Biomedical subjects
Publications and source records attributed to N Südkamp.
The paper defines indications for amputation, reconstruction and replantation of severely injured extremities of multiple traumatised patients using the trauma score PTS (Hannover Polytrauma Score) and the fracture grading for open and closed fractures.
From 1972 to 1980, 153 patients with acute rupture of the Achilles tendon were treated operatively in the Trauma Department of Hannover Medical School, 127 of whom were assessed postoperatively according to the Trillat scale at an average of 9.8 years after injury. Consideration of the tendon ruptures showed that 80% had occurred during sports activities, 86% were in males, and the highest incidence was in the age group 31-40 years (45%). In 67% an indirect trauma was present, and 35% of the patients had a history of antecedent pain and discomfort. In 77 patients the tendon was examined histologically within 24 h of injury. There was no histological evidence of antecedent pathology or degenerative condition in those cases with direct/indirect trauma, whereas in 11 of 13 cases without a history of trauma degenerative changes were observed. The operative procedure of the primary simple end-to-end suture with absorbable material showed fewer wound complications (8.4%) than were seen in the other group, in which non-absorbable sutures were used or secondary reconstructive procedures applied (3 of 8). The results obtained with primary operative tendon suturing were evaluated according to the Trillat scale as excellent in 68.8%; as good, in 20.8%; as satisfactory in 8.8%; and as poor in 1.6%. During a 10-year follow-up after primary tendon suture rerupture occurred in 2% of cases.
The effects of prebending and prestressing in compressional osteo-synthesis with application of the AO small-fragment DC plate on the bones of the forearm were examined. The necessary prestress force, the angle of prebending and the resulting center of compression in the fracture site were experimentally examined. These experiments were performed on fresh cadaver bones using the ulna and the radius. Additionally, after applying small-fragment DC plates with varying angles of prebending and varying forces of prestressing on perpendicular shaft osteotomies, stability tests were carried out. A theoretical analysis of the experiments performed was computed using the finite element method.
The thoracic surgeon is confronted with the question of the operability of patients over 70 years old more and more frequently. Not only the advanced age, but also probable functional impairments are decisive for the outcome of an operation in this often polymorbid age group. Fifty-three patients over 70 years old underwent 58 thoracotomies. The hospital lethality was 7.5%, the complication rate 17%. These results could be obtained by a specific selection of patients, based on functional parameters, intensive preoperative medical and physiotherapeutic treatment in terms of improvement of possible functional deficits and the usual postoperative intensive care. In our long-term observations we could record a 5-year survival rate of 100% in patients with benign diseases and of 46% in cases of bronchial carcinoma. These results confirm our attitude that the age 70 years and older should not be considered as contraindication for thoracic surgery.
AIM: The purpose of the present study is to evaluate wether the gliding nail with it's double-t-shaped geometry is appropriate in the stabilization of unstable trochanteric fractures or not and if this evaluation can be performed with a static finite element simulation. METHODS: Surface-Reconstruction with CT database of a proximal femur and reconstruction with CT based density data was done. After modelling of geometry, isotropic material behaviour and load application during one leg standing in slow walking was done with a limited dataset of relevant muscles. Two relevant fractures are modelled. RESULTS: FE-simulation shows a movement of the femoral head distally, medially and posteriorly. Maximum bending strain is in the femoral diaphysis medial compression and lateral tension strain. In the proximal part we find a nearly homogeneous strain distribution. The clinical effect of lateralization of the proximal main fragment is also result of the simulation. In the area of the modelled fractures there is much more compressive stress than shear stress. CONCLUSION: Elastomechanical behaviour of the gliding nail is demonstrated with correlation of clinical observed effects. In both simulated fracture areas there is a bone union supporting compressive stress. This means in the FE-simulation the gliding nail is appropriate in the stabilization in unstable trochanteric fractures.