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Biomedical subjects

G Schippinger

Publications and source records attributed to G Schippinger.

At least 19 recordsLinked to original sources
PubMed2002

Lipid peroxidation and antioxidant status in professional American football players during competition.

BACKGROUND: Oxidative stress occurs during strenuous physical exercise, perhaps as a result of increased consumption of oxygen. MATERIALS AND METHODS: In this study, different markers of oxidative stress were determined in eight national league American football players. Before (March) and at three time-points during the competition season (May, June, July) serum total peroxide concentrations, auto-antibody titres against oxidized low-density lipoprotein (oLab), and lag time of reactive oxygen species-induced degradation of the fluorophore 1-palmitoyl-2-((2-(4-(6-phenyl-trans-1,3,5-hexatrienyl)phenyl)ethyl)- carbonyl)-sn-glycero-3-phosphocholine (DPHPC) were measured along with serum ascorbate, alpha- and gamma-tocopherol, and beta-carotene concentrations. RESULTS: Before the competition season, serum antioxidant concentrations were within the lower normal range; ascorbate concentrations increased significantly during the competition period (P < 0.05). Serum peroxide concentrations were within the normal range and increased significantly during the competition period (P < 0.05); in four of the eight subjects the increase was several times the baseline values, while four athletes did not show any increase. The oLab titres increased significantly at the mid-competition period time-point (P < 0.01), but levelled off thereafter. DISCUSSION: Given that it could not be predicted from the baseline oxidative stress and antioxidant status which subject would respond to strenuous exercise with an increase in oxidative stress status, it is concluded that oxidative stress should be monitored in all athletes.

Adult↗
PubMed2001

HAGL lesion occurring after successful arthroscopic Bankart repair.

Recurrent traumatic anterior shoulder instability following surgical repair may be associated with implant failure and an array of capsulolabral pathology including separation of the labrum (Bankart lesion), humeral avulsion of the glenohumeral ligaments (HAGL lesion), and capsular rupture. We detail a previously unreported case of a HAGL lesion occurring in a shoulder with an intact arthrosopic Bankart repair following an additional traumatic event. Anatomic repair of this subsequent injury resulted in an excellent outcome. The patient returned to his high-demand ski racing activities without any shoulder limitation.

Adolescent↗
PubMed2000

[Carbon frames. Positioning and reduction aids in tibial intramedullary nailing with unreamed technique].

Intramedullary stabilisation of long bones is an established treatment option since Küntscher. Especially for tibial nailing different methods were proposed in the past, were as the use of a fracture table was more or less the standard procedure. Since 4 years now we are nailing tibial fractures without fracture table. We are now using more and more a simple carbon fibre-frame, easily assembled by parts of the AO external fixator. So we can minimize the additional iatrogenic soft tissue damage during surgery and the logistic preoperative set-up in the operation theatre is shorter.

Adult↗
PubMed1999

[Fractures of the proximal humerus].

Proximal humeral fractures are common particularly in the elderly. The decision of the optimal treatment is dependent on many factors. On the one hand the biological age of the patient and the bone structure plays a key-role, on the other hand the living conditions and individual needs are of importance. Most fractures with minimal displacement respond satisfactorily to simple conservative treatment including short sling immobilisation and functional aftertreatment under supervision of the physiotherapist. Most recently there is a trend towards more aggressive surgical intervention with percutaneous insertion of cannulated screws also in the slightly displaced fracture situation. This protocol allows for earlier functional and less painful aftertreatment, less risk of displacement of the fracture fragments and better outcome. In severely unstable fractures with marked displacement of the fragments an operative stabilisation is advocated by most surgeons. Again there is a trend from plating towards cannulated screw fixation combined with tension absorbing (resorbable) sutures. In special cases which are described in detail a minimal invasive percutaneous screw technique with less stripping of bone and therefore preservation of the crucial blood supply of the humeral head is recommended. Instead of percutaneous pinning using K-wires only, cannulated screws are inserted today. Plating of proximal humerus joint fractures is the exception in our days, only the subcapital unstable fracture of the elderly would be an indication. LC-condylar plating seems to yield better stability than the conventional T-plate-system. In the most severe fractures of the proximal humerus (4-segment-fractures and dislocation fractures according to Neer, respectively C-2- and C-3-fractures according to the AO-classification) there is still controversy on the best management. Most authors prefer hemiarthroplasty in this situation whereas the other group of orthopaedic surgeons try open reduction and internal fixation particularly in the younger individuals. This stabilisation provides the orthopaedic surgeons with a formidable challenge and requires a lot of experience in this field. Also the understanding of the fracture morphology is needed for optimal results. In spite of good stabilisation techniques often partial or total humeral head necrosis occurs in the most severe fractures. Surprisingly enough results with reasonable function can be obtained even with partial avascular necrosis of the humeral head. A crucial part of the management is team work with the physiotherapist and an individual program for each fracture situation, depending on the stability of the fixation. Close contact between these two professions is of utmost importance. Finally it can be stated that the management of proximal humeral fractures is fairly standardised but it is always dependent on the experience and resources of the attending surgeon and must be tailored to the individual needs of the patient.

