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Biomedical subjects

H Schöttle

Publications and source records attributed to H Schöttle.

At least 19 recordsLinked to original sources
PubMed1993

[Local preventive antibiotic treatment in intramedullary nailing with gentamycin impregnated biomaterials].

The benefit of antibiotics applied intravenously to avoid postoperative infection after intramedullary nailing has not yet been proven. Local antibiotic-releasing systems might be more effective because of the high concentration available in the compartments of interest. We report on the pharmacokinetic results of ten patients with intramedullary nailing of the tibia, respectively 15 patients undergoing the same procedure at the femur, in whom we used gentamicin-impregnated biomaterials for perioperative prophylaxis. The elution of gentamicin from a collagen sponge was complete and pharmacokinetic data suggest this drug releasing system is superior to PMMA beads in respect of the studied indication.

Drug Implants↗
PubMed1990

[Ligament reinforcement with resorbable PDS cord and early functional after-care. Results of follow-up of surgically managed cruciate ligament injuries].

After operating on the injured cruciate ligaments, immediate mobilization and protection of the healing ligament are indispensible. However, no approach has yet been shown to safely provide both. Therefore, in 1984 we introduced a new technique: the repaired or reconstructed cruciate ligaments are augmented with a biodegradable material - a doubled-over PDS cord, 1.5 mm in diameter. It allows for immediate and safe mobilization. Because of its appropriate elasticity it does not cause "stress shielding." Postoperatively, the patients are mobilized on a motorized frame for 2 weeks. Subsequently, we have used a limited mobilization cast (LMC). Forty-nine out of 63 patients (78%) have now been reexamined for this follow-up study, using the score from the Hospital for Special Surgery and stress X-rays in the Lachmann, position (30 degrees flexion). The results compare favorably with a prior follow-up study of patients from our hospital without PDS augmentation and without early mobilization. The knees in the present study are more stable and have a better range of motion, particularly when the LMC was used.

Adolescent↗
PubMed1986

[Analysis of the axis in patients with patellar dislocation].

The authors investigated in 25 patients with luxations of the patella if an increased incidence of defective torsions of the leg skeleton could be demonstrated. The torsion conditions of the lower extremity can be easily shown by computed tomography. This was confirmed when 32 femur preparation and 95 sound extremities were examined. The comparison of measuring results does not show any difference between patients and control group regarding the torsion of tibia and femur and the position of the tuberosity of the tibia. Patients with luxations of the patella show an increased external rotation of the tibia with respect to the femur due to a lack of medial muscular and ligamentary guide.

Femur↗
PubMed1985

[Results of surgical treatment of fractures of the metacarpus and fingers].

Ninety-one patients with 108 fractures of the metacarpal and/or finger bones were treated by surgery between January 1974 and June 1982. 70 patients (76.9%) with 81 surgically treated fractures could be checked up after 3 3/4 years on an average. 24.3% out of these patients suffered from associated soft tissue leasions, 25.7% suffered from multiple fractures. 41 out of the 81 surgical interventions were performed for fractures of the metacarpus and 40 for fractures of the finger bones. The results were classified according to an evaluation scheme established for this purpose and containing the following parameters: mobility, trophism and sensitivity, gripping functions, force, and X-ray findings. Subjective troubles were evaluated, too. The great value of osteosynthesis in the surgical treatment of the hand is confirmed by the overall results with 92% of very good or good results and 7% of satisfactory results in metacarpal fractures and 60% of very good or good results, 36% of satisfactory results and 3% of poor results in fractures of the finger bones, the more as patients treated by surgery represent a negative selection among all patients treated for fractures of the bones of the hand. The results were classified and evaluated according to fracture site, severity of associated injuries, and method of osteosynthesis applied.

Adolescent↗
PubMed1984

Spinal fractures: results and experience with computer tomography.

Our results and experience with computer tomography (CT) were analyzed with respect to 41 patients with fresh bone injuries in both the cervicothoracic and the lumbar region of the vertebral column. Besides differentiated representation of the involvement of various parts of the vertebral body, the arch, transverse and spinous processes in 46 fractures, and four luxation fractures, bone fragments were found in the spinal cavity in 12 patients. Two patients displayed spinal bleeding and 3 showed a traumatic vertebral disc protrusion; 5 patients had paravertebral hematomas. Comparison of the CT-verified computer-tomographic fractures with the results of conventional X-ray diagnosis in two planes, as well as partial a.p. or lateral tomography (n = 12), revealed that in 13 patients even the detection of the fracture remained uncertain. Post-traumatic CT investigation (n = 9) showed syringomyelia in 3 patients, dense necrosis in 1 patient, and spinal channel stenoses as well as radicular irritations which could be explained by overshoot bone neogenesis at the intervertebral foramina. New technological developments in CT instruments of the most recent generation (digital radiography, sagittal and coronary image reconstruction) have made CT the most effective method in the diagnosis of spinal trauma. This necessitates a reorientation in the diagnostic procedure in patients with traumatic lesions of the spine.

