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Biomedical subjects

G Taeger

Publications and source records attributed to G Taeger.

12 recordsLinked to original sources
PubMed2004

[Diagnostics and treatment strategies for soft tissue sarcomas].

Soft tissue sarcomas (STS) represent a rare entity of all malignant tumors (1%). Thus, an in-depth understanding of multidisciplinary treatment strategies may not be sufficiently present at all operative units. Consecutively, optimal diagnostic and therapeutical pathways may not be applied. Magnetic resonance imaging (MRI) is the procedure of choice in diagnosing STS. Biopsies should be performed in specialized centers. Identification of cytogenetic factors has become more important for the typing and prognosis of STS. Management of STS should employ multimodal treatment concepts (Oncology, Radiotherapy, Surgical Oncology). The decision on whether radiotherapy, chemotherapy or another option is indicated should be taken by an interdisciplinary tumor board, which also determines the sequence of treatment in relation to resection. To obtain sufficient information from histopathologic examination of the resected tumor, a clear and distinct definition of critical margins and topography by the surgeon is essential. Following these concepts, optimal local tumor control associated with resections preserving function and limbs is achieved without impairment of overall prognosis. Tumor resection alone, without previous evaluation and where appropriate adopting multimodal treatment strategies, no longer meets modern standards. After primary treatment is complete, patients have to be enrolled in a standardized follow-up program.

Biopsy↗
PubMed2003

Knee arthrodesis after infected tumor mega prosthesis of the knee using an intramedullary nail for callus distraction.

BACKGROUND: Infected tumor endoprosthesis of the knee in young patients can prove to be challenging. Common procedures are débridement and prosthesis reimplantation, amputation, revision arthroplasty, and arthrodesis. CASE PRESENTATION: We report the case of a 44-year-old man treated by arthrodesis followed by callus distraction after removal of an infected tumor mega prosthesis (Kotz type). Callus distraction was performed over a distance of 11 cm in 4 months using a femorotibial intramedullary nail with an external traction rope-winch system. METHODS AND FOCUS: The clinical, radiological, technical, and therapeutic features are discussed.

Adult↗
PubMed2002

Fibromyxoma of the iliac wing.

Myxoma/fibromyxoma of extragnathic bone is a rare, benign tumor. We report the case of a 19-year-old man with a myxoma/fibromyxoma of the pelvic bone, who presented with abdominal pain in the right lower quadrant. Radiographs demonstrated a tumor with central scattered calcifications and ossification in the left ilium. CT scans disclosed a solitary ellipsoid tumor with sclerotic borders and no evidence of cortical disruption. MRI showed homogeneous signal enhancement of the bone marrow with slight thinning of the medial iliac cortex. Final diagnosis by radiological characteristics was not conclusive and histopathological examination suggested the diagnosis of a myxoma/fibromyxoma.

Adult↗
PubMed2002

[Influence of unfractionated and low-molecular-weight heparin on bone healing: an animal model].

The inhibition of bone metabolism and development of osteoporosis under treatment with unfractionated heparins (UFH) have been discussed, whereas the pathomechanism and the question of whether low-molecular-weight heparins (LMWH) have an influence on bone healing as well remain unclear. In a blinded trial, three groups of ten rabbits received subcutaneous injections of an unfractionated heparin (sodium heparin), a low-molecular-weight heparin (certoparin), or normal saline over a period of 6 weeks after a standardized bone defect had been applied to both femur condyles. Healing of the defects was investigated in a depth of 1 and 2 mm and the remaining volume of the bone defects was measured. After therapy with UFH, the volume of the defects remained significantly larger in a depth of 1 mm (UFH/control: p<0.001; UFH/LMWH: p<0.005) and in the total depth (UFH/control: p<0.005; UFH/LMWH: p<0.025). After therapy with LMWH, there was no inhibition of defect healing (p>0.05). This study shows that the influence of heparins on fracture healing can be reduced significantly by using LMWH instead of UFH.

Animals↗
PubMed2002

[Primary external fixation with consecutive procedural modification in polytrauma].