Humans↗
PubMed1999

Management of simple elbow dislocations. Does the period of immobilization affect the eventual results?

METHODS: Forty-five patients with a simple elbow dislocation were re-examined at an average time of 61 months after injury. All patients were treated by means of closed reduction. Only patients with minor associated injuries were included in the study. The Morrey score was used to evaluate pain, limitation of motion, instability, and daily activities. The overall results were good or excellent with regard to pain and function. The most common finding was a loss of terminal extension. Nine percent of all patients had a lack of extension up to 30 degrees, while 36% had a flexion contracture of less than 10 degrees. Periarticular ossification was seen in 28 patients, but did not lead to loss of motion. For further analysis, the patients were divided into three groups of immobilization: group I, less than 2 weeks, group II, 2-3 weeks, and group III, more than 3 weeks. RESULTS: We encountered better results from those in groups I and II with regard to pain and score results without any statistical significance. CONCLUSION: Our results suggest that splintage of the reduced elbow for 2 weeks enhances patient comfort and does not adversely affect the eventual outcome. Splintage for over 3 weeks may result in worse function.

Adolescent↗
PubMed1998

Thromboembolic complications after arthroscopic knee surgery. Incidence and risk factors in 101 patients.

Deep venous thrombosis (DVT) and pulmonary embolism (PE) are less common after knee arthroscopy than after elective hip and knee arthroplasties. There is no consensus on the optimal prophylaxis. In this prospective cohort study, we used ultrasound, phlebography and lung scan pre- and postoperatively to assess the incidence of thromboembolic complications in 101 consecutive patients who underwent knee arthroscopy. Preoperatively, patients were screened for typical risk factors for DVT such as age, obesity, varicose veins, contraceptive pills and nicotine abuse. All patients received a once-daily injection of 5000 IU of low molecular weight heparin, at least 12 hours prior to surgery. 5 weeks after surgery, the same screening tests were repeated. In 12 of the 101 patients either DVT or PE was diagnosed. DVT occurred in 8 cases, 4 of which were silent and 4 symptomatic. The number of PEs was 9, 8 silent and 1 symptomatic. We found no correlation between DVT or PE and individual clinical risk factors, but there was a tendency towards the development of DVT and PE, with a higher number of risk factors. We found no correlation between DVT and intraoperative risk factors such as use of a tourniquet, type of anesthesia or duration of surgery. The relatively high rate of thromboembolic events after knee arthroscopy in our study suggests the need of all patients for routine use of thromboprophylaxis, probably in a higher dose than given.

Adolescent↗
PubMed1997

Anatomy of the normal acromion investigated using MRI.

