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Biomedical subjects

G Sperner

Publications and source records attributed to G Sperner.

31 records · Page 2Linked to original sources
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↗
PubMed1986

[Partial meniscus arthroscopic resection].

Arthroscopic meniscectomy was performed in 393 patients in the "three portal technique" in the years 1981 through 1983. The medial meniscus showed a bucket handle tear in 40.3% and a flap tear in 37.3% whereas the lateral meniscus showed a bucket handle tear in 12.2% and a flap tear in 46.1%. More than one third of the meniscus lesions were associated by chondromalacia of patella or femoral condyle. Arthroscopic meniscectomy was combined with shaving of the cartilage or shaving and arthroscopic subchondral drilling in 71 cases. Second-look arthroscopy was performed in 10 patients because of rupture of the remnant rim after the first partial meniscectomy.

Adult↗
PubMed1984

[Significance of acute arthroscopy for the verification of fresh isolated cruciate ligament rupture].

Arthroscopy for diagnosis in isolated rupture of the cruciate ligaments of the knee. Arthroscopy of the knee was performed in the years 1981 through 1983 in 1107 patients, arthroscopic meniscectomy in 340 patients. In acute traumatic haemarthrosis of the knee 74 "isolated" ruptures of the cruciate ligaments were found. The exact disclosure of these 74 cases gave a real isolated rupture of the anterior cruciate in 28.4%, an isolated rupture combined with meniscus tears and connected with flake fracture each in 20.3%. In 17.5% the exact diagnosis was a disruption of the anterior cruciate together with meniscus tears and flake fracture. Acute arthroscopy allows a more accurate diagnosis of injury to joint structures. If there was an intraligamentary rupture of the anterior cruciate and meniscus tear or flake fracture we did arthroscopic meniscectomy and removed the small flake. The substitution of the anterior cruciate was performed, if there were instability complains, later on at agreeable time for the patient.

Adolescent↗