PubMed Health⌕ Search

Biomedical subjects

P Engelhardt

Publications and source records attributed to P Engelhardt.

89 records · Page 5Linked to original sources
PubMedDate not supplied

[Atlanto-axial rotational subluxation in children: therapy in delayed diagnosis].

Children may develop a torticollis due to Rotatory Subluxation not only after minor trauma, infections of the upper respiratory tract, surgical procedures in the oropharynx but also spontaneously. Three cases with a delay in diagnosis are presented; the typical symptoms and other causes of torticollis are discussed. The suggested treatment is mobilisation under general anaesthesia, fixation with a Halo for a few days and consecutive immobilisation in a Minerva cast for 4-8 weeks. This regimen was successful in all three cases.

Atlanto-Axial Joint↗
PubMedDate not supplied

[Epiphyseolysis of the femur head: indications for the treatment of the contralateral hip at cessation of growth].

In general, prophylactic treatment of the contralateral hip in manifest unilateral EFH is a well-proven and efficacious preventive measure. Shortly before the end of growth, however, due to asynchronous closure of the growth plate, the contralateral side may already be fused, so that there is no longer any danger of the hip slipping. Diagnostic difficulties in radiologic assessment of growth plate structure can be resolved with CT. In a two-year period, CT confirmation of closure of the growth plate enabled surgery on the contralateral side to be dispensed with in 3 cases (out of a total of 9).

Adolescent↗
PubMedDate not supplied

[Computerized tomography measurement of humerus torsion].

The angle of humeral torsion may be determined in living subjects by computerised axial tomography, in conjunction with immobilisation of the arm on a rigid board. Transverse scans of each humerus through the proximal and distal ends were obtained in 28 control subjects. The mean angle of torsion was found to be 62.8 degrees with a range of 40 degrees (minimal value 42 degrees, maximal value 82 degrees). These figures were comparable to results obtained by other authors. The wide spread of the measured values allows the clinical application of the humeral torsions exclusively in relation with the contra-lateral side for preoperative planning.

Adult↗
PubMedDate not supplied

[Orthopedic diagnostics using acoustic phenomena].

The clinical analysis of joint noises has practical significance in orthopedics. It has been attempted from time to time in the past 100 years to amplify, analyse and record joint noises. Despite the increased effort from decade to decade, the method of phonoarthrography has not been able to establish itself, since the measurements are complex and poorly reproducible. Artifacts can easily be confused with pathological findings. Finally, because of the different physical properties of light, the sense of vision has essential advantages compared with the sense of hearing, which can localize a sound source only insufficiently accurately.

Arthrography↗
PubMedDate not supplied

[Radiometry of epiphyseolysis capitis femoris. A comparison of conventional roentgen study with axial computerized tomography].

CT scans are proposed for the measurement of tibial, femoral and humeral torsion. The value of computerised tomography in the evaluation of slipped capital epiphysis is yet not discussed. Conventional roentgenographic studies have shown that the capital femoral epiphysis slips by rotating backwards. In a study of 5 cases with a right site slip of the capital femoral epiphysis of different extent a comparison of conventional radiography with CT-scan was undertaken. True lateral films of both hips were obtained at the same time when CT scan of the femoral head and the condylar region of the femur were performed. The optimal site of cross-sectioning the femoral head lies in its center. Both measurements of the epiphysial torsion vary more ore less. This is believed to be related to the different plans in which the upper femoral end is projected in conventional radiography and CT-scan. Both angles of epiphysial torsion are geometrically related. A formula is given for mathematical transfer. Only by marked epiphysial displacement both angles vary to a greater extend. CT scan is suggested to be of certain value in the preoperative evaluation in heavy slips.

Biomechanical Phenomena↗
PubMedDate not supplied

[Neurologic complications in implantation of knee endoprostheses. A clinical and EMG-documented study].

In a retrospectively studied group of 253 knee joints treated by total replacement, six (2.4%) nerve lesions were clinically diagnosed. In the vast majority there was damage to the peroneal nerve, and in a single case also to the tibial nerve. After between one and three years only two patients still had permanently impaired function. In a second prospective study of 27 patients, examined by EMG before and after surgery, signs of bland, fresh neural damage was found in just under 30% following implantation of a knee joint prosthesis. In none of the cases had clinically manifest defunctionalization symptoms occurred. In the subsequent course, proof of far-reaching remission of the subclinical lesions was obtained, also by EMG. The causes of the perioperatively inflicted nerve lesions are discussed; the correction of axial defects (knee-bending contracture, genu valgum) in particular seems a likely cause of neural damage.

Electromyography↗
PubMedDate not supplied

[Late prognosis of Perthes' disease: which factors determine arthritis risk?].

In 55 patients with Perthes' Disease the radiographic and clinical results were reviewed at the Orthopedic Clinic Balgrist of the University of Zurich (Switzerland) an average of 42 years (range: 28-56) after onset of the disease. Radiographs were available from the onset of disease to maturity. They were systematically evaluated utilizing the following criteria: Catterall grouping, "head at risk" signs, Mose's criteria and various indices and quotients for the measurement of femoral head deformity. The late results of the affected hips in adult life based upon clinical and radiological examination, and especially the development of arthrosis, were correlated with the earlier evaluations using statistical methods. Our results support the therapeutic concept of "femoral head containment" which means a better prognosis for those hips in which the femoral head is well contained without lateral subluxation or extrusion. In contrast to the negative prognostic significance of lateral calcification, which was found more frequently in the older children with poor end results, the amount of femoral head involvement according to the Catterall grouping was not found to have any influence upon the late outcome. A very important predictor of the prognosis was found to be the sphericity of the femoral head evaluated according to Mose's criteria, followed by the head-acetabulum quotient, the acetabulum quotient and the radius quotient. When severe residual deformity persisted after the healing phase arthritis developed in many cases. Age was also a significant factor. Fewer good results were found in children who were more than 8 years old at the onset of symptoms. The last assessment, based on clinical and radiological criteria, showed that 46% of patients had an excellent and 33% a good late result. Disabling arthritis requiring surgery developed in only 9 cases. We found, as have other authors of long term follow-up studies, that many patients, especially those with no or only mild femoral head deformity, do not develop significant coxarthrosis in early or middle adult life. More than 50% of the patients showed only mild or even no arthrosis an average of four decades after the onset of Perthes' Disease.

Adolescent↗
PubMedDate not supplied

[Does Osgood-Schlatter disease modify the position of the patella?].

The Blackburne and Peel method of assessing the position of the patella was applied to 185 knees with Osgood-Schlatter disease in 125 patients. The normal index of 0.80 was confirmed in 73 controlled knees. The average index in the knees with Osgood-Schlatter disease measured 1.01 (patella alta) in boys and 0.91 (normal) in girls. The value increased to 1.06 in boys with radiological evidence of loose ossicls in the tibial tuberosity or the patellar tendon. This finding indicates that the strong pull of the well developed quadriceps muscle in probably the most important aetiological factor in the patella alta associated with Osgood-Schlatter disease.

Adolescent↗
PubMedDate not supplied

[Pathological patella fracture in gout tophus].

Although gout is known to cause destruction of bone by the deposition of tophaceous material, the documented cases of pathologic fractures due to gout are rare. We report the case of a pathologic fracture of the patella. Union of the fracture was seen at 3 months after surgery.

Bone Wires↗