Biomedical subjects
H M Sommer
Publications and source records attributed to H M Sommer.
Functional treatment of recent ruptures of the fibular ligament of the ankle.
A prospective randomised study was undertaken to compare the results of functional and operative treatment of recent ruptures of the fibular ligament of the ankle in 80 patients, aged from 18 to 45 years, with similar injuries. The best results were obtained from functional treatment and it is to be hoped that early movement and a stable ankle will avoid later osteoarthritis.
[Subcutaneous muscle and tendon ruptures].
Reasons for subcutaneous ruptures of muscles and tendons are discussed from biomechanical and kinesiological points of view Experimental findings and clinical diagnostic procedures applied in muscle and tendon rupture are discussed. It is concluded that the aim of repair in the case of either muscle or tendon must be the reconstruction of their physiological length in order to avoid loss of muscle strength, which would increase the frequency of muscle and tendon injuries and cause a decline in sports performance. Therefore, surgical repair of complete muscle and tendon rupture has to be regarded as the therapy of choice especially in young patients and those engaged in competitive sport. It must be taken into account, however, that both surgical and non-surgical repair lead to the same weight-bearing capacity. Therefore, functional, non-surgical treatment must be preferred in the case of partial muscle and/or tendon rupture and in older patients.
[Central dysregulations as a cause of movement disorders in performance sports? An analysis of movement in sports with reference to functional anatomic and neurophysiologic viewpoints].
Typical orthopaedic findings and typical disturbances of movement in sports point to central dysregulation in motor disturbances in competitive sports compared with the ideal models set up under biomechanical aspects and from the viewpoint of sports practice. Neurophysiological data collected so far confirm this view. The central influence on movement is manifested by a change in peripheral proprioceptive properties, i.e. by a change in the pre-innervation of the musculature. If the musculature is subjected to high strain as in sports aiming at high performance levels, such changes produce an extremely high stretch tone in the phase of dynamic-eccentric muscular contraction resulting in functional reversal of two-joint muscles such as the M.rectus femoris and the M.gastrocnemius. This procedure is manifested in the region of system-immanent weak spots of the positional and locomotor system and, in the pelvic girdle region by tipping of the pelvis in ventral direction, with consecutive evasive shifts of the vertebral column and extremities.
Patellar chondropathy and apicitis, and muscle imbalances of the lower extremities in competitive sports.
The jumping motion of 15 competitive basketball and volleyball players was tested until exhaustion in a cinematographic study. A stereotyped motion pattern was recognisable. The knee joint shows an evasive movement into a valgus and internal rotation position during the acceleration phase before take-off. Furthermore, the knee shows a brief stabilisation in overextension at heel strike. An imbalance of the muscles which stabilise the pelvis and the lower extremities can be regularly found in these athletes and could be a possible cause for this jump motion. It leads to a shortening of the hip flexors and adductors and of the knee extensors with the final evasive action of the knee joint. Though the anatomical condition of the joint is not directly observed, such a motion pattern must be the cause of additional shear forces and peak loads in the area of the patellofemoral joint and of the apex patellae. Clinical experience shows that an active correction of the evasive motion can be achieved by systematic physiotherapy. It ensures muscular balance of the pelvic region and lower extremities and thus lasting good results.
[Cause and treatment of back pain in athletes].
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The biomechanical and metabolic effects of a running regime on the Achilles tendon in the rat.
The Achilles tendons of 192 albino rats were subjected to biomechemical and metabolic testing after a defined running period and compared with a control group. After 2, 4, 8, 12 and 16 weeks, the cross-sectional area, ultimate tensile strength and oxygen uptake of the Achilles tendons were determined. Different reactions were demonstrated particularly after intensive training. These tendons showed an increase in cross-sectional area and a decrease of ultimate tensile strength when compared to the control group after 12 and 16 weeks of training. In contrast to these results the oxygen uptake was higher than in the control groups after 4 and 8 weeks of training. Alterations in the biomechanical and metabolic properties of tendon tissue occur at different times after the running regime.
[Conservative functional treatment of fibular capsule ligament rupture even in the performance athlete?].
In a prospective randomised study we examined 80 men and women of 18 to 45 years of age and 40 competitive sportsmen and sportswomen with fresh ruptures of the talofibular and calcaneofibular ligaments treated either surgically or conservatively by functional bracing. We controlled the results by anamnesis and by clinical and radiological follow-up. Conservative treatment leads to the same results after 3-8 months as surgical treatment (5 +/- 2 degrees of talar angulation). Functional conservative treatment results in earlier painless weight bearing in comparison to the surgical treatment which was, however, combined with three weeks immobilization directly after surgery. This proves the superiority of the early functional conservative treatment as long as there are no bony capsuloligamentous tears, osseocartilaginous lesions of the joint surface with splintered-off chips or "flakes" of cartilage ("flake fractures") or reruptures of a chronically unstable ankle joint. The similarly good results achieved in the group of 40 sportsmen and sportswomen by early functional conservative treatment do not justify operation of ruptures of the talofibular and calcaneofibular ligaments.
3-0-demethyl fortimicin A: in vitro activity and interpretive zone standards for disk diffusion susceptibility tests.
The in vitro activity of 3-0-demethyl fortimicin A was compared to that of amikacin and tobramycin against 5,230 clinical isolates in four institutions. Amikacin and tobramycin were more active than 3-0-demethyl fortimicin A against Pseudomonas aeruginosa and Acinetobacter spp., but all three drugs had similar activity against the Enterobacteriaceae and Staphylococcus aureus. Additional tests with 335 representative gram-negative bacilli compared five different aminoglycosides, demonstrating differences with some isolates. Standardized disk diffusion tests were also performed with 30 micrograms 3-0-demethyl fortimicin A disks, according to the National Committee for Clinical Laboratory Standards. The following interpretive breakpoints are proposed: less than or equal to 11 mm for resistant (MIC greater than or equal to 32 micrograms/ml) and greater than or equal to 15 mm for susceptible (MIC less than or equal to 16 micrograms/ml).
pH and bicarbonate excretion in the rat parotid gland as a function of salivary rate.
The bicarbonate concentration in rat parotid saliva increases with increasing flow rates and approximates plasma values at highest salivation. At lowest flow rates the bicarbonate concentration in the secretory fluid markedly exceeds the plasma levels. Intravenous administration of acetazolamide has no influence on the bicarbonate excretion of the parotid gland. Following retrograde application of acetazolamide into the gland duct the concentrations of both bicarbonate and sodium are elevated. The potassium concentrations in final saliva exceed 70 mEq/l at flow rates below 5 mul/min g gland weight. With increasing flow rates a precipitous decrease in potassium concentration below 10 mEq/l occurs. With further increase in flow rate the potassium concentration remains unchanged. The sodium concentrations increased with augmented salivation rate. At lowest flow rates the sodium concentrations showed an increase of modest degree. Our findings can best be explained by the existence of two independent ductular mechanism: a) bicarbonate reabsorption probably in the striated ducts of the parotid gland; b) secretion of potassium with concomitand secretion of bicarbonate in the main excretory duct.