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Biomedical subjects

H W Stedtfeld

Publications and source records attributed to H W Stedtfeld.

At least 19 recordsLinked to original sources
PubMed2000

[Experiences with arthroscopic therapy of chondral and osteochondral defects of the knee joint with OATS (Osteochondral Autograft Transfer System)].

Between 1.6.1997 and 31.12.1998 an osteochondral transplantation with the OATS (Osteochondral Autograft Transfer System) was performed in 18 patients. Indication for OATS was in 9 cases a chondral defect in ACL deficient knees. 3 times we found a fresh chondral defect, in 6 cases we found cartilage damage on the medial femoral condyle at the main weight-bearing area (Outerbridge, type III-IV) in chronic ACL deficient knees. The defect-size in these 9 patients (7 male and 2 female) ranged between 12 mm and 23 mm in diameter and had an average-size of 15 mm. There have been 3 cases with osteochondrosis dissecans, 4 patients had a osteonecrosis at the medial femoral condyle. In the 18 cases an average of 1.8 grafts was needed; more than 3 grafts were used only in exceptional cases, because in such cases the stability between the grafts is reduced. The short outcome in the Lysholm-score showed mainly good results. The average score value during follow-up was 89.5 (range 78-92). This outcome makes hopeful for likewise middle-term-results. The OATS can be recommended for the treatment of chondral and osteochondral defects in the main-weight-bearing area of the knee as a safe procedure for transplantation of hyaline cartilage.

Adult↗
PubMed1998

[The impacted intramedullary nail. Re-discovery of an old problem with a new nail].

Impaction of an intramedullary nail during extraction is an unpredictable and delicate situation. Its problematic nature is unfolded on a report of two cases, one with a Küntscher nail and one with a modern solid titanium nail. This event is caused by ingrowth of new bone formation into the slot or the dorsal flute respectively. The new bone formation is a mechanical barrier which effectively forces the distal part of the nail to jam against the cortex. Both, the slot of the unlocked reamed clover leaf nail and the wider dorsal flute of the solid titanium nail, realize certain therapeutic concepts. Their factual benefit within the concept of interlocking nailing is doubtful.

Adult↗
PubMed1997

[Arterial vascular lesions after total hip joint replacement].

We report on three arterial thromboses of the external iliac artery following total hip replacement. As a result of implanted cement/spongiosa or protrusion of the acetabular component, the iliac vessels were compressed. Furthermore, we report about one intraoperative arterial vessel lesion in a 65-year-old patient during a revision operation. We recommend that in case of acute ischemic syndromes of lower limbs following total hip replacement, an angiography should be performed in order to exclude an extravascular cause of thrombosis. For therapy in those cases extra-anatomic bypasses should be preferred to thrombectomies.

Aged↗
PubMed1997

[Outcome of management of femoral neck fractures with cemented bipolar endoprostheses].

In our hospital 334 patients were treated with a bipolar prosthesis for medial femoral neck fracture in the years 1990 and 1991. After an average of 54 months (minimum 48 months) informations about function could be obtained by examination and x-ray from 19 patients (5.7%), from 42 patients (12.6%) a questionnaire was analyzed. No function of the hip was described as poor, 2/3 of the patients had no pain, nearly 50% walked without crutches or other tools. No protrusio acetabuli or acetabular erosion was seen. Together with further follow-up examinations from another 230 patients out of 1365 patients treated with a bipolar prosthesis up to now, these results support the statement that bipolar prostheses play an important role in treatment of medial femoral neck fractures in the elderly.

Aged↗
PubMed1993

[Seat-belt syndrome. Is "securing" children in back seats of cars exclusively with a lap belt defensible?].

In automobile accidents the "seat belt syndrome" describes a combination of injuries involving the thoraco-lumbar vertebrae and intraabdominal organs. This may result from wearing of only a pelvic seatbelt. Children are often involved. Analysis of two separate cases showed the "assurance" of children as passengers on the backseat with a pelvic belt to be dangerous and not longer justifiable. Anatomical proportions and posture in childhood necessitate backseats especially designed for children. They should include the possibility of installing a three point safety belt system.

