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Biomedical subjects

H Troeger

Publications and source records attributed to H Troeger.

At least 19 recordsLinked to original sources
PubMed1997

Increased surface expression of CD18 and CD11b in leukocytes after tourniquet ischemia during elective hand surgery.

The surface expression of beta2-integrins was investigated in leukocytes from patients undergoing ischemia induced by tourniquet application for elective hand surgery. Blood samples were obtained before initiation, at the end of ischemia, and after 15 minutes of reperfusion from ischemic and contralateral arms of five patients. Comparable expression of CD18, CD11a, CD11b, and CD11c could be detected by immunofluorescence in leukocytes from samples drawn from either arm before tourniquet application. In contrast, a significant increase in the expression of CD18 was detectable in monocytes, granulocytes, and lymphocytes from the ischemic arm compared with that in the nonischemic contralateral control, at the end of the ischemia time (80 +/- 16 minutes). A significantly increased expression of CD11b, but not CD11a or CD11c, determinants was also observed in granulocytes and monocytes. Concomitantly, a significant reduction in the percentages of granulocytes in samples from ischemic areas was detectable. After 15 minutes of reperfusion, differences in the expression of these adhesion molecules were no longer significant. The expression of the genes encoding interleukins IL-1alpha, IL-1beta, and IL-6 and tumor necrosis factor alpha (TNFalpha) proinflammatory cytokines was also studied by reverse polymerase chain reaction (rPCR) in peripheral blood mononuclear cells (PBMCs) obtained from the same samples in three patients. IL-1beta or IL-6 gene expression was never observed. Expression of IL-1alpha and TNFalpha genes, as detected in two patients, was not related with induction of ischemia. However, in these patients expression of one or both these genes was observed in samples derived from the ischemic but not the control arm after 15 minutes of reperfusion. These data document that overexpression of adhesion molecules and sequestration of leukocytes take place following short ischemia times, as routinely applied clinically for minor surgical procedures.

Adult↗
PubMed1997

[Wrist impaction syndrome after distal radial or forearm fractures treated by ulnar osteotomy. Surgical techniques and results in 26 cases].

Twenty-six of 27 patients in whom an ulnar shortening osteotomy had been performed to treat ulnar impaction following distal radius (20 patients) or forearm (6 patients) fractures were evaluated at an average follow-up of 21 months. All but 3 patients were satisfied with the end-result and according to a modified Gartland-Werley score there were 1 excellent, 10 good, 10 fair and 5 poor results. This is distinctly inferior to other reports of mainly non-traumatic indications. Degenerative changes at the distal radioulnar joint were associated with fair and poor results and careful radiological examination of this joint is mandatory before ulnar shortening is performed in posttraumatic ulnar impaction syndrome. Bony union of the osteotomy was achieved at 12 to 16 weeks postoperatively except for 2 cases and there was no difference between transverse (13 cases) and oblique osteotomies (13 cases). We therefore prefer the technically easier transverse osteotomy and recommend the use of 3.5 dynamic compression plates for stabilisation which resulted in a low complication rate in our series and enables early active wrist mobilisation.

Adolescent↗
PubMed1996

Ulnar shortening osteotomy in posttraumatic ulnar impaction syndrome.

Twenty-eight patients (average age 45 years) with posttraumatic ulnar impaction syndrome underwent ulnar shortening osteotomy of 3-15 mm. Contributing factors were malunited fractures of the distal radius in 20, diaphyseal fractures of the ulna and radius in 6, resection of the radial head and a traumatic tear of the triangular fibrocartilage in 1 patient each. Evaluation at an average follow-up of 20 months showed a high rate of satisfied patients (89%), but according to Chun's modification of the Gartland-Werley score there were 1 excellent (3.5%), 11 good (39.5%), 11 fair (39.5%) and 5 poor (17.5%) results. Degenerative changes of the distal radioulnar joint were associated with fair and poor results, and ulnar shortening osteotomy is only recommended in ulnocarpal impaction with an intact distal radioulnar joint. Osteotomy fixation with 3.5 mm dynamic compression plates enabled immediate postoperative mobilisation and resulted in a low complication rate. There was no advantage for the technically more demanding oblique as compared with a transverse osteotomy.

Adolescent↗
PubMed1996

Acute median nerve compression at the distal forearm caused by a thrombosed aneurysm of an epineural vessel: case report.

