACL (sensitivity 0.95; specificity 0.98). The dynamic sonographic technique is a simple and highly sensitive specific diagnostic method that can be used to quantify the results found on clinical examination.

Acute Disease↗
PubMed1995

[Ultrasound criteria of fresh rupture of the anterior cruciate ligament].

In a prospective, controlled, monocentric clinical study 193 recently traumatized knee joints, suspicious of a ruptured anterior cruciate ligament, were examined sonographically. Three indirect signs of rupture were analyzed and compared to the results of the clinical tests of stability (Lachmann). Arthroscopy and arthrotomy were regarded as approved methods of reference. The sonographic pattern of an echo-free mass in the area of the femoral insertion of the anterior cruciate ligament proved to be more informative (sensitivity 0.91, specificity 0.78, effectivity 0.84) than the clinical signs of instability. A standardized sonographic examination of the knee joint should be a constant component of the posttraumatic examination. It is an inexpensive method, easy to learn and to perform, and is more reliable in the diagnosis of the ruptured anterior cruciate ligament than the clinical evaluation of instability.

Adult↗
PubMed1995

[Physical prevention of thrombosis with the ankle joint with the motorized ankle joint movement device. Initial results of a clinical study].

Between 1993 and 1994 the value of the "Artroflow" device in deep venous thrombosis was tested in 95 trauma surgical high risk patients. Parallel to the application of Heparin and physical methods, the "Artroflow" device was employed. The test and compare group showed an equal amount of risk parameters and comparable injuries. In all patients until full mobilization a weekly clinical examination, a compression sonography of the deep leg veins and a venous Doppler examination was performed. In the test group 1 deep venous thrombosis (2.3%) and no clinically manifest lung embolism occurred. In the control group, the deep venous thrombosis rate was 21.6%. This showed a highly significant drop of the deep venous thrombosis rate in trauma surgical patients (p < 0.0041 Fisher test) and allows us to suggest the use of the "Artroflow" device in high risk patients parallel to heparin prophylaxis.

Adolescent↗
PubMed1994

[Dynamic skin suture for closure of the incision defect after compartment incision].

Dynamic skin suture consists of a technique that diminishes local pressure on skin and permits progressive tightening of the sutures for stepwise incisional closure. A clinical series of 28 repairs after release of compartment syndromes shows complete closure in 22 incisions, the other 6 defects could be reduced in size. Technique, results and biological basics are discussed.

Adolescent↗
PubMed1992

[Treatment of closed dislocations of the knee joint].

Nineteen knee dislocations in 18 patients (one bilateral) occurred over a period of twelve years. The age range was 17 to 70 years with an average age of 33 years. There was no injury of the popliteal artery and five peroneal nerve injuries in the group. One compartment syndrome occurred after reduction. The follow-up study including examination showed good and satisfactory results for early surgical repair. After delayed surgical repair there were more signs of instability, pain and restrictive range of flexion movement. Early operative repair followed by cast bracing for six weeks and an intensive mobilisation therapy after cast bracing are the method of choice. An immobilisation period of three to four weeks is possible.

Adolescent↗
PubMed1992

[Three-dimensional computerized tomography in trauma surgery. A case presentation].

Three-dimensional images of bone structures can easily be reconstructed from computed tomography data. The technique and the advantages of contemplating reconstructions of bone defects in different directions are described. A special software programme allows to combine all data which are given by the standard CT. The slice diameter is two millimetres. The reconstruction shows bone surfaces in all required views. In traumatic and orthopaedic surgery 3-D-CT is useful in the analysis, detection and preoperative planning of comminuted bone injuries of the spine, pelvis, knee, shoulder and the calcaneus. With this technique it is possible to see the bone in its topographic constellation, to observe fractures in unusual directions and to identify fragments from each other. The surgeon gets a lot of additional information which is helpful to decide on the incision, the reduction and the fixation of fragments. Undesirable effects during operation are reduced, which leads to a more accurate treatment and subsequent better results.

Accidents↗
PubMed1992

[Indications, choice of procedure and results of conservative therapy of spinal injuries].

For conservative treatment of injuries of the cervical spine, two different methods are available: The HALO fixator and the collar. The choice depends on the kind and extension of the injury. Stable thoracic and lumbar vertebral fractures are treated in a conservative functional way in order to strengthen the muscular apparatus. Three-point-fixation with a brace is not necessary. Functional therapeutic methods can also be applied in the case of instable fractures if they are not operable. During a rigid confinement to bed, the postural reduction by increasing lordosis has turned out to be the treatment of choice. As an essential measure the patient has to take part in a "backschool" with postural exercises for the daily life.

Braces↗