PubMed Health⌕ Search

Biomedical subjects

H Hornung

Publications and source records attributed to H Hornung.

At least 19 recordsLinked to original sources
PubMed2003

[Acute limb ischemia from the general surgeon's point of view. How much knowledge of vascular surgery is necessary?].

The diagnosis of acute peripheral ischemia can be obtained based on clinical presentation, inspection, and palpation of the affected extremity. Unfractionated heparin as a single shot is immediately given followed by continuous infusion when diagnosis is clinically evident and contraindications are excluded. Thromboembolectomy using a Fogarty catheter is immediately performed in patients with evidence of arterial embolization and signs of advanced ischemia (TASC IIb/III) followed by intraoperative angiography. Patients with evidence of arterial thrombosis require urgent angiography followed by thrombectomy and probably subsequent endovascular or surgical interventions and vascular reconstruction. For patients with moderate ischemia (TASC IIa), initial diagnostic angiography is recommended followed by primary thrombectomy with subsequent intraoperative angiography and immediate endovascular or operative treatment of remaining vascular problems. As an alternative therapeutic option initial catheter-guided local thrombolysis can be performed in selected patients with the intention of subsequent limb revascularization or unmasking relevant vessel alterations leading to specific endovascular or surgically performed vascular reconstruction. Possible development of muscle ischemia because of increased compartment pressure should be considered and fasciotomy performed when indicated. Primary amputation of the severely ischemic limb after initial thrombectomy might be recommended in patients with life-threatening organ failure related to muscle necrosis.

Acute Disease↗
PubMed1999

An intranet-based system for quality assurance in surgery.

Quality assurance in surgery relies on precise medical records about surgical procedures and outcomes. Data quality is crucial for statistical evaluation; missing values cannot be avoided but must be minimized. The quality assurance system must be accessible from many locations within the clinic; given the complex and heterogeneous computing infrastructure this is a technological challenge. Intranet-technology--the application of internet-tools in local networks--can help to solve the technical problems. We designed, implemented and evaluated a generic Intranet-based quality assurance system in surgery. The basic concept is multi-purpose data entry with predefined textblocks, i.e. the same data is used for clinical reports as well as scientific evaluations. Our first instance were reports on laparoscopic cholecystectomies consisting of 41 Items and 132 textelements. Because of the good clinical acceptance of the system it will be expanded to other surgical procedures.

Cholecystectomy, Laparoscopic↗
PubMed1997

The treatment of idiopathic scoliosis in adolescents: rotation or in situ bending?

Rotation alone is not fully efficient in order to correct all types of scoliotic curvatures. We report a series of 30 cases instrumented with the EUROS spine system and analyse reductions obtained with in situ rotation or bending alone or with combined maneuvres. The average age of surgery is 17 years for this series composed of 24 female and 6 male patients. The average follow-up is 2.3 years. The curve patterns are displayed with 6 major thoracic, 5 genuine double major, 4 double major thoracic predominant, 6 double major lumbar predominant and 9 double thoracic curves. Combination of both reduction techniques is advisable and is to be made according to the type of curvature and its reducibility in situ bending is made easier with this system without lockers and by reduced diameter of the rod.

Adolescent↗
PubMed1997

Femoral insertion of the ACL. Radiographic quadrant method.

The optimal femoral insertion or footprint for an anterior cruciate ligament (ACL) graft is the anatomic site. This study was designed to determine the radiographic localization of the femoral insertion of the ACL on a lateral roentgenogram using a quadrant method. Ten human cadaveric knees with intact ACL were dissected. The most anterior, posterior, proximal, and distal borders of the femoral insertion of the ACL were marked with K-wires that were shortened at the bone level of the intercondylar fossa. A roentgenogram was obtained in the strictly lateral position. The end of the K-wires determined the projection of the femoral ACL insertion on the lateral roentgenogram. The center of the radiographically marked area was defined as point K, then four distances were measured on the lateral roentgenogram: distance t (representing the total sagittal diameter of the lateral condyle measured along Blumensaat's line), distance h (representing the maximum intercondylar notch height), distance a (representing the distance of point K from the most dorsal subchondral contour of the lateral femoral condyle), and distance b (representing the distance of point K from Blumensaat's line). Distance a is a partial distance of t and distance b is a partial distance of h, and distances a and b are expressed as length ratios of t and h. The center of the femoral insertion of the ACL was located at 24.8% of the distance t measured from the most posterior contour of the lateral femoral condyle and at 28.5% of the height h measured from Blumensaat's line. Based on these results, the ACL can be found just inferior to the most superoposterior quadrant, which means in anatomic terms it is localized from the dorsal border of the condyle at approximately a quarter of the whole sagittal diameter of the condyle and from the roof of the notch at approximately a quarter of the notch height. By using this radiographic quadrant method combined with fluoroscopic control during surgery, we were able to reinsert the ACL at its anatomic insertion site. This method is independent of variation in knee size or film-focus distance, easy to handle, and reproducible.

Anterior Cruciate Ligament↗
PubMed1993

[Surgical treatment of panaritium articulare with the external minifixator].

Septic interphalangeal arthritis can cause severe damage to the joint affected. Two patients treated by the appropriate operative procedure are presented. After interphalangeal distraction by external fixation two drains are placed in the joint and saline solution is infused regularly. The distraction improves the catheter irrigation and the prospects of success. At follow-up examination we saw no negative consequences of the joint distraction.

Adult↗
PubMed1986

[Surgical treatment of congenital dislocation of the hip in older children; analysis of the results. Apropos of 46 cases].

The results of surgical treatment of 46 congenital dislocations of the hip in children older than 4 years are analysed. Several techniques were used; progressive traction for a short time, stabilisation by plaster cast immobilisation or surgical reduction, pelvic osteotomy with or without combined femoral rotation osteotomy with shortening. Apart from other means of assessment, 3 radiological signs were used to determine the results - sphericity of the femoral head, coverage of the femoral head and centering of the femoral head. A new classification is proposed by the authors. Only 25 p. 100 of the results were excellent or good. The other hips had at least one radiological anomaly and 17.5 p. 100 of the hips had a non-spherical head. Cases with poor coverage of the femoral head did well when this was the only defect because this anomaly was easily corrected. In contrast, excentration of the femoral head was poorly tolerated in the long term. The degree and direction of excentration had to be assessed in the frontal plane.

Acetabulum↗