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Biomedical subjects

J Pfeil

Publications and source records attributed to J Pfeil.

At least 37 records · Page 2Linked to original sources
PubMed1996

Bone quality in the lumbar spine in high-performance athletes.

Little is known about the influence of high-performance training on the bone quality of the lumbar spine, in particular, the effects on bone mineral density (BMD) in athletes with high weight-bearing demands on the spine. Measurements were therefore performed in internationally top-ranked high-performance athletes of different disciplines (weight lifters, boxers, and endurance-cyclists). The measurements were carried out by dual-energy X-ray absorptiometry, and the results compared with the measurements of 21 age-matched male controls. The BMD of the high-performance weight lifters was greater than that of the controls by 24% (0.252 g/cm2) on the AP view by 23% (0.200 g/cm2) on the lateral view (P < 0.01), while difference in BMD between the boxers and the controls was +17% (0.174 g/cm2) on the AP view and +19% (0.174 g/cm2) on the lateral view. The BMD of the lumbar spine in all endurance cyclists was lower than that in the controls (AP view -10%, 0.105 g/cm2; lateral view -8%, 0.067 g/cm2; P > 0.05). The results show that training program stressing axial loads of the skeleton may lead to a significant increase of BMD in the lumbar spine of young individuals. Other authors' findings that the BMD of endurance athletes may decrease are confirmed. Nevertheless the 10% BMD loss of cyclists was surprisingly high.

Absorptiometry, Photon↗
PubMed1995

[Quantitative follow-up of callus distraction with dual-energy roentgen absorptiometry (DEXA)].

With dual-energy X-ray absorptiometry (DEXA), bone mineralization during and after limb-lengthening procedures with unilateral fixators can be monitored quantitatively and precisely with low radiation exposure. We measured prospectively the bone mineral density (BMD) in the newly formed callus, in the bone adjacent to the callus and in the proximal femur in 21 patients with leg lengthening of the femur and/or tibia with unilateral external fixators. Mineralization showed a typical course with a peak value of 0.365 +/- 0.196 g/cm2 (30.9% of the first value) at 6-8 weeks after the beginning of distraction and a minimum value at the time of maximum distraction. In the consolidation period BMD in the distraction gap increased to 1.020 +/- 0.234 g/cm2 (87%) at the time of fixation removal. BMD in the regenerated bone increased faster in regions of interest (ROIs) opposite the fixator compared to ROIs near it. Dynamization of the fixation device led to a 13% increase in mineralization velocity (VBMD). On the other hand, dynamization caused more homogeneous regeneration equalizing VBMD in the different ROIs as well. BMD in the proximal femur of the leg operated on decreased to 67% and in the contralateral leg to 87% of the preoperative value. We consider DEXA to provide a precise and quantitative assessment of callus and bone mineralization during limb lengthening with unilateral fixators. Since we are well aware of the limitation of the technique. DEXA helps to understand what is happening in limb-lengthening procedures by providing quantitative values.

Absorptiometry, Photon↗
PubMed1991

Spinal growth after irradiation for Wilm's tumour.

Between 1960 and 1983, 82 children were treated for Wilm's tumour at our hospital. The secondary effects and changes in the skeleton have been assessed. Radiotherapy was found to cause growth disturbances and osteochondrosis of variable degree, but not osteonecrosis. Since irradiation produces late damage, it should be applied symmetrically to the spine and the dose limited as far as is possible. A long follow up is necessary since skeletal damage can only be assessed after the end of growth.

Child, Preschool↗
PubMed1991

The stump capping procedure to prevent or treat terminal osseous overgrowth.

Terminal overgrowth in transverse deficiencies and in amputations, particularly of the humerus and tibia necessitate serial trimming procedures or re-amputation. Capping using an autogenous bone graft or a titanium and polyethylene endoprosthetic cap provides a satisfactory way of avoiding these re-amputations and allowing end-bearing.

Amputation, Surgical↗
PubMed1990

[Lower leg lengthening using the Ilizarov system. Presentation of the various surgical techniques and analysis of lower leg lengthening procedures performed 1986-1989].

