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Biomedical subjects

J Rehn

Publications and source records attributed to J Rehn.

At least 19 recordsLinked to original sources
PubMed1992

[What modifies the outcome of abdominal trauma? An analysis of 558 patients].

A consecutive series of 558 patients with abdominal trauma were treated at "Bergmannsheil" Trauma Center in Bochum between 1974 and 1989. The most common patient group was traffic casualties with an age of up to 30 years a total of 218 (31.1%) patients underwent surgery, in which can the diagnosis was made only by surgeons. Isolated injuries were predominantly in the spleen (33%), liver (29%), mesenterium (16.1%), bowel (14.2%), and bladder and urethra (10.1%). Eighty-three of the patients who were operated on had multiple intra-abdominal injuries; 208 (37.3%) patients were included with polytrauma. Despite the increasing number of patients with multiple injuries mortality decreased from 27.1% between 1974 and 1979 to 19.7% between 1980 and 1989. This emphasizes the progress that has been made in diagnostic methods, surgical intensive care and the improved education of trauma surgeons.

Abdominal Injuries↗
PubMed1991

[Post-traumatic correction osteotomy of the distal forearm. Which factors modify the results?].

Post-traumatic deformities are a typical complication of fractures of the distal radius, occurring in about 20% of cases. They are associated with ulno-carpal pain and malfunction of the wrist. Different indications for surgery are given and various operative techniques are recommended. Between 1972 and 1987 a total of 108 patients with post-traumatic disorders following fractures of the distal radius underwent surgical treatment by one of three different procedures: isolated correction of the distal radius, combined correction of the radius und ulna, isolated correction of the ulna (distal resection, shortening osteotomy, hemiresection arthroplasty). 92 (85.2%) followed-up for an average of 9 years postoperatively was possible in 92 (85.2%) of the patients. The functional results were evaluated according to Lidström's system. Excellent and good results were found in 64 (69.6%), fair results in 22 (23.9%), and poor results in 6 (6.5%) of the patients studied. The best results were seen mainly in cases with a short time lapse between trauma and corrective surgery. Distal resection of the ulna has not been performed since 1986 because of poor results and wrist instability. Following isolated correction of radius or ulna, in some patients axial malalignment of the distal radius by about 10 degrees and/or length differences of 2-3 mm with persisting pain or malfunction were seen. In summary, we recommend the combined correction procedure in patients with painful deformities, not more than 6-9 months after the injury. The range of indications should be determined by individual aspects, such as profession, age, activity, discomfort and radiological findings.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthroplasty↗
PubMed1991

[Arthrolysis of post-traumatic stiff elbow. Which factors influence the end result].

In a retrospective study of 59 patients the results obtained with elbow arthrolysis performed for the treatment of posttraumatic stiffness were analyzed. The intraoperative functional result was classified as excellent in all cases, while an average of 27 months after the operation the range of movement was decreased again to varying extents. This deficit correlated with the type of injury, timing of arthrolysis, duration of metal implants and timing and type of postoperative rehabilitation program. The relative increase in function was better after simple fractures, with 47%, than after fracture dislocations, with 35%. After arthrolysis within 3 months of onset of posttraumatic stiffness the range of improvement was 55%, compared with an increase of only 30% after 10 months' stiffness. When arthrolysis was combined with metal removal and the implants had been in place for longer than 9 months the increase achieved was only 15%. Patients mobilized on the 1st day postoperatively lost only 15% of their intraoperative function. If mobilization was delayed to between the 2nd and 5th days, 30% was lost. Changing splints for maximal joint flexion and extension at 4-h intervals resulted in a 35% loss of range of movement postoperatively. In contrast there was a loss of only 17% in the group with combined additional physiotherapy and continuous passive motion. The results show that the prognosis of elbow arthrolysis is determined by optimal operative planning and a meticulous rehabilitation program. The time to arthrolysis should be as short as possible, as should the time to removal of metal implants. The aim of the rehabilitation program is immediate postoperative mobilization.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

["Prognostic" analysis of late results of trochanteric femoral osteotomy following post-traumatic malalignment].

