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Biomedical subjects

G Sperner

Publications and source records attributed to G Sperner.

At least 19 recordsLinked to original sources
PubMed1992

The effects of alcohol and benzodiazepines on the severity of ski accidents.

Urine samples from 402 victims of ski accidents were analyzed for the presence of benzodiazepines (BZD) and alcohol. Eighty-one (20%) samples were positive for alcohol; BZD were detected in 34 (8.5%) cases. Ten of the samples (2.5%) were found to be positive for both alcohol and BZD. Subjects who were positive for either alcohol or BZD or both were older than the other persons examined. The prevalence of alcohol was significantly higher among male accident victims. BZD intake could be demonstrated to have a significant influence on the severity of injuries. Besides an increased awareness of the need for skier education regarding drug use, heightened attention of medical caregivers is warranted to inform their patients about potential accident hazards in sport activities when BZD are prescribed.

Adolescent↗
PubMed1992

[Arthroscopic and percutaneous bone screw techniques with a new screw system].

A new screwdriver is presented with which small titanium screws can be introduced into a joint under arthroscopic guidance. The screws are centrally cannulated, 2.7 mm thick (thread diameter), and available with and without a washer (5 mm in diameter, serrated and convex, flexible but not removable). The screwdriver has a special screw-holding device which allows the screw to be grasped and released making it possible to remove a screw already implanted in the joint at an earlier time. This arthroscopic screwing system has been used in 81 cases to date. In 59 patients with shoulder instability, arthroscopic refixation of the detached labrum-capsule complex was performed. In the first 32 of these cases an intra-articular screwing technique was used and in the following 27 cases an extra-articular screwing technique was applied. In addition, in 9 patients a fractured and displaced greater tuberosity was reduced and fixated percutaneously under the guidance of an image intensifier by means of this screwdriver. Other fields of application were the knee joint (type III fracture of the intercondylar eminence in 5 patients) and the ankle (displaced fracture of the talus in 2 patients and osteochondritis dissecans in 1). Complications were seen only in the patients with shoulder instability who were treated by the intra-articular screwing technique (screw loosening in 4 patients). This was the reason why the intra-articular technique was replaced by the extra-articular method. Since that time no further complications caused by the screws have been seen. Redislocation of the shoulder joint occurred in 1 case 7 months after operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthroscopes↗
PubMed1991

[Growth in length after femoral shaft fracture in childhood].

At the Innsbruck Trauma Department a total of 75 children with closed femoral shaft fractures were reviewed with reference to length discrepancy. The femurs were measured radiologically two times within four years to find out, if overriding of the fragments is useful to prevent overgrowth of the broken limb. In 60 patients conservative treatment and in 15 cases operative treatment was performed. The cases may be divided in two age groups: one ten years of age or younger, the other eleven years to 15 years. Shortening of the fragments shows no evident advantage preventing overgrowth of the broken limb, but in elder children it may provoke a persisting shortening of the limb. As a matter of fact anatomical reduction in conservative treatment of femoral shaft fractures, especially in elder children, should be performed. After operative treatment the children ten years of age to 15 years showed not even more lengthening of the femur than the patients with conservative treatment.

Adolescent↗
PubMed1991

[Effect of alcohol and benzodiazepines on the severity of ski accidents].

Urine samples from 402 victims of ski accidents were analyzed for the presence of alcohol and benzodiazepines. In a second stage of the investigation, patients were asked to fill in a questionnaire evaluating among other things the consumption of alcohol and the use of benzodiazepines during the last 24 hours before the accident. 81 (20.1%) samples were found to be positive for alcohol, in 34 cases (8.5%) benzodiazepines were detected by urinalysis. 10 samples were positive for both alcohol and benzodiazepines. Subjects positive for alcohol and benzodiazepines presented with significantly more severe injuries than the negative controls. Native accident victims were significantly less frequently positive for alcohol than were subjects from foreign countries. Accidents most commonly occurred early in the afternoon, the positive urine samples, however, were evenly distributed over the whole day. The questionnaire was answered and returned by 76.6% of the study population. 80% of the patients with urine samples positive for alcohol reported having consumed alcohol before the accident, whereas none of those who had been positive for benzodiazepines admitted having ingested tranquilizers.

