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Biomedical subjects

H W Vogler

Publications and source records attributed to H W Vogler.

14 recordsLinked to original sources
PubMed1995

Fifth metatarsal fractures. Biomechanics, classification, and treatment.

Fractures of the fifth metatarsal are treated conceptually based on anatomic location and character of the fracture site. Intra-articular disruptions require reconstruction, if possible. Malalignment of acute fractures requires either closed reduction or open reduction if the malalignment represents a load-bearing dysfunction to the forefoot. Segmental defects require bone grafting and stabilization with plate and screws. Jones fracture is most effectively managed with medullary lag screw delivery in the active or athletic patient. Casting can be considered for high-risk patients. Late bone grafting for sclerotic nonunion is necessary with inlaid grafts harvested from the calcaneus or tibia. Tuberosity fractures require open reduction only when articular involvement is a problem or when distraction is apparent. Otherwise, they can be expected to heal rapidly without long-term problems.

Fractures, Bone↗
PubMed1994

Anterior ankle impingement arthropathy. The role of anterolateral arthrotomy and arthroscopy.

The choice of anterior ankle arthroplasty conducted by anterolateral arthrotomy versus arthroscopic techniques depends on the severity of the osteophytosis and the dominance type. This can be determined in most cases by conventional radiology, contrast arthrography, or MRI. Diagnostic arthroscopy may be required when noninvasive means fail to provide the answer to anterior frontier joint pain. Thorough arthroplasty must be performed and the joint placed through its end range of motion to verify reduction of all impingements. Extensive bony impingements are most effectively treated by conventional anterolateral arthrotomy. This is particularly true in posttraumatic cases with considerable arthrofibrosis infiltrate. Lesser degrees of osteophytosis confined, in particular, to the leading tibial edge are effectively reduced by arthroscopic technique. Anterior ankle arthroplasty by either technique offers symptomatic relief of pain with minimal morbidity. It can serve as a definitive treatment protocol for many patients or simply represent a temporary step along the way to more aggressive salvage surgery such as arthrodesis.

Ankle Injuries↗
PubMed1989

Shaft osteotomies in hallux valgus reduction.

Osteoplasty of the first metatarsal is a form of "plastic surgery" of bone. It is technically demanding and requires a thorough knowledge of anatomy and morphology of bone. Direct dissection techniques are recommended rather than layering, which unnecessarily devascularizes the tissues. Understanding the principles of osteosynthesis and absolute stability is important and will allow the surgeon confidence in knowing that these operative procedures can be performed safely with a high degree of predictability in the correction. These procedures open a new area for consideration in the management of the hallux valgus deformity with intermediate IM angle deformities.

Hallux Valgus↗
PubMed1989

Triple arthrodesis as a salvage for end-stage flatfoot.

End-stage flatfoot is a challenging surgical deformity. It is most commonly rigid and painful, although it may be totally or partially reducible. Arthrosis may be a major feature causing pain, but not necessarily. The terminology "end-stage" means that the deformity and compensation has progressed as far as it will go and that salvage is required when disabling. The most dramatic and effective operation available to solve this problem is triple arthrodesis in its various modifications. The problems associated with this condition and the applied operation have been discussed.

Ankle Joint↗
PubMed1987

Surgical management of neuromuscular deformities of the foot and ankle in children and adolescents.

Foot and ankle deformity in the face of neuromuscular involvement will challenge the podiatric surgeon's ingenuity. The basic principles of management of the various major conditions encountered in spastic and flaccid muscle paralysis-paresis has been discussed. The use of a combined approach of hard and soft tissue surgery is emphasized as well as an intimate understanding of the specific neuromuscular process itself.

Adolescent↗
PubMed1985

Basic bioengineering concepts. Concepts in bone performance, failure, and osteosynthesis.

The basic concept of engineering applied to the biomechanical performance behavior of solids has been presented. Areas of conceptual disagreement in bone failure loading modes have been indicated and provide an excellent area for continuing investigation by the podiatric surgeon. Special application to bone tissue has been emphasized with several examples of functional loading seen in podiatric performance. The underlying requirements for primary bone union by the production of absolute stability have been discussed and some of the present problems with the use of A-O in podiatric surgery have been suggested.