AIM OF STUDY: It is the purpose of the current investigation to determine whether immediate external fixation of fractures, which is a simple and fast procedure, followed by secondary planned conversion represents a safe and reliable procedure without additional trauma in multiply injured patients (ISS > 15). METHODS: With a prospective protocol, all data of multiply injured patients with fractures which required immediate osteosynthesis were registrated. Demographic data, severity of injury (AIS and ISS), data of primary surgery and osteosyntheses, course of intensive care (organ failure, local/systemic complications, infectious protocol), secondary conversion (time, duration, osteosynthesis related complications) and further course were analysed. RESULTS: Out of 679 mulitiply injured patients (ISS 22), 118 required immediate surgical procedures for intracranial injury and 175 for further indications. In 45 multiply injured patients (ISS 37), 83 external fixations were performed. According to 59 planned secondary conversions (13 days), one patient developed deep infection, no other local complication was registrated. The average time for conversion procedures lasted three times longer as in immediate external fixation (43 vs. 139 min). CONCLUSIONS: Immediate external fixation in multiply injured patients is fast and poor of complications. It is a expedient procedure which is safe and careful for critically ill patients. The required conversion procedure shows no raised rate of complications.

Adolescent↗
PubMed2001

[Postoperative morbidity in surgically treated extension fractures of the distal radius. A comparative study of dorsal and volar approach].

The aim of this study was to investigate perioperative morbidity in operative interventions in distal radiusfractures, comparing the operative approach from volar and dorsal. Only problems, resulting from the operative approach towards the distal aspect of the radius, were examined. In a Case-Control-Study, we investigated patients with operative by plate-osteosynthesis treated distal radius-extensions-fractures. During 3 years we investigated 92 patients. 49 were operated with a volar approach, and after changing the operative management, consecutive 43 patients with a dorsal approach to the distal radius. Indications for operative treatment were not changed. The approach to the distal aspect of the radius corresponded to the recent guidelines. Further perioperative procedures were identical, including procedures in anesthesiology. Datas of patients have been investigated for epidemiology, kind of operations, point of time in treatment, duration of operation, X-Ray, immobilisation and time of inhospital stay as well as all documented complications. It has been shown, that in respect of all criterias, concerning length of operation (106 vs. 83 min), intraoperative X-Ray (3.0 vs. 1.65 min) as well as postoperative immobilisation (33 vs. 25 days), and documented incidences of complications like secondary wound-healing (19/49 vs. 0/43) or nerval irritations (13/49 vs. 1/43), the dorsal osteosynthesis is definitively to be favored.

Adolescent↗
PubMed2000

[Stable and unstable pertrochanteric femoral fractures. Differentiated indications for the dynamic hip screw].

The aim of all surgical procedures in the treatment of trochanteric fractures in elderly and even geriatric patients is achievement of initial stability. We examined in a clinical trial whether primary stability was achieved in all types of trochanteric fractures following osteosynthesis with the Dynamic Hip Screw (DHS). From 1994 to 1996, 122 patients with trochanteric fractures had osteosynthesis by dynamic hip screw. Patient records were evaluated and all data got registered with a standardized protocol;clinical radiological outcome was analysed after an average period of 1.9 years after injury according to the Traumatic Hip Rating Score. 22% of all patients died meantimes, 51.6% of the remaining 95 patients could get examined. The average age was 75.5 years, the patient population showed an increased preoperative morbidity (2.5 points) according to ASA-Score. 81% showed progressive osteoporosis. According to the AO-classification 47% stable fractures (type A-1) and 53% instable trochanteric fractures (type A-2 and A-3) occurred. Surgery lasted 77 minutes average in osteosynthesis of stable fractures. The duration of 108 minutes in instable fractures was significantly higher, as well as the blood loss was 43% increased in these complex fractures. Complications closely associated to the osteosynthesis appeared only in instable fractures (7%). Also common complications (24.6%) predominated with 15.6% in type A-2 and A-3 fractures versus 9% in type A-1 fractures; mortality was also different with 5.7% versus 1.6%. Assessment of the functional outcome according to THRS showed a significant deterioration of 20 points in 71% of all patients compared with the preoperative score. The results show that dynamic hip screw osteosynthesis in instable trochanteric fractures is associated to a higher incidence of complications. While the dynamic hip screw still represents the standard implant in stable fractures of the trochanteric region, being aware of improved intramedullary implants regarding biomechanical features and surgical technique, the results justify to critical consider the use of DHS for osteosynthesis in instable fractures of the trochanteric region.

Aged↗