Adolescent↗
PubMed1991

[Early and intermediate results of conservatively and surgically treated lateral clavicular fractures].

Between 1986 and 1988 67 patients with distal clavicular fracture were treated at the trauma hospital in Innsbruck. Depending on type of fracture conservative treatment (using a spica or other bandages) was performed in those cases without dislocation. Operation was necessary if coracoclavicular ligament was ruptured and dislocation of the distal clavicular end was found in X-rays. The most common practice was the use of K-wires and wire-loops. Plate fixation was necessary in one case of delayed fracture healing. No pseudarthrosis was seen in X-rays, mobility of the shoulder girdle was good and symptoms of pain were rare.

Acromioclavicular Joint↗
PubMed1990

[Pathology, diagnosis and therapy of patellar dislocation].

Patella dislocation in sports trauma is a common injury and is influenced by minor alterations or derangements of dynamic or static factors. The sulcus angle should not exceed 138 degrees and the Q angle should not be more than 15 degrees. Patella alta has some influence on the dislocation tendency, and so has weakness and atrophy of the musculus vastus medialis obliquus, causing muscular imbalance. Diagnosis is made via x-ray in tangential as well as a.p. and lateral view. Clinical examination of the patella reveals in lateral dislocation or redislocation can be provoked after positioning. Tenderness is present along the medial retinaculum associated with haemarthrosis in most of the cases. Conservative treatment includes evaluation of haemarthrosis and physiotherapy especially with regard to strengthening the vastus medialis obliquus. Surgery includes lateral release and medial capsular plication or transposition of the patellar tendon for correction of the Q-angle.

Adolescent↗
PubMed1990

[Late results in patellar fracture].

This article surveys a follow-up of 31 patients suffering from a patella fracture 6 to nearly 9 years ago. Patients complaints are compared with objective circumstances. Conservative treatment only was exercised in fractures without displacement and in longitudinal ones, which had an intact extensor mechanism. Results after patellectomy are not satisfactory. Most of fractures are treated with tension cerclage combined with K-wires or with screws. Partially difference was realized between patient's feelings and medical evidence.

Bone Screws↗
PubMed1990

[Arthroscopy of traumatic hemarthrosis following sports injuries. A 5 year analysis].

This retrospective study was made to evaluate the significance of different sports activities that cause variable haemarthrosis with intraarticular lesions of the knee joint. Throughout 1984 to 1988 arthroscopy was performed in 337 patients with acute haemarthrosis. The average time between trauma and arthroscopy was 8 days. ACL rupture was diagnosed in most of these cases. Regarding the different types of sport activities ACL lesions were found in skiers (74%), other winter sports (47%), soccer (53%), tennis and squash (58%), athletics (41%) and indoor (61%). Peripheral meniscus tears associated with haemarthrosis were found in 36% and patellar dislocations in 8%. Isolated MCL ruptures were diagnosed clinically and arthroscopy was not performed in these cases. Throughout 1987 isolated ACL ruptures were fixed by reattachment. This technique was not continued any longer and ACL replacement by patellar tendon as bone-ligament-bone was performed routinely since 1988 in those patients, who required surgery. 56 patients required ACL reconstruction following conservative treatment because of ACL deficiency, when they went back to sports activities. Longitudinal peripheral meniscus tears were fixed by the scape in inside-out technique.

Adolescent↗
PubMed1990

[Clinical management of lesions of the rotator cuff].

Lesions of the rotator cuff are caused in most cases by degenerative changes in the critical area around the tuberosities of the humerus. Clinical examination reveals atrophy of the supra- and infraspinatus muscles, a painful arc of movement and, especially, pain at night. There are many clinical tests that can be helpful in the diagnosis. Both ultrasonography and arthrography have proved to be very sensitive methods for the detection of rotator cuff tears. Ultrasonography allows determination of the size and location in addition. Conservative treatment includes rest, physical therapy and anti-inflammatory medication. In many cases the symptoms are improved by many weeks of conservative treatment alone. Operative treatment becomes necessary when no pain relief and no satisfactory movement can be achieved. Complete correction of the tendon defect is important for postoperative care. Passive exercise must allow the tendon repair to remain intact without subjecting it to undue stress.

Adult↗
PubMed1990

[Knee joint hemarthrosis--differential diagnostic considerations for planning an operation].