Arthrodesis↗
PubMed1985

Ankle arthrodesis. Clinical and conceptual applications.

Ankle fusion provides an excellent salvage for an otherwise intolerable deformity or painful joint derangement. It is the only available alternative for a failed ankle prosthesis. It produces a serviceable foot when done in proper perspective for the appropriate indication. It produces a good result when consolidation occurs and the remaining tarsal joints have preserved integrity. Improvement in occupational and daily activities can be anticipated when arthrodesis and correct alignment are obtained.

Ankle Injuries↗
PubMed1982

Ankle joint arthroscopy.

The arthroscope has been used clinically on the knee for quite some time. The history of arthroscopy is reviewed. The technique of arthroscopic surgery on the knee is summarized. The applications of its use on the ankle joint is discussed as well as technique for arthroscopy. A case report is presented and experiences with arthroscope for diagnosis of ankle problems at Harrison Community Hospital are summarized.

Ankle Injuries↗
PubMedDate not supplied

An assessment of oblique base wedge osteotomy stability in the first metatarsal using different modes of internal fixation.

The modified Juvara osteotomy is a classic oblique base wedge osteotomy of the first metatarsal and is often used to reduce hallux valgus deformity. However, complications attributed to osteotomy instability and currently available modes of osteosynthesis are common. The authors have developed a technique that enables them to quantitatively and objectively evaluate the stability of this osteotomy when various modes of internal fixation are used. Stability testing was performed on fresh, previously frozen human cadaveric specimens using engineering principles. Results indicate that there is no statistically significant difference in stability between crossed 0.062-inch Kirschner wire fixation and internal fixation using a single 3.5-mm. cancellous screw. The tests also indicate that both of these techniques are superior to two 2.7-mm. cortical screws for stability.

Biophysical Phenomena↗
PubMedDate not supplied

Ankle fusion: techniques and complications.

Ankle fusion is an extremely useful operation. It has the capacity to allow a crippled patient to re-enter the mainstream of life from an otherwise disabling injury or joint disease situation. It requires careful attention to details and the principles of alignment and execution of the procedure in an exacting fashion. Improper position can strain adjacent joints, causing pain and degeneration with the need for additional fusion surgery. Some shortening of approximately 1 to 2 cm usually will result. The surgeon should understand all of the special modifications of the fusion procedure so he can tailor the specific modification for his circumstance. When done properly in the appropriate situation, ankle fusion is an impressive operation for salvage of otherwise hopeless situations.

Ankle Joint↗
PubMedDate not supplied

Unusual juvenile ankle fracture: explanation and surgical repair.

Juvenile ankle fractures are reasonably common, comprising approximately 11% of all epiphyseal injuries. They are more common in males and occur most frequently in the age distribution of 11 to 15 years. They characteristically fall into one of the Salter-Harris classification patterns; however, atypical cases do occur that present classification problems and treatment consideration questions. An illustrative case is presented with an explanation, to alert the clinician to these situations and provide a basis for care.

Accidents, Traffic↗
PubMedDate not supplied

A retrospective study of the Swanson great toe hemi-prosthesis.

This work is the summation and analysis of data received from a questionnaire forwarded to all Board Certified podiatric surgeons regarding their experience with the Swanson great toe hemi-prosthesis. The responses pertaining to a variety of concerns, including erosive changes, years in vivo, signs and symptoms indicating retrieval, percentage of surgeons polled performing retrieval and perceived reasons for observed erosive changes, were recorded and analyzed. The resultant data reveal significant erosive changes occur early after implantation with a plateau effect within 3 years. Persistent pain following implantation was the most common reason for removal followed by limited range of motion and nonspecific swelling. These three concerns comprised 70% of the reasons for retrieval followed by 18 other cited problems. The results of this poll originate from subjective and objective impressions of surgeons. It is clear that further work is required to scientifically identify and document the specific reasons for these findings, including the circumstances that result in successful implantation of this prosthesis.

Humans↗