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Biomedical subjects

P M Karpf

Publications and source records attributed to P M Karpf.

At least 19 recordsLinked to original sources

[Imaging of the Achilles tendon on the computed tomogram. Normal findings and pathological changes].

Ligaments and tendons, including the Achilles tendon, show the highest density among normal soft tissue structures in the body. Traumatic and degenerative changes of the Achilles tendon are often associated with marked thickening and reduction in density associated with increased opacity of the space in front of the Achilles tendon. These changes are easily demonstrated by CT, whereas conventional radiological techniques only show non-specific changes. Twenty-five patients were examined, including nine with pain, seven following rupture of the Achilles tendon and nine post-operative controls; it was found that CT can add information important for the diagnosis and treatment planning of abnormalities of the Achilles tendon.

Achilles Tendon

[Arthroplasty of the upper ankle joint. Possibilities and limitations].

It is out of the question that alloarthroplasty of the upper angle joint must today belong to the therapeutic repertoire of the orthopedic surgeon. The anatomical situation of the upper ankle joint brings considerable problems for the total replacement and then also for the surface replacement. At the time being models are already available, which, seen on the whole, have already brought quite reliable results. Requirement for the success of the operation is the technically perfect insertion of the surface replacement or of the total joint and furthermore the insertion of the replacement under appropriate conditions, whereby the operation in an aseptive room ("Reinraum") has proven itself effective also on the upper ankle joint.

Air Pollution

[Juvenile hip pain. 2. Femur head epiphysiolysis, hip dysplasia, tumors].

The early symptom in hip joint diseases in children is pain. Pain is localized in the groin and thight, but mostly in the knee. Other important signs are limping and reduced internal rotation. If a hip disease is suspected it is necessary to take X-rays in two planes. If diagnosis is early and special therapy started immediately, the results are usually excellent without deformation of the hip. Otherwise early osteoarthritis can develop. This is important because osteoarthritis in the hip joint is in 75% of the cases due to hip joint diseases in childhood. The problems of diagnosis and treatment of the most common hip joint diseases in children (transient synovitis, rheumatoid arthritis, osteomyelitis, Legg-Perthes disease, slipped capital femoral epiphysis, dysplasia, tumors) are discussed.

Adolescent

[Prognosis of idiopathic scoliosis].

The prognosis of the scoliosis is determined by early and exact treatment, which depends on the degree of curvature, age, localization and expected of deviation. Scoliosis up to 30 degrees is treated by physical therapy. Between 30-50 degrees an active treatment with the Milwaukee-brace is recommended. Over 50 degrees surgery is required, because further progression is to be expected. The Harrington procedure should now be used in all centers of scoliosis. Paraplegia is seen in 0,5%. Minor complications and better correction can be expected by surgery carried out in special centers.

Braces

[Reticulum cell sarcoma of the pelvis. Diagnostic and therapeutic problems].

Diagnostic and operative problems of malignant bone tumors of the pelvis are discussed. Especially mentioned is resection therapy of pelvis tumor including large parts of the pelvis and the hip joint. A case-report is given. In this case replacement of the entire hip joint was successfully performed with a special prosthesis. Stabile fixation of the prosthesis is one of the major problems to be dealth with. Follow-up examination of our patient one year after the operation showed no loosening of the prosthesis and free movement of the hip joint iwth partial loack capacity of the leg.

Angiography

[Neurofibroma and neurofibrosarcoma in Recklinghausen's neurofibromatosis].

The neurofibromatosis von Recklinghausen is a systemic disease, which can cause various different changes in the body. The case report of a female patient shows all the typical signs of neurofibromatosis von Recklinghausen. These signs are café-au-lait spots, congenital tibia pseudarthrosis, abdominal plexiform neurofibromatosis and peripherical neurofibromas with sarcomatous degeneration.

Adult

[Current concepts in the diagnosis of knee injuries].

The exact diagnosis of affections of the knee is most important, especially of the capsulo-ligamentous lesions. To-day more and more younger patients are suffering from knee-instability. The modern possibilities of operative reconstruction lead to excellent results if the operation is performed at an optimal date. During the last years progress also was achieved concerning the knowledge of the mechanics and the pathophysiology of the knee. New methods of clinical investigation and new clinical findings were possible. Specific tests for the diagnosis of instability of the anterior cruciate ligament have to be emphasized. These tests are specially important if there is only an insufficiency of the anterior cruciate ligament which cannot be proven by the other clinical findings. X-ray examination is necessary to search for a fracture or an avulsion of the bone. In all other problems the exact clinical examination leads to the diagnosis.

Humans

[Problems of surgical management of old knee joint injuries].

The problems in reconstructive surgery of old ligamentous injuries arise with the claim for restoration of normal function and anatomy. Based on new findings they are achieved by passive stabilization of the injured ligamentous structures as well as by their active reinforcement by the hamstring muscles. Surgical procedures may be traced back to a sort of integrated system; according to our own experiences these can be performed in any combination when reconstructing rotatory instabilities. Procedures eliminating one plain instability should only be applied with special indication.

Humans

[Periarticular ossification following severe brain injury].

A particular ossification should be considered besides primary neurological causes, if there are functional restrictions of the joint movements after severe head trauma. New bone formation has been seen extending from the periarticular tissue. The problems of the new bone formation in both hip-joints are shown in a patient with traumatic apallic syndrome. After exact indication and with careful and atraumatic operative technique functional restitution of the joints can be achieved without danger of recurrence.

Adult

[Injuries of the capsular ligament of the ankle joint, so-called "ankle joint distorsion"].

The capsular and ligamentous lesion of the ankle is the most frequent injury and very common in sports. Still these injuries are frequently minimized and not treated properly. Late results are instability, subluxation and finally posttraumatic osteoarthritis. Anterio-lateral instability indicates lateral capsular-ligamentous lesions. Antero-lateral instability can be proved chinically by the anterior drawer-test and radiologically by a standardized stress x-ray in lateral position. The fresh lesion has to be treated by primary ligamentous suture or by plaster cast for 6 weeks. The treatment of chronic instability is secondary reconstruction. Severe osteoarthritis can be treated by an ankle replacement (endoprosthesis) or by arthrodesis.

Ankle Injuries