The technique of lengthening the tibia with the Ilisarov device is explained. Different variations (bifocal or simultaneous) of the method are demonstrated, as well as the results of 53 cases of tibia lengthening in 37 patients of our hospital between 1986 and 1989. In 14 patients, a second operative procedure was necessary during treatment. In no case was internal fixation or grafting necessary. The Ilisarov ring fixator is very efficient, especially in major lengthening procedures and for simultaneous correction of deformities.

Achondroplasia↗
PubMed1988

[Clinical and sonographic study of the infant hip. A prospective study].

In 1985 a clinical and sonographic study in 693 children was done. The instability and the limitation of the abduction of the hip joint proved to be the most important clinical signs. The weight of the newborn and the time of birth had no influence on the hip configuration. The importance of the sonographic and clinical examination was demonstrated in the follow up. In the ultrasonic examination qualitative signs rather than quantitative measurements were preferred in routine diagnosis.

Birth Weight↗
PubMed1987

[Ultrasonic and anatomical correlation of the normal hip in the newborn infant].

Ultrasound studies were made on the cadavers of seven normal new-born foetuses. The sonographic images obtained were compared with anatomical sections made in corresponding planes. An accurate analysis of the anatomy of the cartilaginous acetabular roof and labrum in these hips confirmed the accuracy of ultrasonography. Ultrasonography has made it possible to resolve certain doubts about the radiographic examination of infants between birth and the third month.

Fetus↗
PubMed1986

[Alternatives to endoprostheses of the hip and knee joint].

Total hip and knee replacement is one of the most successful operative procedures in orthopaedic surgery. With respect to greater life expectancy, however, loosening of the implant and revision surgery with all its sequelae must be taken into account. Therefore joint preserving procedures resp. arthrodesis of the hip and knee joint are still of great importance. The best long term results can be achieved by operations which can improve the biomechanics of the joint. Operative procedures which aim at the biology of the joint only lead to temporary pain relief. Arthrodesis of the hip and knee joint should always be considered in young patients with no possibility for joint preserving techniques.

Arthrodesis↗
PubMedDate not supplied

[Modification of bone quality by extreme physical stress. Bone density measurements in high-performance athletes using dual-energy x-ray absorptiometry].

The treatment of osteoporosis is still controversial. Rehabilitation programs which stress strengthening exercises as well as impact loading activities increase the bone mass. On the other side activity level early in life has not been proven to correlate with increased bone mineral content later in life. Little is known on the influence of high performance sports on the bone density especially in athletes with high demands on weight bearing of the spine. In (n = 40) internationally top ranked high performance athletes of different disciplines (n = 28 weight-lifters, n = 6 sports-boxers and n = 6 bicycle-racers) bone density measurements of the lumbar spine and the left hip were performed. The measurements were carried out by dual-photonabsorptiometry (DEXA; QDR 2000, Siemens) and evaluated by an interactive software-programme (Hologic Inc.). The results were compared to the measurements of 21 age-matched male control individuals. In the high performance weight lifters there was an increase of bone density compared to the control individuals of 23% in the Ward's triangle (p < 0.01). The sports-boxers had an increase up to 17% (lumbar spine), 9% (hip) and 7% (Wards' triangle). In the third athletes group (Tour de France-bikers) BMD was decreased 10% in the lumbar spine, 14% in the hip and 17% in the Wards' triangle. Our results show that training programs stressing axial loads of the skeletal system may lead to an increase of BMD in the spine and the hip of young individuals. Other authors findings, that the BMD of endurance athletes may decrease, is confirmed. Nevertheless the bikers BMD-loss of 10 to 17% was surprisingly high.

Absorptiometry, Photon↗
PubMedDate not supplied

[Humerus lengthening in a unilateral technique: case report].

Surgical lengthening of the humerus is indicated for cosmetic and functional reasons. The discrepancy should exceed 4 cm. Complications (review of literature) and our own experience regarding lengthening of extremities indicate that surgical lengthening of the humerus is technically feasible and reasonably safe. It appears to have fewer risks and complications than surgical lengthening of the femur or the tibia; even though radial nerve paralysis is an important complication.

Bone Lengthening↗
PubMedDate not supplied

[Ultrasound follow-up of bone lengthening osteotomy].