From 1980 to the end of 1988, arthroscopy has been performed on 620 patients with acute hemarthrosis of the knee joint. Of all the intraarticular lesions, 89.4% required surgery. Arthroscopy has changed in the last decade from diagnostic screening to invasive instrumentation for exact operative planing and alternative operative techniques. Hemarthrosis in stable knee joints was caused by minor lesions (7.84%) that did not require surgical procedures. Seventy-three patients had traumatic patellar dislocations--in 33 cases associated with chondral or osteochondral fractures. In 54.8% of the isolated medial retinacular ruptures, simple suture was performed in 14 cases--3 times arthroscopically and 11 times open, combined with lateral retinacular release without redislocation following. Associated chondral fracture indicated surgery in all cases. Isolated meniscus pathology (12.48%) was treated by arthroscopy alone, and refixation of the medial meniscus was carried out using the inside-out technique in 27 cases. Arthroscopic elevation of lateral tibia plateau fracture--indicated by type II fracture according to the AO classification--was performed in 3 cases with excellent results, and was associated with screw fixation and image intensification in 2 patients. Intercondylar eminence fracture is an excellent indication for arthroscopic refixation in the presence of the mono- or two-fragment type of fracture. ACL rupture is the main intra-articular pathology (64.8%) for hemarthrosis of the knee joint, which was diagnosed as an acute injury within the 1st week following trauma (51.04%). Anterior instability can be detected clinically if a careful examination with the Lachman test, combined with the missing end-point and pivot-shift test, is performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthroscopy↗
PubMed1989

[The pattern of injuries of the ankle joint in ski boots--a retrospective analysis].

This study is dealing with the analysis of isolated ankle fractures in ski boots which are nowadays very seldom. Modern equipment and excellent prepared skiing facilities reduced this kind of trauma. In the early sixties about 60% of lower extremity injuries were caused by ankle fractures. Now, 25 years later, only 10% of injuries concerning to lower extremity are injuries of medial and lateral ankle or of the talofibular ligaments. At the department of trauma surgery of the university hospital of Innsbruck we use a questionnaire for winter sports injuries. We made a retrospective follow up study of the last three years, in which we found 100 patients with ankle injuries. Pilon tibial- and tibia shaft fractures are not included. The classification was made by the Lauge-Hansen system. Supination-inversion and supination-eversion fractures were found more often than others. Fractures of both medial and lateral ankles were only seen in three cases. One reason for this result could be a lack of movement of the ankle in the ski-boot. Modern plastic boots seem to protect ankle and distal tibia and fibula. Another remarkable result was the fact that we could not find any difference in the types of fractures comparing patients with released and not released bindings.

Adolescent↗
PubMed1989

[Technical errors and early complications of osteosynthesis of pertrochanteric femoral fractures using the dynamic hip screw].

Within a period of 3 years, 198 patients with pertrochanteric fractures were operatively treated with implantation of the dynamic hip screw: 141 were female and 57 male (ratio of 2.5:1). The youngest patient was 27 and the oldest 100 years of age (average 74.4 years). Most preoperative failures in management were caused by insufficient reduction when no valgus of the femoral head and neck was achieved. Some patients had ulcers in the genital region because of forced reduction on the traction table, and in one of these cases plastic surgery was necessary. Intraoperative failures may occur because of too early removal of the guide pin, which should remain in the center of the femoral head until the screw is placed in the right position. Postoperative complications are caused by full weight bearing, which leads to varus and recurvation malposition. In 2 cases, deep wound infection occurred. The plate broke out in 3 cases, 2 of those required reoperation. Six patients between 61 to 84 years of age died in the early postoperative period during their stay in hospital.

Adult↗
PubMed1989

[Therapy forms and treatment results of patellar fracture].

Concerning the therapy of fractures of the patella one has to discern between non-dislocated fractures being treated conservatively and all other kinds needing an operation. Between 1984 and 1987 172 patients with fractures of the patella were treated at the University Clinic of Traumatologic Surgery in Innsbruck. Transverse and vertical fractures were the majority. 84 patients were operated and most of them by means of tension band wiring principle. After operation patients normally received a plaster for approximately five weeks. Accompanying injuries were observed in several times. In five cases we had to do a reosteosynthesis because of secondary diastasis. One patient with a refracture could finally by cured with conservative methods.

