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K Dresing

Publications and source records attributed to K Dresing.

28 records · Page 2Linked to original sources
PubMed1994

Compartment pressure in the carpal tunnel in distal fractures of the radius. A prospective study.

In a prospective controlled study, carpal tunnel tissue pressures were determined in a group of 56 patients with distal dislocated fractures of the radius at initial presentation, immediately prior to and after reduction, and 1, 2, 4, 12, and 24 h after reduction. Depending on the severity of the trauma and delay to presentation at the hospital, initial measurements revealed raised pressure averaging 23 mm Hg, which further increased during reduction to 44 mm Hg. After 4 h the average pressure was 37 mm Hg, and it then dropped to 26 mm Hg after 12 h. For anatomical reasons the median nerve is quite vulnerable in the region of the wrist joint. Chronic pressure here may cause carpal tunnel syndrome. Acute pressure in the carpal tunnel, which according to our investigations represents a distinct compartment, results in an overt compartment syndrome. The possibility of a direct relationship between markedly elevated tunnel pressure and the development of Sudeck's dystrophy is discussed.

Adolescent↗
PubMed1994

[Primary diagnosis and follow-up after thoracic trauma and lung contusion].

In 212 patients after injury of the thorax (54 males, 158 females; penetrating (15), blunt (197), multiple trauma (128)) 158 cases demonstrated rib fractures and 103 radiological proven pneumo- or hematothoraces or sometimes both, 108 of 138 had to be drained. 96.5% of the effusions and 98% of the pneumothoraces were clinical confirmed. 93.5% of 97 pulmonary contusions (79 unilateral, 18 bilateral) were detected by bronchoscopy within 10 h, 72% by x-ray. Caused by anatomical problems or for additional diagnosis 4 patients underwent thoracic CT. During ICU treatment 31 patients developed septic complications without detection in x-ray studies. In CT (n = 64) we found: 5 empyema, 13 pleural effusions, 4 pneumothoraces, 4 pneumocysts, 72 condensations of a lobe. After CT we performed: 9 resections of the lower lobe, 1 pneumectomy, 1 decortication, 7 thoracotomies with drainage, 8 drainages. To detect a septic focus under treatment the CT proved being an important diagnostic tool in chest trauma and lung contusion.

Adult↗
PubMed1993

[Measuring pressure in the carpal tunnel in distal radius fracture].

During to the nature of its anatomical locations the median nerve is the nerve most often and most severely affected in compartment syndromes. In our controlled prospective study of 59 patients with distal fractures of the radius, critically high pressure was recorded in the carpal tunnel even in sites of moderate soft tissue swelling. The increase in pressure is directly related to the extent of fracture hematoma, the interval between injury and treatment, and the amount of manipulation during reduction. The average pressure within the carpal tunnel of a normal wrist joint held in the neutral position is 5 mm Hg. In contrast, the average carpal tunnel pressure in the distal radius fracture group in this study was increased to 24 mmHg. During reduction average pressures increase to 44 mmHg, subsequently decrease for a brief period, and finally increase to 34 mmHg 4 h later. At 12 h after reduction average values are still 26 mm Hg. Patients developing Sudeck's dystrophy during treatment (n = 4) exhibit above-average carpal tunnel pressure.

Adolescent↗
PubMed1993

[Repeated routine determination of pulmonary microvascular permeability after polytrauma].

We present a technique to measure pulmonary microvascular permeability for albumin in patients with multiple trauma by means of bronchoalveolar lavage (BAL). Routine laboratory tests for the analysis of BAL fluids are used. The results were clinically validated in 10 healthy volunteers and 12 patients with multiple trauma in a first prospective study. Additionally, another 11 severely traumatized and 24 less traumatized patients were evaluated in a second prospective study. Normal values (> 0.09 +/- 0.02), posttraumatic physiological ranges (< 0.35), and a "high risk" range (> 0.5) for pulmonary microvascular permeability for albumin were developed. There was a high correlation between the first posttraumatic values of pulmonary microvascular permeability and the required duration of intensive care treatment (r = 0.81), the duration of continuous mandatory ventilation (r = 0.78) and the mean lung injury score by Murray (r = 0.76). We conclude that the presented method is harmless and useful to describe the post-traumatic course of pulmonary microvascular permeability.

Adult↗
PubMed1991

[Port-catheter perforation into the duodenum and other early complications after port implantation before intra-arterial infusion therapy of the liver with chemotherapeutic drugs].

Early complications following implantation of intraarterial hepatic port catheter systems from 1985 to 1988 in 24 patients are reported with special view to the perforation of a port catheter into the duodenum. In this case the primary postoperative angiographic control four weeks after implantation showed correct placement and perfusion of the liver. The perforation occurred before starting any cytostatic regimen. We observed a total of 21% irregularities and complications: dislocation of port membrane (n = 1), incorrect catheter displacement but regular liver perfusion (n = 1), catheter leakage (n = 1), subhepatic abscess (n = 1) and perforation of the catheter in the duodenum. When possible we combine port-implantation with resection of the liver.