Adolescent↗
PubMed1983

[Atlas arch aplasia].

A bilateral aplasia of the dorsal arches of the atlas with persisting tuberculum posterius has been observed by the authors. Since the patient had suffered a severe cranio-cerebral trauma, it became necessary to exclude a possible fracture by differential diagnosis. This was possible by means of CT and conventional x-ray diagnosis. According to the classification of dorsal atlas arch aplasia by von Torklus and Gehle (1975) into 6 types, the diagnosis was, in the case under report, Keller's type of aplasia of the arch of the atlas.

Adult↗
PubMed1983

[Functional adaptation of the bones. Animal experiment studies on rats].

The authors wanted to study the effect of non-physiologic muscular forces on growing rat bones. 35 animals were submitted to a total extirpation of the femur, 40 animals served as control group. They were killed immediately, six, twelve, or 24 weeks later, respectively. The results determined by macroscopic X-ray and fluorescence microscope examination are identical. As opposed to the control tibiae, the tibiae exposed to a greater load showed an increased bone density, increased ventral and lateral annexes, above all within the proximal third, and a torsion apparent in the cross-section. The less loaded tibiae showed a smaller bone density, increased medial and lateral annexes, above all within the proximal third, and a torsion apparent in the cross-section. The results are explained by the varying action of pressure and muscular forces and compared to those achieved by other authors.

Adaptation, Physiological↗
PubMed1982

[Results of reconstruction in knee band lesions (author's transl)].

Early operated knee band lesions (n = 61) had better end results than in those later treated (note 2.3 versus 2.6). In knee luxations (n = 8) we had an average result of 3.1. In combined knee band lesions (n = 39) the persistent instability of the anterior cruciate ligament was the main problem. In such lesions we had better results with primary substitution of the anterior ligament by a gracilis tendon graft than with suture of the torn band.

Adult↗
PubMed1981

[Choice of treatment of central talus fractures (author's transl)].

Because of the anatomical and functional peculiarities of the astragallus surgical and conservative treatment of central fractures are often unsatisfactory. A follow-up study of 40 patients with 42 central talus fractures were performed over an average of 9 years after the initial trauma. The number of poor results was extremely high; only primary surgical or conservative treatment showed good or fair results. Best results were obtained by primary surgical treatment whereas fractures operated at later stages showed worse results. Therefore fresh central astragallus fractures should be operated upon, fractures older than 1 day should be treated conservatively. If a satisfactory reduction cannot be obtained, the fracture should be operated upon in order to prevent arthrosis in the upper ankle joint.

Adult↗
PubMed1981

[The connecting osteosynthesis and its problems in unstable pertrochanteric fractures of the femur (author's transl)].

In unstable pertrochanteric fractures of the femur a high bending strain and much load lies on the medial part of the bone. The connecting osteosynthesis takes off this load and immediately guarantees a high stability. Clinical experiences with 44 cases of connecting osteosynthesis - among them 35 per-and subtrochanteric fractures of the femur-show, that in 11 cases complications due to the fractures occurred (breaking of the implant, pseudarthrosis etc.) These complications are probably due to a delayed healing caused by bone cement penetrating into the area of the fracture. It is recommended to use an autologous cancellous bone graft. Indications for the compound osteosynthesis are only unstable pertrochanteric fractures in old patients in poor general condition and a short life-expectancy, and fractures in patients with diffuse metastases.

Aged↗
PubMed1981

[The influence of cyclophosphamide upon the healing of fractures in the rabbit (author's transl)].

The influence of cyclophosphamide (Ctx) upon the healing of fractures in the femur of the rabbit is reported. During treatment with Ctx the x-ray shows a reduced callus-formation; the fluorescence-microscopy reveals a decreased apposition of bone. Fracture-load, fracture-energy and mineral content of the intact bone are not influenced by Ctx. Four weeks after an operation fracture-load and fracture-energy are reduced almost by one half and the mineral content is decreased significantly.

Animals↗
PubMed1981

[Results of surgical stabilisation of 307 open fractures (author's transl)].

