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P Matter

Publications and source records attributed to P Matter.

At least 19 recordsLinked to original sources
PubMed2000

[Treatment methods and outcomes of tibial shaft fractures in Switzerland. A prospective multicenter study of the Swiss AO].

Fractures of the tibial shaft are very common and often associated with severe tissue damage. The aim of this study was to investigate the methods of treatment, the results and complications of tibial shaft fractures in Switzerland. In a prospective planned study the Swiss Association for the Study of Internal Fixation (AO) analyzed 585 tibial shaft fractures that were treated in 41 hospitals between 1st of July, 1994 and 30th of June, 1995. The cases were documented in the specific AO-documentation-forms, 78.3% (n = 458) of the cases received an effective follow-up. The most common type of accident were sports accidents with 41.5% (n = 243), followed by traffic accidents in 35.6% (n = 208). Conservative treatment was applied in 9.4% (n = 55). The most frequent used implant was the plate in 43.8% (n = 256), followed by the nail in 36.8% (n = 215) and by an external fixator in 9.5% (n = 56). In the group of patients treated with a nail 116 received an AO-Universal nail, 94 were treated with the solid tibial nail (UTN). 92.4% (n = 423) of the fractures healed with radiological alignment. 11.6% (n = 53) had a delayed or non-union. In this group 37.7% (n = 20) of patients sustained severe soft tissue damage, due to high-energy-trauma in 60% (n = 12). Of the patients with delayed or non-union one was treated primarily conservative, eight were treated with a plate, 24 with a nail and 20 with an external fixator primarily. The indications for fracture treatment with a plate or a nail was nearly the same in different fracture types. In summary, in Switzerland most tibial shaft fractures were treated with a plate or a nail with an equally good outcome.

Adolescent↗
PubMed1998

History of the AO and its global effect on operative fracture treatment.

In 1958 a group of Swiss general and orthopaedic surgeons established the AO (Arbeitsgemeinschaft für Osteosynthesefragen) or the Association of the Study of Internal Fixation (ASIF) to strive to transform the contemporary treatment of fractures in Switzerland. This association was revolutionary in development of instruments and implants for operative fracture treatment. The first instructional course for teaching the use of these instruments and implants occurred in Davos, Switzerland, in the newly founded Laboratory of Experimental Surgery in 1960. Through a process of internal quality control (AO documentation) the clinical success of these new techniques and implants became evident. Operative fracture treatment gained acceptance throughout Europe and finally worldwide. AO/International (AOI) was founded in 1972 to expand education and the teaching programs for surgeons and operating personnel on an international basis. In 1984, the AO/ASIF Foundation was created with an AO Board of Trustees comprising 90 leading trauma surgeons from throughout the world. Continuous research, implant and instrument development, clinical documentation, and multifaceted educational opportunities are coordinated by the AO/ASIF Foundation to maintain its position as the international authority in the treatment of trauma. The medical community recognizes today the enormous positive global effect that this respected and ever changing organization has had by continually improving operative fracture treatment.

Fellowships and Scholarships↗
PubMed1998

[Surgical treatment of proximal humerus fractures--international multicenter study].

To receive an overview of the presently used methods for the operative treatment of fractures of the proximal humerus a prospective controlled multicenter study was arranged. 146 fractures from 145 patients (76 females, 69 men) were assessed, documented with the AO standard sheets and radiographs and with a one year follow-up examination. Each of the nine clinics used his own treatment scheme. They applied: K-wires (27%) for adaptation and for intramedullary fixation; tension band wires (16%) or sutures (11%) alone or in combination with K-wires; osteosynthesis with screws alone (7%) or with plates (22%). In 17% the humeral-head was acutely replaced with a prosthesis. 11 fractures (8%) had to be reoperated because of instability or loss of fixation. 109 patients were available for clinical review, one patient could be questioned by letter and six patients had died after one year (follow-up 80%). In 38% of patients full limb function was restored, slight impairment persisted in 45% and 17% remained severely handicapped. 96 fractures (89%) were consolidated, 30% with a deformity. 35% of patients still were unable to work full time. The treatment of fractures of the proximal humerus is generally difficult. More over the various operative methods and problematic fracture classification make a differentiate statistical analysis impossible. Still many questions remain. For answers a new trial is mandatory. For this future series fixed guidelines for indications and operative treatment modalities are required to allow a meaningful comparison of results and a scoring system for evaluation of functional outcome is necessary.

