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Biomedical subjects

G Imhäuser

Publications and source records attributed to G Imhäuser.

At least 19 recordsLinked to original sources
PubMed1988

[Osseous support in spondylolisthesis. A case report].

A true spondylolisthesis in a 14 year old boy was followed from grade II to maximal dislocation. The 5th lumbar vertebra slipped forward on the sacrum until the contact with the sacrum was lost. The 5th lumbar vertebra, which had in the meantime shrunk to a smaller sized wedge, then dropped without tilting in front of the 1st sacral vertebra. This kind of maximal dislocation is rare. In the course of many years a bony support for the spine developed in the shape of a second sacrum, lying ventrally to the anatomical sacrum. The vertebral arch of the forth lumbar vertebra was supported by the real sacrum. This biomechanical correction was unexpected. At the age of 33 years the patient suffers no pain, and there is no restriction of spine movement and no neurological deficit.

Adolescent↗
PubMed1982

[Errors in diagnosis of children's hip joint using conventional X-ray technique (author's transl)].

X-rays of the hip joints in anteroposterior direction in adults and children should be made with the leg in the middle rotation position. But the middle position is different in children than in adults. In adults the patella should be facing directly upwards because from this position the leg can be rotated medially. In children of 3 to 8 years (or older), however, the leg can be rotated much further medially than it can be laterally. Thus in children the "middle rotation" position is one in which the leg is positioned more medially than would be the case with adults; the ideal position for X-ray is the one in which the leg can be rotated to the same extend medially and laterally. X-rays must be performed in this manner to prevent errors in judging children's hip joints. Examples of wrong diagnosis on the basis of conventional X-rays are demonstrated. Only with X-rays in the correct middle position can we arrive at reliable assessments of the hip.U

Child, Preschool↗
PubMed1980

Follow-up examinations: 30 years of Imhäuser clubfoot treatment.

The author describes his own methods of clubfoot treatment used over 30 years on more than 2,000 children. Correction of form and restoration of function are the two goals of the orthopaedic surgeon. Early treatment consists of closed reduction of forefoot deformity and of varus of the heel, and of operative correction of equinus deformity. Function is restored by a training program developed and introduced by the author for evertors and dorsiflexor muscles. Treatment starting at a later age must take into consideration that in the course of time increasing deformity of all bones and joints as well as marked alterations of soft tissues occur. In these cases closed measures are ineffective and operative measures necessary. After straightening the foot operatively, it is necessary to maintain the normalized position by means of an exterior removable plastic cast until the translocated tibialis anterior muscle can fulfil this task. The later the clubfoot is treated, the longer the period for which these casts are required. The author reexamined nearly 400 feet of adults whom he had treated during their baby or childhood years. The late results of three groups are demonstrated: (a) cases treated before the age of 2; (b) cases treated between 2 and 7 years; (c) cases treated at the age of 7 years or later. Good late results were observed in a surprisingly high percentage of the cases. The author's method--based on a pathophysiological approach--seems to represent real progress in the treatment of idiopathic clubfeet.

Adolescent↗
PubMed1979

[The importance of Simon's symptom in cases of hanging (author's transl)].

Radiological and patho-anatomical investigations of the spines of 32 corpses of persons who had committed suicide by hanging revealed spine damage in 81% of the cases. The cervical spine was damaged in 69%, the lumbar spine in 56% of the cases. The typical damage of the cervical spine is a loosening of the discs at the dorsal side, usually at the level of C 4/5 to C 6/7. In the region of the lumbar spine, bleeding between the (anterior) ventral ligament and the discs is the most frequently observed damage (Simon's sy;mtpom). Simon bleeding is brought about by traction force and is not dependent on the age at death or on any existing degenerative changes of the spine.

Adult↗
PubMed1979

[Operation of hammer toes and claw toes, and treatment of unfavourable results (author's transl)].

Hohmann's operation of hammer toes and claw toes will produce a poor result if there is a contracture due to hyperextension in the metatarsophalangeal joint. In such cases, preference should be given to the operation according to Taylor (resection arthrodesis of the first or, in rarer cases, of the second interphalangeal joint, dorsal incision of the capsule of the metatarsophalangeal joint, if necessary elongation of the extensor tendon, intramedually fixation by Kirschner wire). In case the operated toe points rigidly to dorsal or hangs limply as a result of Hohmann's operation, a cosmetically and functionally entirely satisfactory result can be achieved by means of operative mobilisation of this preoperated toe and by producing a cutaneously syndactylia with the next, smaller toe. - If a hammer toe is dislocated in the metatarsophalangeal joint, removing the base according to Gocht should be combined with an operative syndactylia to guide and hold the toe accurately in line with the other toes.

Adult↗
PubMed1979

[Necrosis in cases of slipped upper femoral epiphysis and its consequences (author's transl)].