Abdominal Injuries↗
PubMed1993

[Fracture management in elderly patients. A technically and ethically challenging responsibility].

The accident surgeon is increasingly being confronted with typical fractures of old age. These differ from those seen in other phases of life in that they characteristically occur in a situation of reduced mental performance, and coordination, and are associated with structural bone weakness. Also typical is the fact that there is usually no external causal factor involved. Many patients are polymorbid. Treatment of lower-limb fractures concentrates on early re-mobilization. Uncontrolled full weight bearing cannot be avoided, and medullary nailing is therefore preferable to plating. In the case of comminuted fracture of the humerus head or medial femoral head fractures, the chances of reconstruction with preservation of bone vitality are poor and the use of an endoprosthesis permits early functional recovery. Rehabilitation facilities tailored to the needs of elderly trauma patients are required. In the acute trauma unit, the increasing demands being made by geriatric trauma care make staff and structural changes necessary.

Aged↗
PubMed1992

[Hemi-arthroplasty of the hip joint: concentric or positive eccentric (self-centering) dual head prosthesis? A retrospective comparison].

In femoral neck fractures in the elderly, the least traumatic operative treatment is hemiarthroplasty. In our Trauma Unit, from August 1986 to December 1986 we implanted 22 concentric bipolar cups. During follow-up this cup proved to be associated with an unjustifiably high failure rate: system-caused interprosthetic dislocation in 4 patients (18%), and extraprosthetic dislocation in a further 3 (13%). In one of the latter, interprosthetic disconnection occurred during closed reduction. In all of these, i.e., in 31% out of the 22 patients, conversion to a total hip arthroplasty became necessary. Since March 1987 we have used a positive eccentric, self-centering bipolar head. Up to September 1990 322 such prostheses were implanted. Bearing in mind the reduced general physical condition of the patients, the complication rate is considered to be low (dislocations 3.4%, conversion to total hip arthroplasty 0.9%, deep wound infections 3.1%).

Aged↗
PubMed1991

[Polytrauma in automobile drivers--on the coincidence of adolescents and the elderly].

In traffic severe accidents accompanied by polytraumata reach more and more importance to traumatology. We explored our own patients with regard to the coincidence of such accidents with juvenile and senior age and found out a very high risk in the age groups between 16 and 25 years. The causes could be little experience, readiness for risks and overrating their own talent. Elder persons driving motor vehicles are also very often involved in traffic accidents. In this group polytraumata however are not so frequent compared to many accidents without severe consequences. Polytraumatisized patients are very important as to the costs in the health and social system. In any case they cause a considerable economical loss.

Accidents, Traffic↗
PubMed1991

[Is there a noticeable temporary protective function of homologous skin grafts of variable thickness in deep burns against the effect of atmospheric oxygen?].

The injurious influence of atmospheric oxygen upon healing of large wound areas for instance of burn wounds is well known, in differently thick skin grafts different protective functions can be demonstrated. Experiments show the isolation functions of the full-thickness on the one and split skin grafts on the other hand in burn wounds by measuring the subcutaneous pO2: under temporary full-thickness grafts there are with regard to the atmospheric oxygen clearly lower oxygen partial pressures than under split skin grafts.

Animals↗
PubMed1990

[Interlocking nailing of fractures of the proximal tibial shaft].

The anatomic construction of the proximal part of the tibial shaft induces high ventral traction forces. Consequently, the mechanical requirements for stability of any internal fixation system are also high. Therefore, interlocking nailing of fractures of the proximal tibial shaft demands a meticulous operative technique as far as the incision, implantation of the nail and the final interlocking are concerned. Typical complications in this area are axis deviation, loosening of the interlocking screws and delayed union. Particular attention should be paid to the risk of hitherto unnoticed fissures ascending into the tibial head.

Adult↗