The case of a patient with a 2-day history of symptoms suggesting acute carpal tunnel syndrome is presented. However, an urgent electroneurographic examination revealed median nerve compression at the forearm and magnetic resonance imaging confirmed compression by a mass proximal to the carpal tunnel. Surgical exploration showed a recently thrombosed aneurysm of an epineural vessel. Histological and, later, general and angiological investigations could not reveal the underlying cause of this aneurysm. Preoperative electrodiagnostic examination is recommended in acute peripheral nerve compression to prevent decompression at an incorrect site. If atypical nerve compression is suspected, magnetic resonance imaging may be indicated to detect localized nerve compression and its underlying cause.

Adult↗
PubMed1996

[Osteosynthesis of the hand--indications, technique, results].

UNLABELLED: Between January 1st 1992 and December 31st 1993 140 non-complex (i.e. nerve, vascular, tendon injuries) fractures of the peripheral hand skeleton were operated at the Policlinic of the Kantonsspital Basel. In a retrospective study we analyzed results, complications and absence from work. We treated 110 male and 30 female patients with a mean age of 47 years. 45 fractures were treated by plate fixation, 45 by screw fixation, 53 times we applied k-wires and once a mini-fix-ex (AO-Prototype). Plate and screw fixation were performed with AO-mini-implants. 90% of our patients had an uneventful postoperative course. In spite of functional after-treatment we noted in 8.6% of the patients a relevant loss of movement leading to operative tenolysis in 7 patients. Fractures at the level of PIP were most frequently associated with loss of movement. Absence from work was 59 days in average (1-206)! CONCLUSIONS: Peripheral osteosynthesis of the hand (non-complex) are effectively treated on an out-patient basis. In spite of functional after-treatment about 10% of patients have a relevant postoperative reduction in motility. Absence from work is relatively long after operative treatment of peripheral hand fractures.

Adult↗
PubMed1996

[AO external mini-fixateur for the hand bones. Surgical technique and initial experiences].

Fractures of the hand and fingers showing comminution or associated soft-tissue lesions are best treated with external fixation. In contrast to other systems, the new AO mini-external fixator enables less bulky unilateral fixation facilitating early mobilisation and the special design of the double clamps allows preliminary intraoperative stabilisation with only one wire in each fragment. Modular fixation makes free placement of the wires possible with accommodation of bone and soft tissue lesions. Twenty patients with hand injuries showed uneventful soft tissue healing and there were no cases of non-union in 19 metacarpal and phalangeal fractures.

Adolescent↗
PubMed1995

[Infections of the hand].

The possibilities of hand injuries lead to the higher incidence of hand infections. The clinical signs of inflammation (pain, swelling, heat, loss of function and red colour) are found in near all cases. The start of pain and its localisation help to find quickly the layer of the inflammatory process. Bites, foreign bodies, puncture wounds and open wounds especially those acquired in slaughterhouse or agriculture are in most cases the predisposing conditions. Treatment of hand infections demands a consequent protocol consisting in: exact diagnostics including clinical picture, laboratory investigation, bacteriology and in some cases X-ray-examination; operative treatment including incision, irrigation, drainage, excision of necrosis and foreign bodies under the rules of hand surgery (i.g. blood--[without exsanguination] and painfree operation field, magnifying lenses, correct incision avoiding scar contractures); immobilisation (dressing or splinting) in intrinsic-plus-position while acute inflammation is going on, early movement combined with ergotherapy and physiotherapy after this. Use of antibiotics is indicated in septic cases or in cases of complications (sepsis, lymphangitis, osteomyelitis) in concordance with bacteriology but it cannot compensate mistakes in treatment. The most common infections are placed around and under nail (paronychia) and in the subcutaneous space of the distal phalanx (felon). They are treated by incision and spontaneous drainage. More severe are infections of tendon sheath, joint, web space and deep palmar space. If pus is present in such cases there is no place for conservative treatment but operative treatment under clinical conditions is imperative.

Anti-Bacterial Agents↗
PubMed1990

[Tibial plateau fractures--indications for and results of surgical and of functional-conservative therapy].

56 patients with fractures of the tibial plateau were treated at the surgical department of the Wilhelm-Pieck-University Rostock between 1980 and 1987. 18 of these underwent on operative treatment, 38 patients were treated nonoperatively. Using a clinical and radiological follow-up on 35 of these patients the results after operative and functional-conservative treatment are shown and the indications for the different methods are concluded.

Adult↗
PubMed1977

[Some new aspects on appendicitis (author's transl)].

50% of all perforations of the vermiform appendix happen 12 hours or less after onset of the disease. Due to the fact that appendectomy is often done too late that the total mortality rate is still to high. This refers especially to infants and elderly people. Prae-, intra- and postoperative mistakes are analysed. Bacteriologically there are some new aspects concerning anaerobic infections with Bacteroides and Yersinia enterocolitica.

Anti-Bacterial Agents↗