The author demonstrates the development and treatment of 6 cases of necrosis of the slipped upper femoral epiphysis. In cases of gradual dislocation, the blood supply of the epiphysis remains normal at all stages. Necrosis does not occur spontaneously. In cases of sudden or so-called "traumatic" separation, the supply of blood to the epiphysis is often disturbed, and necrosis may occur spontaneously. Slight disturbance of the blood supply to the epiphysis may be only temporary and complete recovery may take place. Severe damage, however, leads to necrosis. Operative measures to treat the necrosis may lead to an improvement, but complete restoration of necrosis is not possible--as the examples in the article show. Osteoarthritis will follow at an early age in these cases. Thus, to avoid necrosis in cases of sudden dislocation of the epiphysis therapy must be carried out very gently. Closed or operative reduction should not be performed immediately after the slippage. The deformity should be corrected at a later stage.

Adolescent↗
PubMed1977

[The psychogenic clubfoot. A rare posttraumatic condition (author's transl)].

At the beginning of this century and during World War I psychogenic contractures were very common; later on they became rare.--The author reports and demonstrates 3 cases of psychogenic supination contractures of the foot (functional clubfeet) following a slight trauma of the ankle, the treatment of which was carried out in 1946, 1974 and 1976. All of these patients were women. The deformity of the foot was caused by a permanent contraction of the tibialis-muscles without an underlying organic disease. The therapy consisted of an arthrodesis of the midtarsal joints along with a transfer of the tibialis-anterior-tendon to metatarsus V. In all three cases both deformity and pain disappeared. The quantity and quality of the patients' mobility improved to near normal.--With this article the author intends to remind the orthopedic surgeons and the neurologists of this functional contracture.

Adult↗
PubMed1977

[The importance of the radiological angle between talus and calcaneus in patients with congenital clubfoot (author's transl)].

A reduction of the angle between the longitudinal axes of talus and calcaneus in the lateral X-ray view of a clubfoot is a sign of persistent supination of the subtalar joint and not due to anatomical changes of the bone. Correction of this deformity by closed manipulation produces a normal angle between talus and calcaneus. The angle between talus and calcaneus can thus be used as a guide for adequate correction of the subtalar deformity.

Anthropometry↗
PubMed1977

[Late results of Imhäuser's osteotomy for slipped capital femoral epiphysis (author's transl)].

The author has reviewed the clinical and radiological results of 55 patients 11 to 22 years following an Imhäuser three dimensional intertrochanteric osteotomy for slipped capital femoral epiphysis. 13 additional patients responded by questionnaire. Of these 68 hips 66 were painfree and functional. One patient complained of pain (due to coxarthrosis proven by x-ray). A second patient was dissatisfied with the functional range of his hip. 40 of the 55 hips which were examined clinically and radiologically had full range of motion, 10 hips showed minimal and 5 hips significant limitation of motion. Radiologically 73% of the 55 hips examined were rated excellent or good, 27% showed beginning degenerative changes (including one patient with marked coxarthrosis). The results were greatly influenced by the severity and direction of slipping, preoperative treatment and the accuracy of operative correction. This study permits the conclusion that three dimensional intertrochanteric osteotomy prevented or at least delayed the development of degenerative changes in the majority of cases. It is possible that many of these patients will not develop coxarthrosis.

Epiphyses, Slipped↗
PubMed1976

[Treatment of undesirable results following operations on the proximal end of the femur in children (author's transl)].

The initial results following operations on the proximal end of the femur in children may not be permanent. They are frequently altered by further growth of the bone. This influence of growth on the operative result cannot always be predicted. The author reports 6 cases with poor results following operations on the proximal end of the femus. In 3 children varus-rotation osteotomies resulted in pseudarthrosis and/or severe angulation. Resection of a solitary bone cyst and operative treatment of fractures of the proximal femur in 2 other cases produced similar complications. Treatment of these undesirable results consisted of osteotomy with correction in all 3 dimensions and medial displacement of the shaft under the neck of the femur. Fixation of the fragments was obtained with traction-bracing according to Pauwels. The early results were good in all cases. The author concludes that an operation on the proximal end of the femur in children is indicated only when absolutely necessary and when it is fairly certain that growth cannot alter the results unfavorably. Only those procedures should be recommended which have been shown to give satisfactory results in an adequate number of cases that remain unaltered throughout the entire growth period.

Adolescent↗
PubMed1976

[Coxa valga in childhood. Does it need treatment? (author's transl)].

Coxa valga in a child is not necessarily a pathological condition which needs treatment as long as the acetabulum shows adequate development for the patients age and constitution. Varus osteotomy is not indicated in these cases and may even result in poor development of the hip following operation. The author demonstrates a case in which fracture of the femoral neck on one side healed in varus position. Varus osteotomy was subsequently done on the other side to equalize both hips. This resulted in extreme valgus position and narrowing of the joint space of both hips at puberty. The neck-shaft angle of the femur changes constantly during childhool. Valgus position of the femoral neck with good development of the acetabulum occurs frequently and does not lead to secondary osteoarthritis in later life. Prophylactic correction by varus osteotomy should therefore be abandoned unless there is true dysplasia of the hip.

Child↗
PubMed1976

[Spontaneous stiffness of the hip-joint in puberty (author's transl)].

This condition has been described by the author in 1952. Here a further 12 cases are reported. The condition arises as a consequence of increased prepubertal growth and consequent compression between head of femur and acetabulum. Narrowing of the joint space can be treated by decompressing surgery on muscles. The author belives that such treatment of the less affected side as well serves prevention of arthorosis.

Acetabulum↗