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Biomedical subjects

G Segmüller

Publications and source records attributed to G Segmüller.

At least 19 recordsLinked to original sources
PubMed1992

[The medical record at the center of medical informatics].

Several areas in medical institutions, particularly the technical and administrative ones have been governed by computers for a long time. The proper medical work field (diagnosis, treatment, follow-up, correspondence and billing) however has hitherto mostly been ignored by data processing. We describe an electronic medical record introduced 4 years ago. All aspects of medical practise and all the specialists involved in patient care are integrated in the electronic document. In the center is a medical base of knowledge adaptable to all specialties as well as an expert system for direct control of the data entered by all concerned persons.

Ambulatory Surgical Procedures↗
PubMed1992

[Surgical indications for partial inpatient and ambulatory surgery of the lower extremities].

Outpatient (ambulatory) surgery has become widely accepted in free-standing outpatient surgery centres and in hospitals covering the field of hand surgery as well as, increasingly, the field of lower-extremity surgery. Three factors are decisive for secure ambulatory surgery: adequate material and personal resources guaranteeing a round-the-clock medical service, outpatient anesthesia which focuses mainly on the perioperative care of outpatient surgery, and a well-informed patient. Under these prerogatives the majority of surgical procedures of the lower extremities are performed on an outpatient basis without any undue risk. This includes also the diagnostic and operative arthroscopy of different joints.

Adult↗
PubMed1990

[Electronic organization of patient records as a component of integrated medical informatics].

Conventional patient records are not only inconvenient to store, their structure is often not consistent and faulty, research is difficult and quality control is not possible. One solution to this problem is the computerized patient record. It contains all necessary data beginning with the first medical statements and ending with the final results of treatment. At any time and from any with the system connected computer terminal it allows immediate access to all medical records. In addition to medical information also administrative data are stored. The here presented system of a computerized medical record has proven to be an effective tool in the daily work as well for clinical, administrative and research tasks.

Humans↗
PubMed1989

[Arthrodesis of the central support of the carpus. Indications, technic, results].

We have used this operation for the management of pain due to osteoarthritic changes at the radio-scaphoid and capitate-lunate joints. It allows correction of the carpal height by reposition of the flexed lunate, preserves the load bearing capitate-lunate axis, and decompresses the radio-scaphoid joint. We have carried out the procedure in 25 cases. Perilunate instability with osteoarthritic changes were present in 14 wrists; the remainder were consequent to non-union of fractures of the scaphoid with osteoarthrosis, or following complex fracture dislocations. At review 10 patients were free of pain, 12 had occasional pain and 3 were not improved. The mean residual range of movement in the wrist was 49 degrees, with a range from 20 degrees to 80 degrees. Bony union was not achieved in 5 wrists. At operation the lunate is reduced and carpal height restored with realignment of the weight bearing axis. Bone grafts and internal fixation are used.

Adult↗
PubMed1989

Determining carpal collapse. An improved method.

The carpal height index (carpal height ratio of the diseased wrist divided by that of the normal wrist, as described by Kato et al.) was calculated in forty normal subjects, ten patients who had Stage-III lunatomalacia, and eight patients who had non-union of a fracture of the scaphoid. The method of Youm et al. for determining the carpal height index was altered to include the use of defined points of reference and a standardized radiographic technique. Two tests of reproducibility demonstrated the reliability of the method. The carpal height index was found to be superior to the carpal height ratio for the evaluation of unilateral disease. The mean carpal height index of diseased wrists differed significantly from that of normal wrists. The carpal height index (for unilateral disease) or the carpal height ratio (for bilateral disease) can be used to describe the progression of collapse of the wrist quantitatively and to evaluate and compare various forms of treatment.

Adolescent↗
PubMed1989

[Arthrodesis of the metacarpophalangeal joint of the thumb. Indications, technic, arthrodesis angle and functional effect].

The metacarpophalangeal joint of the thumb has less range of motion than any other digital joint. Its stability is more important than its mobility. Thus, arthrodesis of this joint causes relatively little loss of function, provided only that the joint is fused in the correct position. The authors reviewed all MP joint fusions of the thumb which were done at their hospital between 1974 and 1985. They examined individually forty-one of the fifty patients and studied the indications, surgical techniques and difficulties, and the complications. Furthermore, they measured all angles of fusion and concluded that the optimal position is fifteen degrees of flexion and ten degrees of pronation. The use of tension band wiring facilitates the achievement and maintenance of the desired position. The stability of the fusion permits exercise immediately after the operation; this helps to avoid a tenodesis of the long extensor tendon of the thumb.

Adolescent↗
PubMed1988

[Electronic medical history: utopia or reality?].