The shape of the acromion is strongly associated with impingement syndrome and with rotator cuff tears. It is notoriously difficult to image the acromion with conventional radiography. We have developed MRI techniques to depict the acromion in its longitudinal axis. Furthermore, we have measured the subacromial space in both external and internal rotation. In previous studies, three types of acromial shape have been described with the type III or hooked acromion being present in 66% of cases with rotator cuff tears. We studied 31 normal shoulders in 29 people using MRI. Within this population aged 24-36 years, mean age 31 years, no type III acromions were found. Twenty-one were type I (67.7%) and 10 were type II (32.3%). In addition, we found no difference in subacromial height in external or internal rotation. Low rates of intra- and interobserver error were found. These results imply that the hooked acromion is not present in the normal population and is, therefore, likely to be an acquired abnormality.

Acromion↗
PubMed1997

[Scapholunar ligament injuries in acute wrist trauma. Arthroscopic diagnosis and minimally invasive surgery].

The final result of the treatment of distal intraarticular radius fractures depends both on the accuracy of the fracture reduction and on the presence or absence of additional carpal injuries. In particular, lesions of the intrinsic ligaments usually cause severe degenerative damage of the wrist joint if they are missed primarily. With the introduction of wrist arthroscopy these tears can be evaluated and treated earlier. Since 1993 arthroscopically assisted treatment has been performed in 23 patients with distal intraarticular fractures of the radius (mainly C fractures according to the AO classification system or group VII and VIII fractures according to Frykman). SL tears have been found in 11 patients (47.8%), 7 of whom showed marked instability and were stabilised at the time of surgery.

Adolescent↗
PubMed1997

Lesions of the scapholunate ligaments in acute wrist trauma--arthroscopic diagnosis and minimally invasive treatment.

The final result of the treatment of distal intra-articular radius fractures depends both on the accuracy of the fracture reduction and on the presence of additional carpal injuries. In particular, lesions of the intrinsic ligaments usually lead to severe degenerative damage of the wrist joint if they are missed primarily. With the introduction of wrist arthroscopy, these tears can be evaluated and treated earlier. Since 1993 arthroscopically assisted treatment has been performed in 23 patients with distal intra-articular fractures of the radius (mainly C-fractures according to the AO classification system or group VII and VIII fractures according to Frykman). Scapholunate (SL) tears were found in 11 patients (47.8%), 7 of whom showed marked instability intraoperatively and were stabilised at the time of surgery.

Adolescent↗
PubMed1997

Paragliding accidents in remote areas.

Paragliding is an increasingly popular hobby, as people try to find new and more adventurous activities. However, there is an increased and inherent danger with this sport. For this reason, as well as the inexperience of many operators, injuries occur frequently. This retrospective study centers on the helicopter rescue of 70 individuals in paragliding accidents. All histories were examined, and 43 patients answered a questionnaire. Nineteen (42%) pilots were injured when taking off, 20 (44%) during the flight, and six (13%) when landing. Routine and experience did not affect the prevalence of accident. Analysis of the causes of accident revealed pilot errors in all but three cases. In 34 rescue operations a landing of the helicopter near the site of the accident was possible. Half of the patients had to be rescued by a cable winch or a long rope fixed to the helicopter. Seven (10%) of the pilots suffered multiple trauma, 38 (54%) had injuries of the lower extremities, and 32 (84%) of them sustained fractures. Injuries to the spine were diagnosed in 34 cases with a fracture rate of 85%. One patient had an incomplete paraplegia. Injuries to the head occurred in 17 patients. No paraglider pilot died. The average hospitalization was 22 days, and average time of working inability was 14 weeks. Fourteen (34%) patients suffered from a permanent damage to their nerves or joints. Forty-three percent of the paragliders continued their sport despite the accident; two of them had another accident. An improved training program is necessary to lower the incidence of paragliding accidents. Optimal equipment to reduce injuries in case of accidents is mandatory. The helicopter emergency physician must perform a careful examination, provide stabilization of airways and circulation, give analgesics, splint fractured extremities, and transport the victim on a vacuum mattress to the appropriate hospital.

Accidents↗
PubMed1997

[Are complications in cruciate ligament replacement operations with patellar tendon transplantation dependent on surgical technique and surgical timing?].

