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Biomedical subjects

L Kinzl

Publications and source records attributed to L Kinzl.

At least 199 records · Page 11Linked to original sources
PubMed1991

[Trends in indications and technique of osteosynthesis. Innovations in surgery of the spine].

More understanding of the biomechanics of injured segments, standardized dorsal and ventral accesses to all spinal column levels, and developments in fixation systems specifically conceived for the stabilization of vertebral column lesions have all greatly expanded the operative indications for spinal column injuries. Modern fixation systems should have the following features: short-term application, angular stability, universal suitability for all types of fractures, ability to bear axial loads, thus dispensing with the need for additional external stabilization.

Fracture Fixation↗
PubMed1991

[The treatment of distal upper arm fractures].

The treatment of fractures of the distal humerus is very well standardized. The classification according to Müller allows for easy differentiation between the many types of fractures, helps in the determination of therapeutic guidelines and contributes to an objective comparison of results of treatment. Fractures in group A/B are treated either conservatively or with comparatively simple instrumentation using K-wires, screws, and plates. Injuries falling in group C demand a high standard of operative skill. The underlying principle of internal fixation aims primarily at reconstruction of the articular surface. The next operative step consists in the realignment of the reconstructed articular block with the proximal humeral fragment by osteosynthesis. Autologous cancellous bone is used to give a solid counterbalance for screw fixation and to re-establish osseous continuity. Sound assessment of concomitant injury to the soft tissue demands wide clinical experience. This is necessary for essential decision as to whether primary osteosynthesis, delayed, secondary reconstruction of the joint following recovery of the soft tissue or conservative treatment is indicated.

Elbow Joint↗
PubMed1986

[Fractures of the cervical spine].

A gentle traction is often sufficient to repose unstable lesions of the cervical spine, when a retention by means of conservative methods is not possible. Therefore a ventral, intracorporal fusion with autologous, corticospongious chip material combined with a plate fixation is an adequate solution to obtain a stable, movable blocking of the lower six cervical vertebrae. In case of a completely ruptured dorsal ligamentous apparatus, a ventral bone-chip blocking is generally insufficient. Ventral spondylodesis should be combined with a dorsal traction belt in these cases. Fresh, instable fractures of the odontoid process can be stabilized for exercise by means of two traction screws fastened from the front side. However, the best method to treat a pseudarthrosis of the odontoid process is a fusion performed from the dorsal side.

Atlanto-Occipital Joint↗
PubMed1983

Treatment by external fixation of open fractures associated with severe soft tissue damage of the leg. Biomechanical principles and clinical experience.

External fixation is the treatment of choice for fractures of the leg involving severe damage to the soft tissue. Each of the various patterns of application has advantages and disadvantages. Based on various biomechanical studies and clinical experience, the authors use a right-angle arrangement for the screws. If the type of fracture permits, internal and external fixation may significantly increase stability. During the period from 1978 to 1980, 56 patients with second- and third-degree open fractures were treated. A combination of external and internal fixation was used in 42 patients. Of the 44 patients re-evaluated at follow-up examinations, 19 had returned to unrestricted weight-bearing within 19.8 weeks. If no signs of bony union are noted ten to 12 weeks after the initial operation, cancellous bone grafting and internal fixation instead of external fixation are indicated. Twenty-three patients were fully weight-bearing an average of 14 weeks after internal fixation and cancellous bone grafting. Two patients had difficult problems and did not return to full weight-bearing until about 45 weeks after operation.

Adult↗
PubMed1983

[Carbon fiber ligament replacement in the treatment of chronic instability of the external ankle joint ligament].

Ligament repair should be considered when a patient has disabling pain with giving way and chronic instability of the ankle from old ruptures of the lateral ligaments. Because of some incontestable disadvantages using Watson-Jones-or similar techniques we prefer the alloplastic with carbon fibres to reconstruct the anterior talofibular and calcaneofibular ligaments. Imitating the physiological course and insertions of the ligaments we managed to achieve a permanent lateral stability in 51 cases out of an operated group of 54 patients.

Ankle Injuries↗
PubMed1982

[Load stability in relation to the osteosynthesis method, course and complications in open lower-leg fractures with severe soft tissue lesions ].

The external fixator ("fixateur externe") is today's method of choice in the treatment of lower leg fractures with severe damage to the soft parts. The various application techniques and angles of application of this device entail varying stability and are characterized by certain advantages and drawbacks. Basing on detailed biomechanical studies and experience with patients, the authors prefer the rectangular mode of application using Schanz screws. If the type of fracture allows, a combination of minimal osteosynthesis and external tensor is used; this can significantly enhance the stability. In 42 patients of a total of 56 during 1978-1980 with second-grade and third-grade open fractures of lower leg, combination with minimal osteosynthesis was effected (traction screw). Of 44 patients followed up, 19 achieved stability to load within an average period of 19.8 weeks. If there is no osseous bridging 10-12 weeks after initial treatment, additional measures such as spongiosaplasty and changeover to stable inner fixation with plates become necessary. Following plate osteosynthesis with additional spongiosaplasty, full load was permissible on the average 14 weeks after this procedure in 23 patients. The course was more complicated in the case of the 2 remaining patients; it took up to 45 weeks until full load became permissible.

Bone Plates↗
PubMed1982

[Complications at removal sites of autologous cancellous bone transplants].

1022 autologous bone transplants were performed at the University clinic of Ulm in the years 1971-1977. The cancellous bone deposits removed were localized in the anterior and posterior iliac crest, the trochanter major, the tibial head as well as the distal radius. Since some patients had postoperatively experienced difficulty in the healing of the cancellous bone removal sites, we decided to investigate these complications by means of questionnaires, clinical re-examinations as well as X-ray controls (3-9 years after removal). During the early postoperative phase (2 months), approximately one-fifth of the patients had complained about pain at the removal site. 3.1% had more or less pronounced hematomas in the scar regions, but surgical evacuation of the hematoma was necessary in only 0.28%. Additionally, 2 cases of infection as well as one femoral neck fracture following cancellous bone removal from the greater trochanter were observed. At the time of re-examination, performed 3-9 years after cancellous bone removal, only 3.9% of the patients complained of largely weather-influenced pains in the vicinity of the cutaneous scars. Sensibility disorders in the area innervated by the N. Cutaneous femoralis lateralis, were found in all those 7 patients who, in the course of cancellous bone removal from the iliac crest, had received skin incisions extending ventrally beyond the spina iliaca anterior superior. The X-ray controls showed more or less pronounced changes in the bone structure at the removal sites of cancellous bone deposits in nearly all patients, but correlation could only be determined between the radiological alterations at the anterior iliac crest donor site and the respective complaints of the patients.

Bone Diseases↗
PubMed1982

[Spinal tumors].

Explore the source record for details and available documents.

Bone Plates↗
PubMed1981

[Plain x-ray studies of bone material in the repair of fractures (author's transl)].

Ten patients who had had osteosynthetic repairs of bone defects carried out by means of bone grafts were studied. It was shown that magnification radiography permitted better and more complete evaluation of the healing process. Trabecular bone structure can be recognised and changes in the configuration and position of the trabeculae during their incorporation into the bone can be evaluated.

Bone Plates↗