Adolescent↗
PubMed1989

[The technic of the Bankart operation. A modified reinsertion technic].

A modified technique of reinsertion of the capsule to the bony rim of the glenoid was developed and performed in 57 patients with recurrent anterior dislocation of the shoulder joint. The technique is described in detail. The principal idea of this modified technique is to suture the lateral flap of the capsule into a small sulcus, which is chiselled into the transition zone between the cartilage of the joint and the bony rim of the glenoid. From the bottom of the sulcus four holes are drilled just below the corticalis of the glenoid rim with a dental drill. The capsule is fixed by two U-sutures transosseously. The advantages of this technique are: (1) stable capsular barrier along the rim of the glenoid reinserted by two strong U-sutures; (2) no step between the cartilage of the joint and the reinserted capsule (a Hill-Sachs lesion cannot hook in at the Bankart lesion); (3) the sutures are extra-articular; (4) the lateral flap of the capsule must not be shortened, and therefore full shoulder motion can be obtained; (5) the tendon of the subscapularis muscle is restored to its original position on the lesser tuberosity; (6) a short period of postoperative immobilization. In accordance with the standard rating scale of Rowe, 31 patients were graded as having excellent results, 8 good, none fair, and none poor.

Adolescent↗
PubMed1988

[The value of arthroscopy following traumatic patellar dislocation].

Traumatic dislocations of the patella and associated osteochondral fractures can be easily diagnosed by arthroscopy. During 1984-1986 acute arthroscopy was performed in 280 patients with traumatic haemarthrosis of the knee joint. In 26 cases the intraarticular bleeding was caused by patellar dislocation. Most of these injuries occurred during sports activities. Arthroscopic surgery gave excellent results in most of the cases. Arthrotomy had to be performed in 3 patients only.

Adolescent↗
PubMed1987

[Comparative results of compression and non-compression operation methods following medial femoral neck fracture].

This is a personal clinical and radiological follow-up of 65 patients with fractures of the femoral neck who were treated in 1973 to 1984 at our hospital. 30 patients were operated by nailing according to Smith-Petersen and in 35 patients osteosynthesis was performed by means of three or four lag screws. A comparative study between these two methods was done. The two main complications of femoral neck fracture, a vascular head necrosis and pseudarthrosis, were of special interest. The mean follow-up time was 7.2 years with the fracture fixed by nailing and 4.1 years, with the fractures operated by lag screws. Out of the 65 patients the total rate of femoral head necroses was 21.5% and 10.7% of pseudarthrosis. In the fractures treated by the nailing method the rate of necrosis was 23.3% and the rate of pseudarthrosis 13.3%. In the fractures operated by lag screws the incidence of head necrosis was 20% and 8.5% by pseudarthrosis. Fracture displacement was primarily responsible for the development of aseptic necrosis, but we could see also a relation between head necrosis and the inclination of the fracture line. Fractures of the type PIII/GIII/IV are those with the highest rate of avascular necrosis. Furthermore, the development of both, aseptic necrosis and pseudarthrosis, is strongly influenced by incomplete reduction.

Adult↗
PubMed1987

[What is the significance of posterior boot edge fracture in Alpine skiing?].

Lower leg fractures have decreased in number in alpine skiing since the winter season 1970/71. Yet it seems that the fracture rate remains at a 4% level since 1982/83. In this study we analysed 266 lower leg fractures treated in a period between october 1982 to october 1986 at the Department of Traumatology of the University of Innsbruck. When listing up the various types of lower leg fractures the numerous posterior boot top fractures were evident. These bending fractures with a dorsal wedge make up 82.1 percent of the open lower leg fractures. Radiological evaluation of the fracture type and the personal accident description give evidence of the fall mechanism. The dorsal bending fracture at the crossing of the middle to the distal third of the tibia is caused by a backward fall when the toepiece of today's ski-binding does not release the ski boot in the vertical plane. The high and stiff ski boot has no protective function in a backward fall and the so called "safety effect" of the calf muscles is not effective in such a case. This fracture occurs mainly in the 20 to 25 years age group. To avoid such serious lower leg fractures a toepiece of the ski-binding has to be found which releases not only in the transversal plane but also in the vertical plane, that is multidirectionally.

Adolescent↗