PubMed Health⌕ Search

Biomedical subjects

M Raschke

Publications and source records attributed to M Raschke.

12 recordsLinked to original sources
PubMed1998

Nonunion of the humerus following intramedullary nailing treated by Ilizarov hybrid fixation.

A case of a posttraumatic humeral shaft nonunion, after intramedullary stabilization with a Seidel nail, is presented. Severe osteoporosis, an oligotrophic nonunion, subclinical infection, and adhesive capsulitis of the glenohumeral joint were present. Due to the subclinical infection and severe osteoporosis, other major invasive therapeutic options such as intramedullary nailing or compression plating and bone grafting were not applicable. Nonoperative treatment was also not indicated secondary to the pain and disability present. External fixation with the Ilizarov hybrid fixator seemed to offer a minimally invasive treatment modality without the need of additional bone grafting. After fourteen weeks of "callus massage," consisting of closed alternating compression and distraction with an Ilizarov hybrid fixator, osseous consolidation was achieved. Eight months after Ilizarov treatment the patient had returned to work as a mechanic. At the one-year follow-up examination, the patient presented pain free and with near normal shoulder and elbow motion, with stable osseous consolidation of the humerus. In some cases of nonunion of the humerus shaft, when standard treatment options are not recommended, external fixation with an Ilizarov hybrid fixator may offer a salvage procedure with a successful clinical outcome.

External Fixators↗
PubMed1998

[Retrograde intramedullary nailing in proximal fracture of the humerus in the elderly patient. Results of a minimally invasive management concept].

Retrograde intramedullary fixation of proximal humerus fractures with flexible wires was evaluated in a prospectively documented study. Seventy-four fractures in 73 patients with unstable proximal humerus shaft or neck fractures were fixed with 3-11 flexible intramedullary wires. The age of the patients averaged 72 years (42 females, 31 males). In nine fractures additional implants (screws, cerclages) were used to fix dislocated fragments through an anterior approach to the shoulder. Complications associated with the procedure especially in osteoporotic bone were secondary loss of reduction (16%) and wire migration (21%) which lead to revision surgery in 14% of patients within 6 weeks. A minimum follow-up of 12 months (average 16.5 months) could be obtained in 61 patients (84%). According to the Neer- and Constant-scores 60% showed good or excellent results, 30% had a satisfactory and 10% had an unsatisfactory or poor result.--Retrograde intramedullary, flexible wire fixation can provide an overall satisfactory outcome in unstable proximal humerus fractures of the elderly. However, the high incidence of secondary wire dislocations especially in marked osteoporosis appears to be an unsolved problem of this treatment modality.

Aged↗
PubMed1996

[The monorail system--bone segment transport over unreamed interlocking nails].

A treatment protocol is demonstrated, consisting of an osteotomy, either proximal or distal, of the bone defect with subsequent segmental transport via an anteromedially (tibia) or laterally (femur) mounted AO external fixation over an unreamed interlocking nail (monorail system). Twenty patients were treated by this method with indications as follows: 13 had a segmental bone defect of the tibia, 3 of the femur. Three patients showed post-traumatic and postinfectious leg-length discrepancies and one was treated for hypertrophic non-union of the femur. Defect distance varied between 5 and 18.5 cm and average time for transport was 19,42 days/ cm for the tibial shaft, 15,93 days/cm for the femur. Two patients developed deep infection, which required change of treatment, removing the monorail system and application of an Ilizarov apparatus. Despite complications using the monorail system, all patients healed and no amputations were required. The monorail system can be used as an alternative to the Ilizarov method under certain criteria of patient selection; these criteria are shown by an algorithm for segmental bone defects without infection, respecting the soft-tissue status with or without neurovascular compromise.

Adolescent↗
PubMed1996

[Current status of therapy of subtrochanteric femoral fractures].

Operative treatment of subtrochanteric femur fractures is demanding. The implants available follow different biomechanical and surgical principles. Extramedullary implants like the condylar blade plate and the dynamic condylar screw require subtle surgical and indirect reduction techniques. Intramedullary implants like intramedullary hip screws and interlocking nails are biomechanically advantageous. In contrast to the extramedullary implants these fixations can stand postoperative weight-bearing. The different operative techniques for the fixation of subtrochanteric fractures are presented and evaluated. Current trends in treatment rationales are outlined.

