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Biomedical subjects

H Stürz

Publications and source records attributed to H Stürz.

12 recordsLinked to original sources
PubMed1991

Indications for and results of operative treatment of spondylitis and spondylodiscitis.

We present a retrospective follow-up study of 24 patients with spondylitis or spondylodiscitis whose treatment included surgical intervention. Tuberculous spondylitis was diagnosed in 14 patients and 10 suffered from non-specific spondylitis. The average age of the patients was 50.2 years and average follow-up was 3 years. All patients were asymptomatic at the time of examination and showed radiographic evidence of solid fusion. We recommend radical debridement and spinal fusion through a ventral approach in patients with destruction of the ventral vertebral body, progressive neurological impairment, septicaemia and antibiotic-resistant, symptomatic infections of the spine. In the elderly patient, even in reduced states of health, early surgical intervention can be particularly valuable. Although surgical intervention should be reserved for specific indications, we were able to document favourable results in all 24 patients treated with debridement and spinal fusion.

Bone Transplantation↗
PubMed1991

Cranio-cervical stabilization using contoured luque rectangles.

Cranio-cervical stabilization using preformed Luque rectangles supplemented by autologous bone grafts was performed in 18 patients. Stability at the cranio-cervical junction had been impaired by a number of diseases including rheumatoid arthritis in 12 patients. Metastatic tumour in 5 patients and post-operative swan neck deformity in one patient. In all patients immediate stabilization as well as long-term bony fusion could be achieved, paralleled by improvement of the preoperative neurological condition in differing degrees. Surgery related complications were rare, although, considering the patient population treated, medical and anaesthesiological complications as a result of accompanying diseases may pose serious problems. The technical details of the surgical procedure are described and its application for the treatment of cranio-cervical instability is discussed.

Adult↗
PubMed1979

Osteosarcoma: histological evaluation and grading.

With 60 cases of osteosarcomas a histological evaluation from + to +++ carried out for mitoses, osteoid formation, presence of multinucleated giant cells, and tumor necrosis. A subclassification in osteoblastic, chondroblastic, and fibroblastic type of osteosarcoma (according to Dahlin) and a histological grading from + to +++ based on degree of cellular atypism was also done. In our material no relations between these three types of osteosarcoma and chance for survival became evident. There was, however, a significant correlation between grade of atypism and rate of mitoses. Grading of oestosarcomas from + to +++ showed that cases with grade III osteosarcoma remained only seldomly without metastases during the course of the disease. Grade I osteosarcomas and also grade II tumors showed a higher number of patients with 2-year survival. However, neither correlation between tumor grade and incidence of metastases, nor with chances for survival were statistically significant. Nevertheless, characterization of osteosarcomas, by a histological grading from + to +++ based on cellular atypism and mitotic count is advisable, in addition to the TNM stages. This histological grading appeared to be more practicable than subclassifications of osteosarcoma by type which had been tested by us in a previous study (Konrad et al., in press).

Humans↗
PubMed1979

[Solitary bone cysts of the ulna (author's transl)].

The solitary bone cysts occurs most frequently in the upper humerus and femur in 75% of the cases, and it is very seldom located in the ulna, in 0.5--1.5%. This report deals with the treatment results of two children, five and six years old, suffering from solitary bone cysts of the lower end of the ulna. In one case a subtotal resection of the cyst was carried out and the defect was bridged with an autologous iliac bone graft. In the other case the patient was treated by curettage, and the defect was filled in with an autologous bone graft and cancellous bone out of the tibia. In both cases complete cure of the tumorlike lesion was obtained and no loss of function or deformity of the forearm was observed 12 and 16 years after operation. In the X-ray picture at that time there was no alteration on the length, form or structure of the bone.

Bone Cysts↗
PubMed1979

[Skateboard injuries (author's transl)].

Following the introduction of skateboards into Germany in 1976 an increasing number of accidents and injuries have been noted, affecting mainly children 10 to 14 years of age. The causes were lack of experience and the careless use of the boards on public streets. More than 30% of injuries were fractures mainly affecting the upper limb. Because of the frequent involvement of the epiphyseal plates the post-accidental growth may be seriously disturbed. Severe and sometimes fatal head or abdominal injuries have been reported, mainly after collision with cars.

Accident Prevention↗
PubMed1979

Total subperiosteal resection treatment of solitary bone cysts of the humerus.

