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Biomedical subjects

L Döderlein

Publications and source records attributed to L Döderlein.

25 records · Page 2Linked to original sources
PubMed1998

[Rehabilitation program for children and adolescents with limb defects or amputations of the lower extremity].

In rehabilitation of children and adolescents with lower limb deficiencies it is very important that the medical team taking care of the patient works out a treatment plan. Responsible cooperation with the parents is of utmost importance, the focus of all efforts is, of course, the handicapped child. The aims of rehabilitation are illustrated by examples demonstrating the course of successful rehabilitation of children and adolescents with damaged limbs. Equally, the psychological situation of the parents and child is taken into consideration. Children with limb deficiencies or amputation of the lower extremities should be enabled to stand and walk according to their state of development, because standing and walking in particular are among the most important preconditions for the best possible integration. Provision with a prosthesis, orthosis and orthoprosthesis is therefore indispensable for rehabilitation. While a prosthesis replaces parts of an extremity, an orthosis stabilizes the existing extremity. Orthoprostheses compensate longitudinal malformations, have a supporting effect, allow growth to be controlled, and compensate for shortening. Just as important as these technical aids is early medical treatment. The sooner the treatment starts, the better the results.

Adolescent↗
PubMed1997

[Not Available].

Explore the source record for details and available documents.

Journal Article↗
PubMed1997

Principles of treatment of the upper extremity in arthrogryposis multiplex congenita type I.

The involvement of the upper limb in arthrogryposis multiplex congenita for many patients means a far-reaching dependency on outside help. The extension contracture of the elbow joint especially makes it impossible to reach the mouth or to perform hygienic necessities. Therefore, the rehabilitation program includes an improvement of passive elbow flexion by capsulotomy or of active flexion by triceps transfer if possible, or both. In bilateral involvement, the optimal solution is to have one arm in flexion for reaching the head and mouth passively or even actively and one arm in extension for hygienic necessities. From 1973 to 1993 we performed 22 releases of the elbow contracture in 16 children. An additional triceps transfer was performed in five elbows. The overall results showed a marked increase of the range of motion and a functional improvement concerning the daily activities (in 17 children). In 5 children there was no gain but also no loss of functional capacities. In 3 of 5 children with an additional triceps transfer, an improvement of active flexion was attained. Pre- and postoperative physiotherapy is at least as important as the operative procedure itself.

Adolescent↗
PubMedDate not supplied

[Surgical treatment of cavovarus foot deformity considering dynamic pedobarography].

AIM: The operative management of cavovarus foot deformity using soft tissue and bony procedures turns out to be difficult. The present study was undertaken to evaluate an individualised operative treatment and changes in pathologic peak pressure pattern. METHOD: 38 patients (average age 29.6 years, follow-up 44.6 months) with 59 operated feet were examined pre- and postoperatively. The clinical assessment included a questionnaire, ankle ROM and evidence of callosities. Correction of the longitudinal arch was measured on lateral X-rays using Hibbs', calcaneal pitch and Meary's angles. Plantar peak pressures were analysed in 16 patients (21 feet) using dynamic pedobarography (EMED SF4 system). RESULTS: A good subjective functional and cosmetic result were achieved in 74.6 % of the feet. Walking distance, shoe wear and ankle ROM were improved. The height of longitudinal arch and calcaneal dorsiflexion decreased significantly (p = 0.001). An elevated first ray (overcorrection) was noted in 49.1 % of the cases. Postoperative plantar callosities occurred essentially under the lateral border of the foot but were improved compared to the preoperative situation. Dynamic pedobarography showed a significant postoperative (p = 0.002) decrease of loading under the lateral border, but peak pressures remained relatively high in the midfoot area. An increase of peak pressure under the great toe showed a functional improvement at push off. CONCLUSION: The individualised operative concept has proved to be successful and leads to satisfaction with early improvement of foot function and shoe wear. Nevertheless it is difficult to restore muscular balance and normal foot posture in progressive neuromuscular disorders. A more selective use of the Jones procedure, an additional peroneus longus to peroneus brevis tendon transfer and a dorsal wedge extension osteotomy should prevent overcorrection of the first ray. To avoid a relapsed hindfoot varus deformity, a stabilising triple arthrodesis including lateral wedge resection should be performed early in severe deformities.

Adolescent↗
PubMedDate not supplied

[Principles of orthotic treatment in neuromuscular diseases].

Orthotic treatment has always been one of the main principles in palsy treatment. The effectiveness is always dependent on an exact indication. An orthosis may only support remaining functions but can never act as a substitute. The limitations of any orthotic treatment are the pressure tolerance of the skin and the energy expenditure exerted during the orthotic use. A combination of surgery and orthotics (surgical-orthotic integration; Rose 1986) may be required to give the optimum result. The orthosis must not be seen as a substitute for appropriate surgery. In order to achieve the best result a team approach is recommended in every instance.

Activities of Daily Living↗
PubMedDate not supplied

Distribution of grip force in three different functional prehension patterns.

Normative data of the grip force distribution necessary to complete functional tasks are limited. Small force sensors have been specially designed for accurate measurement of the dynamic handgrip force distribution by attaching them to the palmar surface of the hand. Seventeen healthy participants performed three different tasks, each requiring a different functional prehension pattern. When cylindrical objects were manipulated, the highest average grip forces were found at the fingertips and the thumb, followed by the middle finger. In a spherical grasp pattern, the contributions by the thumb, ring and small fingers always exceeded 71% of the total grip force. The highest local forces of 9.9 N were measured when a zip was closed with a tip pinch. Individual finger forces were found to differ by gender, but not by hand dimension and age. The results are useful for biomechanical modelling of the hand, for designing ergonomic tool grips, and for evaluating hand function.

Adult↗