We report about the possibilities of sonography with regard to postoperative control of limb-lengthening. During the phase of distraction we can show the amount of lengthening with a 5 or 3.5 MHZ linear transducer. We can measure the lengthening or the axial deviation with a sonography as exactly as with an x-ray. X-rays can be saved and the x-ray doses can be reduced.

Bone Lengthening↗
PubMedDate not supplied

[Fractures and epiphyseal injuries in children with myelomeningocele].

Between February 1971 and February 1988, 947 children with myelomeningocele were treated at the Model Center of Heidelberg University Orthopedic Clinic. In 82 of these children, a total of 224 osseous lesions were seen. Metaphyseal and diaphyseal fractures were far more common than epiphyseal lesions, among which epiphysiolysis dominated. Diagnostically important symptoms included swelling, local hyperthermia, and high temperature. Owing to the paralysis, pain is of no value in diagnosing fractures. Protruding periosteal detachments are a common feature of lesions, and if this special form of healing of such fractures is unknown they may cause problems in differential diagnosis. Fractures in children with spina bifida should be treated conservatively, except for fractures of the femoral neck and epiphyseal lesions, which are treated with transcutaneous Kirschner wiring. Immobilization in plaster, postoperatively and during treatment of the injury, is the most common cause of osseous lesions in spina bifida children. Immobilization in plaster should therefore be minimized.

Adolescent↗
PubMedDate not supplied

[How idiopathic is idiopathic scoliosis? Results of neurological studies with somatosensory evoked potentials (SSEP) in children and adolescents].

UNLABELLED: About 90% of all the scolioses are called "idiopathic". Various neurological diseases (for example poliomyelitis, etc.) are frequently accompanied by deformities of the spine. The so-called somatosensory evoked potentials are at our disposal being a very sensitive and a non-problematic neurological diagnostic tool. Formation of the question: Are there clinically non-detectable neurological changes demonstrable by use of evoked potentials in children with so-called idiopathic scoliosis? 45 non-operated patients suffering from scoliosis and 21 healthy children were examined clinically, neurologically, and by use of evoked potentials. RESULTS: 26/45 children with idiopathis scoliosis showed pathological evoked potentials (right-left-side-difference concerning latency and amplitudes of the potentials and generally delayed transmission from peripheral nerves to the somatosensory cortex), mostly concerning the lower extremities. 19/45 children showed normal evoked potentials (EP). There was no correlation between EP and direction respectively degree of the scoliosis. Neurological affections mostly located caudally of the cervical spine are to be discussed (for example protrusion of the intervertebral disc, dysrhaphic processes etc.).

Adolescent↗
PubMedDate not supplied

[Experiences with surgical therapy of scoliosis in patients with myelomeningocele].

This study reports about the experiences in surgical correction of scoliosis, which were performed between 1984 and 1989 in 32 children with myelomeningocele. The average age at time of surgery was 14 years, 1 month; the average degree of scoliosis was 96 degrees preoperatively. 6 different types of surgical techniques were used. In comparison the best results were obtained by a combination of ventral osteodiscectomy with or without instrumentation and dorsal CD-instrumentation; an improvement of 56% was found. Furthermore we sent questionnaires to all patients, who were operated more then one year ago. The majority of them judges the improved sitting stability of the trunk to be the greatest advantage. There is a high rate of postoperative complications. Beside one death, which occurred intraoperatively, especially pseudarthroses of the lumbosacral junction must be mentioned. These pseudarthroses and a to short selected area of fusion are the main reasons for the loss of correction, which was noticed after a mean follow-up period of 24.6 months. The necessity of postoperative bracing was not reduced by using CD-instrumentation.

Adolescent↗
PubMedDate not supplied

[Pathogenesis of pediatric spondylolisthesis].

62 children with spondylolisthesis were examined. Functional anatomical studies on 25 growing human spines were performed to analyse their macro morphological behavior before and after spondylolisthesis. The progression of spondylolisthesis is explained as growth disturbance. The high incidence of spina bifida occulta in spondylolisthesis is a mechanical induced osteochondrosis of the dorsal arc. The different morphology of the spondylolisthesis in children depends mostly of the age of the beginning of this disease. The differentiation between the dysplastic and spondylolytic isthmic type of spondylolisthesis is not indicated. Pour prognosis is expected in young children with kyphosis and high ventral dislocation in the involved segment.

Adolescent↗