Post-traumatic axial malalignment of the lower limbs causes osteoarthrosis of the adjacent joints. Whether or not correction osteotomy is indicated depends upon the degree and the location of the deformity. Malalignment of the proximal femur should be corrected if the axis of the leg does not pass through the knee joint. If the axis is outside the central half of the tibial head, the indication for correction osteotomy is a relative one: varus deformities are more difficult to compensate and it is more urgent that these be corrected. Of 103 patients who underwent osteotomies of the proximal femur during the period 1973-1981, there were 73 in whom it was possible to follow up an average of 7 years after the realignment procedure. In nearly two-thirds of these patients the clinical symptoms noted before surgery had improved. In 10 cases of pseudarthrosis of the femoral neck, necrosis of the femoral head could not be avoided in spite of the surgical correction; nonetheless, the prognosis is better if the correction is done within the first 3 months after the trauma.

Adult↗
PubMed1979

[Special diagnosis and treatment in injuries of parenchymatous organs (author's transl)].

The parenchymatous organs are mostly involved in blunt abdominal trauma. Besides the physical examinations, the additional peritoneal lavage is emphasized as a diagnostic tool of great importance. The special diagnostic and surgical proceedings in injuries of spleen, liver and pancreas are discussed in detail. In cases of spleen injuries -- even if there are only small lacerations -- the total exstirpation of the spleen is necessary. For sutures in hepatic injuries the application of "collagenous bands" is recommended. The different methods of treatment in pancreatic trauma reach from simple drainage to partial resection.

Abdominal Injuries↗
PubMed1978

[Condensor field irradiation (27.12 mhz) and osteosynthetic implants (author's transl)].

The question whether metals implanted in tissue may induce heat damage is yet controversial. Due to physical laws an increased production of heat is to be expected around the metal parts directed towards the capacitor plates. This is due to a converging and shunting effect of the metal in the electric field. Model experiments show that the shunting effect is most significance for the production of heat damage close to the metal. No heat damage is to be expected under the four following conditions: 1. linear or 2-dimensional osteosynthesis implantats are in a rectangular position to the electric field, 2. the metal is covered with at least 10 mm of tissue, 3. the tissue between the capacitor plates is of a with at least 40 mm and 4. common used frequency generators or field intensities are applied. Reported results suggest to investigate whether the high frequent electrical field influences the fracture regeneration advantageously.

Animals↗
PubMed1978

[The technique of arthroscopy with nitrous oxide insufflation (author's transl)].

Since April 1977 we have carried out more than 250 arthroscopies using a nitrous oxide insufflation device. Nitrous oxide is completely non-toxic to the tissues and is rapidly absorbed. Unlike carbon dioxide, which is the other commonly used insufflation gas, nitrous oxide does not combine with water to form an acid which can irritate the tissues. Furthermore, it is more rapidly absorbed than air. The normal insufflation pressure of 50 mm Hg is usually sufficient to expand the soft parts of the knee joint to the required degree. Interstitial nitrous oxide emphysema occurred in only 7 cases; it was of limited degree in each case and attributable to initial technical difficulties with the apparatus, selection of an excessive insufflation pressure, or additional stab incision. The nitrous oxide emphysema was always asymptomatic and, in some cases, was not even noticed by the patient. No infections of the knee joint or other serious complication followed insufflation with this device, which incorporated a bacterial filter.

Emphysema↗
PubMed1977

[Operative treatment of the head of the tibia (author's transl)].

Fractures of the tibial head should be treated operatively only in cases in which the result can be expected to be better than by conservative methods. The osteosynthesis should bring stability in order to allow training of the joint. Depending on the type of the fracture, screws or T-plates or L-plates can be used. In cases of depressed fractures it is most important to restore the level of the joint by underlying the impression by autogen spongiosa.

Fracture Fixation, Internal↗