Biomedical subjects

P Fröhlich

Publications and source records attributed to P Fröhlich.

At least 19 recordsLinked to original sources

PubMed1999

[Experiences with closed screw placement in intra-articular fractures of the calcaneus. Surgical technique and outcome].

For the closed treatment of an intraarticular fracture of the heel bone it is essential to know the 3D shape of the bone, the various types of fractures and to get skilled in reduction under an image intensifier. In our hospital we have made a comparison of 34 fractures treated with a plate and 94 treated with screws. The evaluation was made by the scores based on Merle d'Aubigne and clinical and radiological findings. The method of closed reduction and fixation with screws is easier, less dangerous for the patient and, compared to the open fixation, the results are the same or even better (good and excellent: 79.7%). As a result of gentle treatment of the soft tissues and the early reposition, the wound healing complications decreased to 2.1% compared to the 14% healing problems connected to open plating. Furthermore, cancellous grafting was necessary within the first group.

Bone Plates↗

PubMed1999

Mechanism-based PK/PD model for the lymphocytopenia induced by endogenous and exogenous corticosteroids.

OBJECTIVE: Lymphocytopenia is a sensitive surrogate marker for the immunological effects of corticosteroids. This pharmacokinetic/pharmacodynamic (PK/PD) study investigated whether the circadian variation of blood lymphocytes observed after placebo is secondary to the circadian rhythm of endogenous cortisol, and developed based on this relationship an improved PK/PD model for a more sensitive description of the effect of low-dose corticosteroid therapy on blood lymphocytes considering the net activity of the exogenous corticosteroid budesonide and endogenous cortisol. METHODS: In an open, parallel study design, 3 mg oral budesonide or placebo were given at 8.00 a.m., 4.00 p.m. and midnight to two groups of 12 volunteers. Lymphocyte counts and serum concentrations of budesonide and cortisol were monitored for 24 hours. A mechanism-based PK/PD model which considered the non-linear protein binding of cortisol and the budesonide-induced cortisol suppression was employed to relate changes in blood lymphocytes to free cortisol levels after placebo and to the net activity of free budesonide and free endogenous cortisol after active treatment. RESULTS: The circadian rhythm of blood lymphocytes observed after placebo could inversely be related to the circadian rhythm of serum cortisol. After budesonide administration, lymphocyte counts could accurately be linked to the net activity of budesonide and endogenous cortisol. The resulting EC50 values for the effect of budesonide on cortisol, budesonide on lymphocytes and cortisol on lymphocytes were 0.063 +/- 0.034, 0.22 +/- 0.13 and 26.3 +/- 15.0 ng/ml (placebo group 15.4 +/- 3.4 ng/ml), respectively. CONCLUSIONS: The presented mechanism-based PK/PD model suggests that blood lymphocytes are under physiological control of cortisol. It further indicates that endogenous and exogenous corticosteroids and their pharmacological interaction need to be considered for modeling the effects of low doses of exogenous corticosteroids on the immune system.

Anti-Inflammatory Agents↗

PubMed1996

[Classification of distal radius fractures and its diagnostic value].

In the conservative treatment of distal radial fractures the main problem is redislocation due to instability. We evaluated the three classification methods most often used to find out how well the different groups correspond to instability and severity of fractures-thus what their prognostic value is in the probable recovery time. Based on an analysis of 633 cases, we found that neither the most often used Frykman nor the AO and older classifications have any practical significance in this respect.

Adult↗

PubMed1994

[Prognostic evaluation of the classification of distal radius fractures].

Authors give historical review of different classifications in the cases of distal radial fractures. They give analysis on advantage and disadvantage of three different classifications, based on 633 cases, according to the practical applicability, to the expected outcome and to the way of treatment. According to the analysis the Older classification gives good prognosis, but the Frykman classification is without any practical importance. The AO classification is prognostically more or less satisfactory.

Colles' Fracture↗

PubMed1994

[Osteosynthesis using absorbable implants].

Authors report on one case of malleolar synthesis with the use of biodegradable implants. The advantages of the resorbing osteosynthesis materials and the possible complications are described.

Adult↗

PubMed1993

[Duplex ultrasound evaluation of Basedow struma treated with iodine therapy].