Adult↗
PubMed1996

[Intermittent impulse compression. An alternative in therapy of post-traumatic and postoperative edema].

In patients with foot and ankle trauma, surgery and postoperative mobilization are often delayed because of swelling. The aim of this study was to assess if intermittent impulse compression of the foot is better than the standard therapy of applying cool packs at intervals. For intermittent impulse compression the AV impulse device was used (Novamedix Inc.). From May to November 1993, 40 patients (20 ankle fractures, 8 ruptured ligaments, 6 calcaneal fractures, 4 distal tibial fractures, 1 talus fracture, 1 subtalar dislocation) were prospectively assigned at random to the two groups and treated. After 24 h of treatment, the patients with intermittent impulse compression of the foot showed an average reduction of swelling of 47% around the ankle, midfoot and forefoot. With cryotherapy it was 17%. After 4 days of treatment in the postoperative course the swelling subsided at a rate of 74% with impulse compression and 45% with cryotherapy. Intermittent impulse compression of the foot proved to be a highly effective method of treating post-traumatic and postoperative edema. It seems preferable to the standard therapy using cold packs.

Adult↗
PubMed1996

[Lesions of the popliteus system and their significance for the stability of the knee joint].

INTRODUCTION: Stäubli postulated a clinical significance of lesions to the popliteus system because of a 95% incidence in acute and 85.7% in chronic ruptures of the cruciate ligaments. The sparse clinical literature on this topic favours conservative or operative treatment as well. OBJECTIVE OF THE STUDY: What is the significance of isolated lesions of the popliteus tendon on translational stability of the knee joint? MATERIAL AND METHODS: The popliteus tendon was severed in six sheep. One year postop. the knee joints were evaluated by means of x-ray, biomechanical testing, computed tomography osteoabsorptiometry (CTOAM) and micromorphology. RESULTS: There were no pathological findings on x-ray. The simulation of the trauma situation ex vivo showed no instability whereas increased translation and progressive loosening of secondary stabilizers was found after one year (posterior and total aptranslation, compliance index p < 0.05). The position of the density maxima of the subchondral mineralization are about the same on the operated and the non-operated knee joint. All tendons healed macroscopically, but micromorphology exhibited a persisting increase of cross-sectional areas, a low differentiated ultrastructure of the tendon and an increased cellularity (p < 0.01). CONCLUSIONS EXPERIMENTAL: 1. intraarticular, extrasynovial tendons heal spontaneously even within the synovial environment; 2. healing is defective even one year postop.; 3. the postulate of the significance of the popliteus system for the stability of the knee is proven. Clinical: 1. (isolated) lesions of the popliteus go undetected with clinical and instrumented examination; 2. conservative treatment eventually results in increased posterior translational instability; 3. this will increase strain and load on the menisci and ACL- reconstructions.

Animals↗
PubMed1990

Microangioarchitecture of gastric mucosa in man: antrum ventriculi.

The blood vessels of the antrum area of human gastric tunica mucosa have been studied by scanning electron microscopy and compared with vertical and horizontal serial sections of perfusion-fixed antrum mucosa. In contrast to previous studies on the oxyntic corpus mucosa, where two superimposed capillary layers could be seen, the antrum mucosa presents only one capillary layer. It extends from the lymphatic follicles above the lamina muscularis mucosae up to the luminal surface. No further arterioles exist in the glandular part of the antrum mucosa. The luminal aspect of the capillaries show thin, honeycomb-like capillaries, differing from our previous findings in the corpus area. There the capillaries are wide and circulate in a dense, convoluted way. Arteriovenous anastomoses again could not be seen in the examined tissue. The differences in gastric microangioarchitecture might be explained by the extent of the glandular part in both regions. The findings in the antrum area very much resemble the basal capillary layer in the corpus mucosa. The critical height for one capillary layer in the glandular tissue of human gastric mucosa is estimated to be approximately 1 mm. Larger diameters, as in the oxyntic corpus mucosa, might require a second capillary layer.