The solitary bone cyst is most frequently located in the upper arm and the average age of the affected patients is between 7 and 9 years, thus perceptibly lower than in cases where solitary bone cyst occurs elsewhere, where the average age is 15. The tendency towards recurrence before 10 years of age is twice as great as the tendency after that age. Investigation of the results obtained from the treatment of 26 patients suffering from solitary bone cyst of the humerus showed a recurrence rate of 55% after curettage and filling-in of the defect with cancellous bone grafts, whereas after total subperiosteal resection and bridging the defect with an autologous tibia graft the corresponding recurrence frequency was 7%. The average duration of the plaster cast fixing period after resection treatment was 18 days longer than after curettage, but the low rate of recurrence in the first-mentioned case makes up for this disadvantage. It is absolutely essential to retain the periosteum in cases of cyst resections. The defect is bridged over by an autologous tibia graft, but fibula grafts are also suitable for bridging the defect. Osteosyntheses are not necessary with latent cysts. In the case of active cysts screws, wire loops, Kirschner wires, and thin Küntscher nails can be used as temporary stabilisation means. Plate osteosyntheses constitute an exception. Complete removal of the cyst by resection is the most certain prophylactic method against recurrence, and hence the most reliable form of treatment of the solitary bone cyst of the humerus.

Adolescent↗
PubMed1979

Damage analysis of the Harrington rod fracture after scoliosis operation.

Fracture of the distraction rod is one of the complications following operative treatment of scoliosis by the device of Harrington. It is reported to occur in about 7% of cases. We found this complication twice in our own number of 41 patients during a follow up period of 1 to 4 years. The rods had broken 18 and 23 months after operation, but we never saw a breakage in the 1st postoperative year during the time of cast fixation. The fracture surfaces of each rod were examined under the scanning electron microscope. In one case a fatigue fracture with two beginnings at the opposite sides of the rod was found in combination with a forced fracture in the middle. The number of alterations of load from the beginning of the fracture to the complete breakage was about 10,000. The X-ray showed a loss of correction in the curve of 20 degrees with a pseudoarthrosis visible in the fusion. In the other case a typical pure fatigue fracture was seen 23 months after the operation with 18,000 alterations of load. The X-ray showed only a slight loss of correction of less than 5 degrees and no pseudoarthrosis was visable, neither in the X-ray nor in the operative exploration of the fusion. The breakage of the distraction rod results not only from a pseudoarthrosis but also from other explained facts of the procedure. Further treatment depends on a proven pseudoarthrosis.

Adolescent↗
PubMed1979

[The isolated loss of extension of the great toe following osteotomy of the fibula (author's transl)].

A peroneal nerve palsy can be observed following operative procedures or traumatic lesions of the lower leg. Primary damage of the nerve must be differentiated from the tibialis-anterior syndrome and the pseudo-paralysis. Following corrective osteotomies of the tibia with dissection of the fibula in the upper or medial third isolated lesions of the extensor hallucis longus muscle can be seen. Electromyographic and anatomical studies reveal that they may be caused by an isolated damage of the motor nerve fibres connecting the deep branch of the peroneal nerve with the extensor hallucis longus muscle lying very close to the fibula. Suggestions how to avoid this damage are made in the paper.

Electromyography↗
PubMed1977

[Muscles of the leg during immobilisation. An electromyographic study (author's transl)].

By means of electromyographic evaluation we investigated the function of the rectus femoris, the vastus medialis, the tibialis anterior and the triceps muscle. The effects of immobilisation in above or below knee PoP were investigated with view to the muscular activity in walking and the effect of the immobilization in isometric exercises. The results are discussed. The vastus medialis can only be activated very poorly in a PoP and is not inervated at all during gait. The functional activity of the triceps is reduced markedly in either above or below knee PoP. In knee movement this muscle starts to be activated only over 90 degrees of flexion. The results suggest that an above knee PoP is sufficient to immobilise defects of the quadriceps and its tendon. Defects of the triceps and its tendon seem not necessarily to request an above knee PoP for immobilization. This case has however the advantage to decrease the danger of unexpected knee movements followed by a reflectoric muscle contraction. Its force could be greater than the stability of the repaired tendon.

Achilles Tendon↗
PubMed1977

[Experiences with arthroplasty for tumors and metastases of the proximal femur and humerus (author's transl)].

This report describes the results of 17 arthroplasties of the hip joint for tumors or metastases in the proximal part of the femur and 3 arthroplasties of the shoulder joint because of tumors in the proximal humerus. Based on case reports the paper discusses the indication in the case of malignant, potentially malignant and benign primary bone tumors and in the case of metastases. In addition principles for the construction of suitable hip and shoulder prostheses are cited, whereby the partial joint replacement continues to retain its justification beside total replacement. While the results of the hip arthroplasty proved satisfactory, the results of the corresponding operation on the shoulder are less satisfactory and urge to exercise more restraint in the operative indication.

Adolescent↗
PubMed1977

[Quadriceps femoris muscle during immobilisation and remobilisation (author's transl)].

40 patients of which one leg had been immobilized in a pop cast for 3 and 12 weeks have been investigated with view to the quadriceps muscle. Mechanical and electromyographic investigations revealed the muscular changes under immobilisation and their recovery after removal of the cast. After 12 weeks of immobilisation and 24 weeks of remobilisation the muscle mass is still diminished.

Adult↗