Biomedical subjects

M Baacke

Publications and source records attributed to M Baacke.

13 recordsLinked to original sources

PubMed2003

[Results of elastic stable intramedullary nailing (ESIN) in forearm fractures in childhood].

Conservative treatment of unstable forearm fractures in childhood leads to disappointing results in up to 50%. Therefore the indication for a primary operative treatment is given. In the early 1990s the ORIF (open reduction and internal fixation) Procedure was the commonly practiced treatment. Nowadays elastic stable intramedullary nailing (ESIN) is increasingly recommended. Aim of our prospective investigation was to evaluate difficulties, early results and complications of the elastic stable intramedullary nailing of forearm fractures in children. From January 1998 to December 2000 fifty-four children (23 female, 31 male) with an average age of 8 years (8-16) were treated operatively with ESIN. 48 patients had a single forearm-fracture,6 were multiple injured (ISS<16). Open reduction was necessary in 7,4% cases. Clinically and radiologically a good consolidation was found in all fractures. In one case a large callus formation induced a reduced range of motion. As complications seven superficial infections,which required neither pharmacological nor surgical intervention,were treated. In two cases a temporary paraesthesia of the N. radialis superficialis occurred. In one patient a progressive lesion of the N. ulnaris was observed, due to a constriction of scar-tissue. All fractures healed, in all cases with full range of motion. No relevant difference of length or deviation of the axis was observed. Good clinical results, the low risk of complications and the positive biological impact make the ESIN to the standard procedure in the treatment of unstable forearm fractures in childhood.

Adolescent↗

PubMed2001

[Continuous stroke volume monitoring as "hemodynamic online monitoring" in polytrauma intensive care patients: technically possible--clinically necessary?].

PURPOSE: Is the measurement of continuous cardiac output useful for the management of polytrauma patients? METHODS: In a prospective non randomized study (ethic commission file 43/96) we evaluated the diagnostic and therapeutic impact of the CCO (continuous cardiac output measurement) for polytrauma patients on the ICU. The Baxter Vigilance System was used for measuring the continuous cardiac output. The CCO values were controlled once a day by the conventional "cold" thermodilution technique. RESULTS: All values are given as mean +/- standard deviation. The Patients were scored on the first day for ISS (injury severity score) (47 +/- 17) and APACHE II (15 +/- 5). The CCO was used no later than 12 hours after the initial treatment in 20 polytrauma patients. As clinical outcome parameters were chosen: days on ventilation (23 +/- 23 days), days on the ICU (31 +/- 26 days) and mortality (20%). The treating ICU physicians were asked in a standardized questionnaire, whether or not there was an impact of the CCO measurement on their therapy. Seven different surgeons were working with the system. CONCLUSION: The unique opinion was that the CCO device had an impact on their decision making in the fluid and drug management of the study patients. Our first experience, however, suggests that this device may become an important improvement in the management of haemodynamics in the early trauma phases. Before a wide-spread application of this method on the ICU an evidence based prospective randomized trial should be performed.

Adult↗

PubMed2001

[A minimally invasive technique of intramedullary femoral nailing using the RDS system. A new technique for insertion of retrograde femoral nail].

A total of 72 patients with femoral fractures was treated between July 1997 and November 1999, 41 of them with retrograde intramedullary fixation. A minimally invasive technique was performed in 18 cases using a recently designed retrograde dilatator system (RDS) for the insertion of ACE-nail (DePuy), the reaming of the femoral canal and the locking of the distal screws. The mean age of the 18 patients (7 men and 11 women) was 49 (+/- 21) years. 8 type A, 6 type B and 4 type C fractures of the femoral shaft according to the AO classification were observed. 5 of the patients had sustained a severe polytrauma. The mean ISS of the total collective was 18 (+/- 19). No nail failed, no infection occurred, and no nerve palsies were recorded. The follow-up time was 10 (+/- 7) months. All fractures healed uneventfully. 16 patients were mobilized under full weight-bearing and regained a full range of motion without pain. In 2 cases of very old patients nursing was possible without pain. In 5 cases an implant removal was carried out in the same technique. The performed minimally invasive technique using the RDS minimizes damages to the patella ligament and the articular cartilage. It facilitates the control of rotational deformities and length discrepancies of the femur also under difficult conditions, e.g. polytrauma and obese patients.

Adult↗

PubMed2001

Procalcitonin versus interleukin-6 levels in bronchoalveolar lavage fluids of trauma victims with severe lung contusion.

OBJECTIVE: To examine whether measurement of procalcitonin (PCT) in comparison with interleukin-6 is a reliable marker to score the extent of lung contusion in bronchoalveolar lavage (BAL) fluids in polytrauma patients. DESIGN: Prospective, nonrandomized, observational study. SETTING: Twelve-bed intensive care unit in a 1,100-bed primary care university hospital. PATIENTS: Fourteen trauma victims presenting with severe lung contusion and acute lung injury or acute respiratory distress syndrome were enrolled in the study. INTERVENTIONS: Bronchoscopy with collection of lavage fluid and serum blood samples. Samples were obtained on days 1 and 2 after severe chest trauma, and lung contusion was assessed by computed tomography scan. MEASUREMENTS AND MAIN RESULTS: PCT was detectable in BAL fluids of all 14 patients. A significant correlation for PCT serum and BAL levels was found on day 2 (p =.0063). For PCT, no significant correlations (Spearman rank) were found to the lung injury score (p =.93), the abbreviated injury scale-lung (p =.33), or the sepsis-related organ failure assessment score-lung (p =.38). Also, for interleukin-6 there was no significant correlation to the lung injury score (p =.62), abbreviated injury scale-lung (p =.45), or the sepsis-related organ failure assessment score-lung (p =.54). CONCLUSIONS: PCT and interleukin-6 BAL levels cannot be considered as reliable parameters to assess the extent of lung contusion.

Adult↗

PubMed2000

Comminuted pelvic ring disruption in toddlers: management of a rare injury.

Pediatric pelvic fractures are rare injuries. The clinical management, classification, and operative treatment of this type of injury was presented in two toddlers ranging in age from 1 to 3 years. The CT examination proved to be the most reliable diagnostic tool for the assessment of the fracture morphology. The findings of the CT examination provide the possibility for an exact classification and operative planning. The surgical treatment was performed with the AO instrumentation for small fragments by using the approved standard approaches of adult surgery. The postoperative management has to be adapted to the physiology of the children. It is important to remove the osteosynthesis material in due time to avoid the risk of epiphysiodesis at the pelvis. To detect late sequelae of the trauma, follow-up should be performed regularly until growth is completed.

Accidents, Traffic↗

PubMed1978