Over a period of 18 months the thyroid gland of 31 patients suffering from Grave's disease was examined by Duplex ultrasound for changes in blood perfusion. In 24 of these patients a follow-up study was achieved immediately after a presurgical iodine therapy. For estimation of the perfusion the "Pulsatile Flow Index (PFI)" was calculated. Compared to the normal group (22 volunteers, mean: 0.46 +/- 0.11) changes of 41 and 22% were highly significant for this pre (mean: 0.65 +/- 0.08, p < 10E-6) and post therapy (0.56 +/- 0.1, p < 5E-5). Therapy was unsuccessful in 3 cases on a single, in one case on both sides. Altogether PFI yielded semiquantitative information on blood perfusion of the gland as well as on the rate of success.

Adolescent↗

PubMed1993

[Structure of external fixators].

Authors described the development of the construction of fixateur externes supported by historical facts, analyse the biomechanical problems of the fixateur osteosyntheses, illustrated by drawings. They propose mountings, of modern montage proving its rightness. Finally a collection of synonyms is given to clear the nomenclature of the several montages.

External Fixators↗

PubMed1993

[DHS (Dynamic Hip Screw)-osteosynthesis in the management of femoral fractures in the hip region and the place of this method in the treatment of such injuries].

In the last four years we performed 182 osteosynthesizes with Dynamic Hip Screw, besides other methods on the fractures of the hip region. Here we are presenting the evaluation of our results, which, regarding the international scene, fall into the medium category. The operations were performed within three days after the injuries in 61 per cent of our patients. Our results are good in 80 per cent of our patients. The incidence of method-specific complications is 15 per cent in our statistics/such as wound haematomas, local infections, cut out of the device of the femoral head, metal failures, the fracture of the femur at the site of the introduction of the device). The rate of complications is 30 per cent in case of Ender nailing. More than a 1 cm shortening in the fracture after weight bearing was observed in the 47 per cent of our DHS cases. Patients who are complaining of pain during weight bearing belong to this group. In accordance with other authors, we consider the DHS osteosynthesis, due to its high stability, the best technique in case of unstable pertochanteric fractures of elderly patients. We recommend the angular plate fixation to the pertrochanteric fractures in young patients, in whose case it requires a more accurate reposition and who are able to walk without weight bearing. We can achieve good results with Ender nails in case of stable pertrochanteric fractures of elderly patients.

Adult↗

PubMed1992

[New information about the biomechanics of fracture fixation].

The better knowledge of the biomechanics of bone tissue and fracture healing resulted in the development of the AO principles and its methods of treatment. I have demonstrated on the femora of rabbits that the consequence of progressive dynamization versus the current unchanging stability of fracture fixation was a more rapid healing. According to our knowledge the more elastic, dynamizating or dynamizable fixation of the fracture are the methods of future. The new biodegradive implantates make not only their removal superfluous but help the fracture healing, too.

Biomechanical Phenomena↗

PubMed1990

[Method of fracture fixation using external fixation devices].

An improvement of the results of treatment can be reached, beside respecting the indication of external fixateurs, with correct tactics of the treatment. Because of the disadvantages of the fixateur externe, we strive to restrict their use, to the time by all means necessary, and if possible to use other methods of fixation. This is motivated especially by the effect on fracture healing and the hindering of the movements and activity of the patient.

Biomechanical Phenomena↗

PubMed1987

[External fixation of the pelvis--indications, assembly and results].

Stabilisation of pelvic ring fractures by means of external fixation has been found to provide certain advantages over internal fixation. Good results can be achieved, provided that optimum forms and techniques of assembly are used. The authors' indications are reported together with their assembly techniques and forms. The clinical results reported are relating to ten patients, with a pelvic-arm fixator being used in three additional cases. The simple clamp fixator is recommended by the authors for cases of stable symphyseal rupture with a diastasis of more than 1.5 cm.

Acetabulum↗

PubMed1987

[Fixateur osteosyntheses of the femur].

Clip-type fixators are preferred for femur treatment because of the specific anatomic conditions. Good experience has been obtained from the Magdeburg fixator (an improved configuration of the Wagner fixator). Indication for fixator osteosynthesis on the femur does not differ from the generally valid principles. The approach was found to be suitable also for polytraumatised cases. Complications are controllable, and late results are satisfactory. The rate of osteitis amounted to 3.2 per cent. Problems were recorded from cases of infection, following plate-type osteosynthesis for multifragment fractures, which were even more severe when inspection and plate removal had been delayed. Methods have to be changed in all cases in which fractures have not healed within four to six months. Secondary osteosynthesis in such cases is usually combined with spongiosa reconstitution. A load-relieving fracture box may be sufficient for six months.

Femoral Fractures↗

PubMed1987