With the advent of computers in medicine, the patient's chart has a more varied function. The basic use has been as the physician's instrument to provide information about diseases and their evolution. In order to link the physician with the capacity of a computer, a common language was elaborated based on the patient's chart. Computerized charting now makes possible not only improved communication and administration but also serves as a statistical databank. Important applications of a medical databank are statistical analysis of the chart, quality control of medical practice and facilitation of scientific studies. The patient's chart becomes a powerful multifunctional instrument in the clinic, the practice, and in research.

Electronic Data Processing↗
PubMed1987

The late reconstruction of the ligament of the metacarpo-phalangeal joint of the thumb.

The disruption of the ligaments at the level of the MP-joint jeopardizes the function by lack of stability. The reconstruction by free tendon grafting, anchored in a dorso-lateral plane in the metacarpal an in the proximal phalanx, restores stability and good functional results in spite of a slight amount of loss of flexion. Two out of 25 operated thumbs failed and fusion of the MP-joint was necessary. A minimal limitation of flexion may be desirable since a tendon graft never restores a full physiological function. Our data show no need for K-wire transfixation of the MP-joint, since there is no evidence of a difference in late stability with or without such additional fixation. The mean pinch-grip pressure, restored to normal in the majority of cases, was not influenced by the mentioned reduction of flexion nor by the amount of stability restored.

Arthrodesis↗
PubMed1986

[Anatomic basis of a new concept of stability of the carpus].

Based on anatomical and biomechanical evidence, we conclude that the stability of the carpus relies on the lunate bone which is the centre of the longitudinal as well as the transverse functional axis. The lunate is firmly stabilised proximally to the radius and the radio-ulnar ligament complex by the proximal V-ligament, and so becomes a weight bearing structure. It is anchored by strong ligaments to the scaphoid on one side and the triquetrum on the other, thus forming a 3-bone intercalary system, which is in turn guided by the palmar distal V-ligament and the dorsal radio-triquetral ligament.

Biomechanical Phenomena↗
PubMed1979

[The idiopathic osteolysis syndrome].

Idiopathic osteolysis of the multicentric type is a rather rare clinical entity without known causative factor at onset. It displays rapid clinical progression and destruction of bone is completed before the end of growth. A review of the literature is presented with a view in particular to useful classification of the different types of osteolysis. A case followed up at our clinic for surgery of the hand is described and discussed.

Arthrodesis↗
PubMed1979

[Kirner's deformity: an isolated malformation of the third phalanx of the little finger].

A typical growth deformity of the third phalanx of the 5th finger known in the literature as "Kirner's deformity" has been observed over 5 years in 4 patients (there are now 5 patients) at the Clinic for Hand Surgery in St. Gall. Almost all reports (39 cases) are in the English-language literature. It is felt that apart from esthetic problems functional deficiency is of considerable relevance, and the only existing therapy mentioned in the literature (osteotomy) has been supplemented by localized partial epiphysiodesis by microsurgical operative technique.

Abnormalities, Multiple↗
PubMed1978

Stabilization of bone in replantation surgery of the upper limb.

The principles of sound osteosynthesis of the skeleton of the hand are the same as in internal fixation of other bones. Small implants and instruments are essential. In replantation surgery healing of microvascular anastomoses and nerve sutures as well as repaired tendons is possible when the skeleton is stabilized. Only the minimum metal should be implanted to avoid interference with joint and tendon function. A small implant can provide an adequate stability, when it is applied correctly. Replantation should be performed only by surgeons with extensive experience in the field.

Bone and Bones↗
PubMed1978

[Diaphyseal and articular fractures of the growing skeleton of the hand].

The closed as well as the operative treatment of fractures of the skeleton of the hand during growth must take into consideration the growth potential of the bones. It is particularly important in its potential to correct shortening as well as axial deviation and angulation (except rotational deformity). There are, however, limits to this potential as shown in epiphyseal fractures. Modern internal fixation has, therefore, an important -- though very restricted -- place in the treatment of these epiphyseal fractures. Other rare indications are mentioned.

Adolescent↗
PubMed1977

[The carpal tunnel syndrome. Indication, technic and results following epineural and interfascicular neurolysis].

In the advanced stage of the carpal tunnel syndrome with apparently "irreversible" loss of motor function and sensibility, epineural and interfascicular neurolysis has been recommended as an idjunct to the conventional decompression of the median nerve. Nevertheless the literature is lacking in data concerning recovery of motor function after operation. In addition to clinical examination, histological and electromyographic data are proveded to demonstrate the histo-pathological changes and the late results after neurolysis. Indications for the technique of this more radical operative procedure as well as late results are described.

Adult↗