[Comment on the contribution by A. Siegel et al. Fatal iliac vein injury caused by guide wire used during dynamic hip screw (DHS) implantation"].
Explore the source record for details and available documents.
Bone Screws↗
Biomedical subjects
H G Hermichen
Publications and source records attributed to H G Hermichen.
[Primary valgisation osteotomy in femoral neck fractures].
Technique and results after primary valgisation osteotomy in 41 patients with femoral neck fractures are described. 2 non unions and 9 avascular femoral head necroses were observed. The primary valgisation most probably does not influence the rate of necrosis. When performed by accurate technique it lowers the incidence of non union of the femoral neck. Postoperative leg lengthening is always evident. The most current avoidable mistake is an external rotational deformity. The procedure requires proper preoperative planning.
Adult↗
[Indications status and surgical treatment of spinal fractures. Attempt at a survey and determination of present status].
Indications for operative treatment of spinal fractures sometimes are difficult to work out. Undoubtedly deteriorating neurological deficits require decompression always combined with stabilization. Due to new classifications a severe instability of the fracture, an axis deviation more than 25 degrees and polytraumatized patients show up being an indication for operative treatment. A proper preoperative planning with use of X-rays and CT Scan as well as the knowledge of the kind and site of instability is mandatory. In cervical spine fractures anterior fusion seems to be the best method. In thoracic spine fractures dorsally attached plates give enough stability. In the thoraco-lumbar spine region and in the lumbar spine itself the internal fixator with dorsal instrumentation together with a transpedicular bone graft is preferred by the authors. Among 384 fractures of the spine 62 have been operated. Both kinds of treatment do not compete; they are complementary instead.
Bone Plates↗
[Stable osteosynthesis following ilial resection in intraosseous Ewing sarcoma].
A case of a young man with Ewing's sarcoma of the os ilium is demonstrated. The tumor is removed by resection of the os ilium and the adjacent musculature. The bony stability is reconstructed by means of a double autogenous free fibula graft in combination with a broad plate, braced between os sacrum and the roof of the acetabulum. Full weight bearing is possible, at present there is no evidence of a local recidive or of metastases.
Adult↗
[Special problem in the replacement operation in cemented prostheses].
The replacement of a loose total hip prosthesis requires a great amount of surgical skill and experience. Severe bony defects in the acetabulum should be filled by homogeneous bone grafts. Implantation of a Schneiderring together with the graft gives sufficient stability. The new shaft should be cemented very carefully, avoiding cavities between bone, cement and stem. The shaft of the femur should be reinforced by a long bridging plate.
Bone Cements↗
[Bore wire osteosynthesis in distal radius fractures].
In the presence of an area of extensive dorsal comminution percutaneous pinning is indicated in a typical distal radius fracture (Colles). It enlarges the stability and thus helps avoiding a secondary dislocation of the fracture. Indication and technique of this procedure are discussed following a series of 66 patients. Typical mistakes are as follows: insufficient reduction, poor diverging of the K-wires and improper anchoring in the opposite cortex. Avoiding of these possible faults leads to good final results. Flexion fractures and extensive shattering of the bone are contraindications for percutaneous pinning of these fractures.
Bone Wires↗
[Non unions of the humerus shaft (author's transl)].
The clinical evaluation of 121 cases of non union of the humerus shaft shows that 46 of these occurred after conservative and 75 after operative treatment. The main failures could be found after conservative treatment by traction methods. Operative treatment by intramedullary splinting did not achieve sufficient stability. The high rate of non unions after plate osteosynthesis is caused by basic technical faults in nearly all cases. The number of postoperative nerve palsy is remarkable. All cases could be healed by means of proper plate osteosynthesis after decortication combined with cancellous bone grafting in 12 atrophic non unions. The high rate of non unions of the humerus shaft gives occasion to reflect upon the correct indications for fracture treatment. From our point of view a more conservative attitude should be required.
Adolescent↗
[Influence of the treatment of fractures on the development of pseudoarthroses of the humerus shaft (author's transl)].
The evaluation of 98 pseudoarthroses of the shaft of the humerus showed that 42 of these occurred after conservative and 56 after surgical treatment of the original fracture. It appears that pseudoarthroses are caused in conservative treatment chiefly by the traction methods. Among the surgical methods, intramedullary nailing does not seem to bring about sufficient stabilization with a satisfactory measure of safety, whereas in the case of plate osteosynthesis, errors in respect of operation technique are mainly responsible for causing pseudoarthroses. All 98 pseudoarthroses returned to normal condition after proper plate osteosynthesis and, if necessary additional deposition of cancellous bone graft.
Adolescent↗
[Treatment of necrosis of the femur condyle with a medial gliding knee prosthesis].
Spontaneous osteonecrosis of the femoral condyles occurs rather seldom particularly in elderly patients. Whereas some authors recommend valgusosteotomy and bone drilling, implantation of a unilateral knee prosthesis should be performed in the presence of large defects. It is reported a series of 11 patients suffering from osteonecrosis of the femoral condyle. All patients were treated by a unilateral knee prosthesis with good results except one case. The filling of the defect with cancellous bone prior to the implantation of the condylar part of the prosthesis is mandatory.
Aged↗