Adult↗
PubMed1987

Microvascular architecture of the mucosa of the gastric corpus in man.

Vascular casts of human gastric mucosa of the corpus area were studied by scanning electron microscopy and compared with vertical and horizontal series of semithin sections of perfusion-fixed corpus mucosa. The submucosal arteries give off short and long arterioles. The short arterioles branch into a basal capillary network reaching from the basis to the isthmus of the gastric glands. The long arterioles pass through the lamina propria without ramifications and supply a second, apical capillary layer reaching from the base to the top of the gastric pits. Anastomoses connect both capillary layers. Dense, convoluted capillaries at the mucosal surface encircle the gastric pits. Both capillary layers drain into venules at the level of the gastric pits. Below, on their way to the submucosal plexus, the venules do not receive any further capillary tributaries. In the examined tissue no arteriovenous anastomoses could be identified. A microvascular architecture with two capillary layers is presented, which guarantees a luxurious oxygenation throughout all layers of the gastric corpus mucosa in man. These findings are in contrast to previous descriptions of human corpus mucosa, where only one capillary layer, reaching from the base to the top of the corpus mucosa, has been identified.

Adult↗
PubMed1983

Absorption rates of subcutaneously injected insulin in the dog as calculated from the plasma insulin levels by means of a simple mathematical model.

The appearance rate of insulin (calculated insulin secretion rate) in the circulating blood after subcutaneous injection was estimated in diabetic dogs from serial measurements of immunoreactive insulin concentrations using a simple mathematical model based on the insulin half-life and the distribution space. In the case of highly purified monocomponent porcine insulin, maximum concentrations occurred after 30-60 min. The duration of insulin appearance was dose-dependent and the rate of appearance could be described by a bi-exponential function. It was linearly dose-dependent but the effect on glycaemia showed saturation kinetics. The action of the injected dose on the fasting glycaemia diminished when the appearance rate became less than 0.3 mU X kg-1 X min-1. Fractional dose recovery was between 70% and 90% and was not different between depot and regular insulin. Appearance kinetics were not significantly affected by the initial glycaemia. The model presented provides a means for quantitative characterization of different insulin preparations.

Absorption↗
PubMedDate not supplied

Prevalence of peripheral and autonomic neuropathy in newly diagnosed type II (noninsulin-dependent) diabetes.

Type II (noninsulin-dependent) diabetes (NIDDM) can be preceded by a relatively long period of disturbed glucose metabolism. Therefore, the prevalence of neuropathy and its possible relationship to metabolic abnormalities were investigated in 95 newly diagnosed type II diabetics (upper age limit was set at 55 years) with a mean age of 49.7 years (men/women ratio 1:1). The study program was as follows: Detailed history, clinical investigation of peripheral nerves, sensory assessment to touch and pain (pinprick), vibration sensation using established techniques, and motor nerve conduction velocities (MNCV) of the fibular (peroneal) and ulnar nerves. Three cardiovascular autonomic function tests were performed: the Valsalva maneuver, standing (ratio between RR-intervalmax: RR-intervalmin), and deep breathing (maximum/minimum heart rate). Vascular diseases were diagnosed using a conventional 12-lead resting electrocardiogram (ECG) and impedance measurement of the lower extremities. The results were as follows: abnormal vibration sensation in 80.0%, abnormalities of MNCV in 15.7%, abnormal sensations to touch or pinprick in 14.7%, and loss of reflexes in 13.6%. If peripheral neuropathy was defined as having at least three of the four abnormalities plus neuropathic symptoms, the prevalence was 6.3% (6 of 95 patients). Abnormalities of the three cardiovascular autonomic function tests were much less prevalent in type II diabetic patients (2.1-7.3%). In conclusion, the study showed that peripheral and autonomic neuropathy is not common at diagnosis in middle-aged type II diabetic patients without signs of microvascular or macrovascular complications.

Autonomic Nervous System Diseases↗