HYPOTHESIS: In a retrospective study we analyzed our results of ACL reconstructions with a patellar tendon graft. We wanted to know if the complications were dependent upon timing and technique of surgery. METHOD: We reviewed 283 patients after ACL-reconstruction, who underwent an operation with bone patellar tendon graft between 1984-1993. In our study we particularly looked for complications. The overall rate of complications was 21.6% dependent on the applied technique. Infections, DVTs, limitations of movement and graft failures were the most common complications. Furthermore we analyzed the timing of operation. Arthrofribrosis was less common in the group with delayed reconstruction (6.1%) whereas in the primary reconstruction group the rate was 17.6%. For this reason we changed our management with regard to the timing of operation. Meniscal injuries were the most common additional injuries in both groups. Conservatively treated ACL-ruptures showed a high rate of mensical ruptures in combination with cartilage injuries. CONCLUSION: Because of these results we put more emphasis on patient information to achieve the optimal result and to meet the individual needs for every patient.

Anterior Cruciate Ligament↗
PubMed1996

[Indications and use of "AO pinless fixateurs". A preliminary report].

Improvements in techniques for the management of open tibial fractures with the external fixator have made a great impact on the final results in recent years. More recently this system has been discussed controversially. The longer treatment takes, the more likely it is that complications will occur when relying solely on the conventional external fixator. The new pinless fixator for the tibia was designed to overcome these problems. Early conversion to a more stable implant is one of the primary goals of this system. In this article the pros and cons are presented in detail and the limitation of this device explained. Moreover first clinical experiences are summarized and possible additional indications highlighted.

Equipment Design↗
PubMed1996

[Posterior dislocation fracture of the shoulder].

Posterior dislocation fracture of the shoulder is a rare injury that often occurs in association with a grand mal seizure. Our aim with this paper is to emphasize diagnosis and therapy. In the past 5 years seven patients with nine posterior dislocation fractures were treated operatively. In six patients a grand mal seizure was the cause of the injury and in one a direct trauma. Three four-part fractures were found in two patients and six locked posterior dislocation fractures in five patients. Clinical examination in locked posterior dislocation fractures showed a lack of external rotation, and flexion was performed by movement of the scapula. Radiological examination demonstrated an overlapping of the contours of the humeral head and the glenoid and the "trough line". The operations were performed in the time between 4 h and 10 days later. Two of three four-part fractures (in one patient) were treated with hemiarthroplasties, and one was fixed with screws. Closed reduction was attempted in six shoulders but was possible only in one patient. In this patient a redislocation occurred 3 days later and a combined anterior and posterior approach was done. A fracture of the anatomical neck was produced in another shoulder. Six open reductions and stabilizations with screws were performed, and three times we fixed the subscapular tendon in the reversed Hill-Sachs lesion with anchor sutures. Patients after grand mal seizures may have a posterior shoulder dislocation, and clinical and radiological examination should be emphasized. In locked posterior dislocation we favour early open reduction, fixation of the subscapular tendon with anchor sutures in the reversed Hill-Sachs lesion and stabilization of the lesser tuberosity with screws.

Adult↗
PubMed1995

[Complications in 283 cruciate ligament replacement operations with free patellar tendon transplantation. Modification by surgical technique and surgery timing].

In our retrospective study we reviewed 283 patients who were operated on between 1984 and 1993 after an ACL-rupture. We used a free patellar tendon bone graft in all patients. The aim was to assess the complications such as infections, thrombosis, limitation of movement and graft failures. We also looked on the timing of operation and the technique. We saw an overall complication rate of 21.6%. The most common complication was a restricted range of motion in 10.9% which required surgery. In patients treated immediately after injury (within 7 days) we found an arthrofibrosis rate of 17.6%. In delayed surgery (more than 4 weeks after injury) this complication was only seen in 6.1%. The rate of infection was 4.6%, the rate of thrombosis 1.8% and in 4,2% we had to accept an ongoing instability. With these findings we now evaluate the needs and the social environment even more closely to find the best treatment protocol for each individual. In conclusion we favour secondary ACL-reconstruction.

Anterior Cruciate Ligament↗
PubMed1995

[Tennis shoulder].

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Athletic Injuries↗