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Biomedical subjects

H Zilch

Publications and source records attributed to H Zilch.

At least 37 records · Page 2Linked to original sources
PubMed1984

[Indications for operative stabilization of spinal fractures].

Absolute indications are seen in lesions of the spinal cord; increase of an incomplete paralysis, paralysis after free interval or after a primarily good restitution and in case of an ascending complete paralysis. The decompression depends on the actual site of compression. If there is an anterior compression not laminectomy but only the anterior approach will be successful. Relative indications are instability, especially disco-ligamentious ones. Late results with permanent instability, pseudarthrosis of the dens axis and marked angulation (40 degrees) of the vertebral body.

Fractures, Open↗
PubMed1983

[Outcome after late reconstruction of dislocations of the acromioclavicular joint].

In a total of 130 cases with a complete luxation of the acromioclavicular joint (Tossy III) which were treated operatively, there are included 29 cases with older injuries (6 to 28 months after accident). Late reconstruction were regarded only such cases which needed a plastic reconstruction of the lig. coracoclaviculare. An account is given of the 21 cases, followed up on an average of 5,6 years after the operation. The material for the plastic reconstruction was autologous and heterologous tendons, fascia lata, carbon-fibres-ligaments, and especially lyodura. The results are very satisfied regarding to the mobility and stability of the shoulder joints. But there was seen a high rate of arthrosis of the a.c.-joint, which causes are discussed as well as the opportunity to make an osteotomy of the clavicula to degress the pressure at this point. The arthrosis is only painful in cases with a simultaneous instability.

Acromioclavicular Joint↗
PubMed1982

[Ankylosis of the elbow joint].

The authors present a definition of the ankylosis of the elbow joint as well as of arthrolysis and arthroplasty and give a detailed description of the factors causing the ankylosis. The indication of arthrolysis and the operation time are discussed, the surgical method is described in detail. The type of follow-up treatment is of special importance. Results from literature are communicated.

Ankylosis↗
PubMed1982

[Long-term results of compression-osteosynthesis with three AO-screws for spongiosa in fractures of the femur-neck (author's transl)].

Between 1969 and 1978 in 42 patients fractures of the femur-neck were treated with three AO-screws for spongiosa (screws with a short thread). Late results in these patients are reported. The interval between operation and follow-up was in average 90 months. In no case pseudarthrosis had developed; the rate of necrosis of the femur head was 23.8%. The method is suitable in selected cases of medial fractures of the femur-neck, type I and II, and in lateral fractures, preferably in younger patients. The results in fractures of type III according to Pauwels show, that in advanced age these fractures should be treated with a partial or total prosthesis, because the rate of necrosis of the femur-head cannot be lowered.

Aged↗
PubMed1981

[The problem of osteosynthesis in peripheral replantation].

In this report, 16 cases of peripheral replantation are described, in which osteosynthesis was carried out by means of AO-mini or small-fragment plates with the obvious advantage of allowing early mobilisation. A disadvantage of this method is that it is necessary to dissect the soft tissue to a greater extent and to elevate the periosteum more than in using Kirschner wires, this dissection to permit sufficient fixation of the plate and screws. As a result, primary technical difficulties in the venous anastomosis may occur and there is a risk of adhesions developing between the extensor apparatus and the bone (two cases). Difficulties occur when using plates and screws for comminuted and juxtaarticular fractures. In these cases Kirschner wire osteosynthesis is preferred. For injuries in zones 1 and 2 in the majority of the cases an osteosynthesis with wire is indicated. Only in cases of replantation in zone 2, where the DIP joint is destroyed, can an arthrodesis be performed by means of a screw. When using the above mentioned osteosynthesis for peripheral replantations, we have achieved good to very good end results in the majority of the cases.

Amputation, Traumatic↗
PubMed1980

Material properties of femoral cancellous bone in axial loading. Part II: Time dependent properties.

In part I of this communication we reported on some time independent material properties of cancellous bone specimens from different regions of human femora. In part II we will report on our investigations of the time dependent behaviour, i.e. stress relaxation and creep. Cylindrical specimens were obtained from the head and condyles of pairs of cadaveric femora and subjected to axial loading. The data were evaluated statistically. The medianL values for relaxation of cancellous bone were greater in the femoral head than in the condyles, greater proximally than distally and greater medially than laterally in the condyles. The distribution of creep was found to be the reverse. The correlation analysis showed that a linear correlation between compressive strength, apparent density and the time dependent properties cannot be assumed. The time dependent properties reported here would appear to demonstrate the visco-elastic behaviour of cancellous bone. An experimental foundation and explanation is presented for the clinical practice of re-tightening cancellous bone screws one time only.

Biomechanical Phenomena↗
PubMed1980

Material properties of femoral cancellous bone in axial loading. Part I: Time independent properties.

The time independent material behavior of cylindrical specimens obtained from the cancelous bone of 20 cadaveric human femora were determined. In this part of the publication, the nominal values for compressive strength, limits of elasticity (yield point), strain, elastic modulus and apparent density are being reported for the cancellous bone of the femoral head and condyle. The correlations between the various parameters are analysed. A positive linear correlation between the four parameters compressive stength, limit of elasticity, modulus of elasticity and apparent density could not be excluded. The material properties vary considerably both within one single bone and between individuals. Compressive strength, modulus of elasticity and apparent density found for cancellous bone of the femoral head are greater than those found in the condyles. Within the condyles, compressive strength, elastic modulus and apparent density increase from the proximal parts to the parts closer to the joint. The medial femoral condyle showed higher compressive strength than the lateral one. Relating each of the three other parameters to the apparent density of the individual specimen did not result in equalizing the data for the material properties. This indicates that the mechanical properties of cancellous bone are strongly related to the direction of loading.

Aged↗
PubMed1980

[Animal experiments on cementing small osteochondral fragments with fibrin glue].

An experiment on revascularization of glued osteochondral fragments was carried out. A chiseled part of the medial femoral condyle of the knee joint of the rabbit was fixed on the right side with an acryl adhesive and on the left side with a new fibrinogen adhesive system (FAS), consisting of highly concentrated fibrinogen, thrombin, and factor XIII. The animals were sacrificed after three, six, ten, and twenty eight days. The FAS is changed into granulation tissue rich in vessels and, therefore, there is a quick revascularization of the fragments soon after three days. On the contrary the acryl adhesive is a foreign body and prevents ingrowth of capillaries during the time of investigation. Immobilization with plaster is necessary to prevent the fragment from gliding off.

Animals↗