Primary operative care with debridement and the soft tissue protective osteosynthesis is the method of choice in the management of open fractures. A follow-up study of 307 so treated fractures was performed over an average of 3 years after the initial trauma. The overall rate of osteomyelitis was 8.5% in below knee compound fractures and 4.9% in all other areas. During the past two years while using the external fixation device in 2nd and 3rd degree compound fractures in the lower leg the osteomyelitis rate was reduced to 5.5%. In the 2nd and 3rd degree compound crural fractures due to the delayed bone healing with the external fixation method alone we recommend the so called "combination osteosynthesis" in which a screw or a AO-2-hole-plate is employed additionally. Furthermore it seems essential to perform an autologous cancellous bone graft in these fractures to reduce the long healing time.

Follow-Up Studies↗
PubMed1980

External fixation as an alternative when treating 2nd and 3rd degree open lower leg fractures.

The infection rate of open lower leg fracture is extremely high. Surgical treatment guarantees a reduced risk of infection when compared with conservative treatments. But even osteosynthetic methods such as screw or compression plate fixation show unsatisfactory results because of the additional traumatization of the primarily injured soft tissue combined with a reduction of blood circulation. From July 1973 till September 1976 we treated 57 2nd and 3rd degree open shank fractures with osteosynthetic methods: 46 with compression plate osteosynthesis and 11 primarily or secondarily with external fixation. The osteitis-rate was 14%, in addition to that there was a soft-tissue infection rate of 5%. In order to change our therapeutical procedure we stabilized 2nd and 3rd degree open lower limb fractures and lower leg fractures complicated by soft-tissue damages consequently by external fixation. From October 1976 till May 1978 we treated 39 open shank fractures; 24 of them were 2nd and 3rd degree open fractures. They were treated by external fixation. This change in our surgical treatment resulted in an osteitis-rate of 2.6%, there was no case of soft-tissue inflammation. These results underline the superiority of treating 2nd and 3rd degree open lower leg fractures and fractures combined with soft-tissue injuries consequently and chiefly with AO external fixation.

Bone Plates↗
PubMed1980

[Healing of segmental defects in long bones. Animal experiments. Part II. Histological and micro-angiographical findings (author's transl)].

In part I of this paper the radiological findings in segmental defects of long bones were discussed. The histological regeneration originates from the marrow cavity. An endostal framework of bone is formed; this is more pronounced on the proximal resection place than on the distal one. The new bone formation within the defect depends on the revascularization through medullar blood vessels. The increased osteogenesis on the proximal site of resection is due to the increased formation of vessels in this area. The vascularization and the filling of segmental defects in tubular bone occurs faster, if only one metal plate and on the opposite side an autologous bone graft (cortical bone) is used in order to stabilize the bone. This method is superior to the use of a double-plate osteosynthesis. The graft unites with the underlying bone within twelve weeks by forming a trabecular network of new bone. If the autologous bone graft has become stable, it is vascularized from the bone and from the sorrounding soft tissue. Afterwards an osteolysis and at the same time an osteogenesis take place. The dead bone graft is replaced by newly formed bone within about 40 weeks. The loss of stability which occurs does not endanger the osteosynthesis.

Animals↗
PubMed1980

[Results of stabilisation in pathologic fractures in the femoral shaft region by nailing (author's transl)].

The article reports on 11 patients with metastases in the femoral shaft. In 5 patients, a pathological fracture had occurred, whereas in 6 patients the femur, which was liable to fracture, was prophylactically stabilised by means of the femoral shaft nail. Eight of these patients were able to walk after the operation, whereas 4 patients died after an average period of 19 weeks following surgery of their primary diseases. The method employed in these cases was of a palliative nature, resulting in considerable relief from pain, improved ability to walk, and hence in an improvement of the quality of life of these patients.

Adult↗
PubMed1979

[On the problem of industrial accidents under drug influence (author's transl)].

Industrial accidents resulting from technical defects have decreased in the last eights because of improved safety precautions. In contrast, accidents resulting from "human error" are increasing steadily. Toxicological urine analysis for drugs--directed mainly at soporifics, sedatives, tranquilizers, and pain-relievers--on 84 patients involved in industrial accidents yielded the following results. 1. Drugs were identified in 44 patients (= 52%). 2. In 13.4 patients, more than one drug was identified (= 16%). 3. Only five of the 44 patients admitted on being questioned that they had taken drugs (= 10%). On the other hand, in a control group of 47 persons who and not suffered any accident, drugs were detected in 19 cases (= 40%). The results show that the physician will have to take into account that healthy and efficient persons, too, are very often likely to practise drug abuse. It must be considered probable that this helps to promote accidents. Medical prescription, especially of neuroleptics and psychotropics, as well as of sedatives, should be practiced more.

Accidents, Occupational↗