Adult↗
PubMed1991

Endosonographic detection of rectum anastomoses.

Following preliminary studies on 15 pig-bowel EEA anastomoses, anastomoses in 20 patients were consecutively examined between the 12th and 14th days after anterior rectum or sigmoid resection. Resections were performed on 16 patients for a malignant tumour and on 4 individuals for a benign lesion. The examination programme included detailed clinical examination of the patient, digital palpation, rectoscopy and endorectal sonography, as well as radiographic examination of the large bowel using aqueous contrast medium 1 day later. All rectoscopic and X-ray findings of anastomotic insufficiency were confirmed by means of endosonography. The sensitivity of the latter technique in verifying the radiographic detection of an insufficiency was 1 and its specificity was 0.82. Endorectal sonographic detection of an anastomotic insufficiency was successful in six cases, and suspected insufficiency was noted on three occasions. Radiographic detection of insufficiency was confirmed in three patients; radiographic results suggested an insufficiency in two cases. On one occasion, a suture insufficiency was confirmed by an immediate operation carried out without a radiographic examination. The present study shows that accurate detection of a suture insufficiency after deep resection is possible with the aid of endorectal sonography.

Anastomosis, Surgical↗
PubMed1990

Ultrasonic endoluminal examination in the follow-up of colorectal cancer. Initial experience and results.

We have been using endoluminal ultrasonography since 1988 as part of the follow-up procedure after colorectal surgery. A total of 106 patients with anterior resection of the rectum or the sigmoid colon were involved in 1988. The follow-up period for these patients ranged from 1 to 56 months after surgery (23.1 +/- 15.1 months after anterior resection of the rectum; 25.7 +/- 22 months after anterior resection of the sigmoid). During the observation period 7 patients developed recurrence after anterior resection of the rectum and 5 after anterior resection of the sigmoid. The primary stages for these patients had been 7 cases of Dukes' B, 3 of Dukes' C1 and 2 of Dukes' D. Raised serum CEA levels were found in 5 cases. In 3 other cases, we found pathological changes in the anastomotic region by means of endoscopy. In these the endorectal ultrasonic scan showed hypodense masses as a sign of recurrence. In 2 of these 3 cases, the serum CEA level was normal. In 4 cases endoluminal rectal ultrasonography alone was suspicious. This led to further diagnostic procedures and finally to radical excision. All suspicious ultrasonic images were monitored 2 to 4 weeks later. In cases of suspicion, endoscopic, needle or surgical transrectal biopsies were taken from all patients. In all cases, histological analysis confirmed the ultrasonic diagnosis of local recurrence.

Aged↗
PubMed1990

[Treatment of intra-articular calcaneus fracture in the standard care hospital].

A total of 49 intra-articular fractures of the calcaneum were treated from January 1985 to December 1988. In 27 cases the fracture was treated with functional therapy, while in 21 cases management was surgical. The diagnostic procedure was the following: conventional radiography was lateral, axial and dorsoplantar exposures after Böhler. These radiographs allow adequate classification and selection for surgery for the treatment of intra-articular fractures. CT examination is often not available in a general or county hospital, and is not essential for the decision as to whether a conservative or a surgical procedure is more appropriate. Intra-articular fracture of the calcaneum is an indication for surgery except when the bones are totally fractured. We excluded from surgery: 6 patients older than 65 years, 3 with multiple trauma, 2 patients who were receiving coumarin treatment, 3 patients with occlusive arterial disease, and 1 patient who had suffered a cerebral stroke. In 4 cases the patients declined the proposed surgical treatment. Surgery was performed 8 days after trauma. Only lateral incisions were used. We used the Bézes technique, in which bone plate and screw fixation is combined with spongiosa grafting. We observed no necrosis of skin or soft tissue and no infection. Follow-up examination was possible in 33 patients (59% after conservative and 81% after surgical treatment). The patients who had undergone surgery had better results as measured by ability to work, gait pattern and radiological findings of arthrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[The peroneus brevis muscle flap-plasty. A simple procedure for covering fibular soft tissue defects after osteosynthesis].

Fractures in the region of the ankle associated with soft tissue trauma often present a problem for the traumatologist. After osteosynthetic repair, primary closure of the skin may be prevented by soft tissue oedema or a local circulatory disorder. However, it is necessary for the wound to be closed in such a way that the fibula and metal implant are covered with vital soft tissue. The peroneus brevis muscle flap represents a local and simple method of covering soft tissue defects in the region of the distal fibula. With help of this flap it is possible to cover defects of up to 20 x 4 cm without disinsertion of the tendon. After performing anatomical studies, we successfully performed the above-mentioned technique on 21 patients. At no stage did we observe ischaemia or necrosis of the muscle flap. Our modification of the peroneus brevis muscle flap is a reliable and simple method for routine management of soft tissue defects in the fibular region by the traumatologist.

Adult↗