Adult↗
PubMed1997

[Fixation of femoral shaft fractures from a Swiss viewpoint. An international prospective controlled study by the Study Group for Osteosynthesis Problems].

A prospective, controlled study of fixation for femoral shaft fractures was undertaken by the Documentation Centre of the Association for the Study of Internal Fixation (AO/ASIF) at 7 Swiss and 5 foreign clinics in Europe, South America and Asia. 283 fractures in 272 patients were evaluated. 17% of all patients suffered a polytrauma. Only two fractures (1%) were treated conservatively. Ten percent of all fractures were stabilised by external fixation, 35% were plated and 54% were treated by reamed intramedullary nailing. An ARDS and deep venous thrombosis occurred in 1% respectively. The local infection rate was 2%. Seven patients (2.5%) died perioperatively. 32 fractures (12%) were reoperated. At follow-up 86% of all fractures appeared consolidated on radiography. Full limb function was restored in 61% of all patients, slight impairment persisted in 32% and 6% of all patients remained severely handicapped. The average age of the female patients was significantly higher in Europe. Wide differences existed in the administration of prophylactic antibiotics and antithrombotic drugs. In some centers antithrombotic drugs were not part of the treatment scheme. Femoral shaft fractures were treated with high priority in Switzerland. Patients profited from short transport ways and from the routine use of high end material. Most operations in Switzerland were performed by registrars. Their assessment of stability of the fixation was high, as 90% of all patients were allowed to bear weight postoperatively. There is an international consensus on the need for surgical stabilisation of femoral shaft fractures. However divergent views on surgical management and perioperative care remain.

Adult↗
PubMed1996

[Feedback-controlled weight bearing following osteosynthesis of the lower extremity].

Truly partial weight bearing by usual mode of mobilisation after an operation of the lower limb is not a realistic goal. Frequent and massive overloading could recently be shown in a series of patients with joint replacements. Significant improvements in the loading pattern could be demonstrated with the use of an acoustic feedback system. Our goal was to test the clinical application of this method by using a similar system in the form of an insole-installed device. In the same trial, data on the real weight bearing pattern with prescribed loading after osteosyntheses was to be collected with and without the feedback device. We measured weight bearing continuously in two groups of patients. The first group was mobilised in the usual manner whereas the second group was acoustically alerted to overloading when passing the limit of 15 kg by a sensor device in the insole. Our results showed that 40.8% of steps made by patients mobilised in the usual manner were massively overloaded whereas 12.7% of steps in the second feedback-group produced even minor overloading. Apart from certain technical difficulties, the method was well accepted by the patients. The usual method of progressive weight bearing is unreliable. The value of partial weight bearing after internal fixation of the lower limb remains to be evaluated. In cases in which partial weight bearing is recommended, more attention should be paid to observing the prescribed limits and a reliable system that alerts the patient of excessive weight bearing would be most useful. For routine use in clinics a technically more reliable PMT Feedback System has to be developed.

Acoustic Stimulation↗
PubMed1995

[35 years fracture documentation by the Working Group for Osteosynthesis Problems (AO)].

35 years of AO-Documentation has clearly demonstrated the possibilities and the effectiveness of fracture documentation. The fracture classification, x-ray documentation and recommended evaluation scores are essential prerequisites for trend analysis and comparison of results. AO offers today the methodology for a decentralized data collection and scientifically planned clinical trials.

Data Collection↗
PubMed1994

Documentation.

In the period from 1. January to 31. December 1992, the new pinless external fixator was applied in eight European and North American clinics as part of a prospective multicentric study run by the AO/ASIF Documentation Centre. The aim of this study was to determine the indications, handling, and clinical results with the new fixator. The new pinless fixator was used 77 times on a total of 75 patients. The main indications were fresh tibial shaft fractures for which immediate definitive treatment was impossible. The majority of cases were secondarily stabilized with an unreamed tibial nail once the local and/or general condition of the patient had improved. In the remaining cases the pinless fixator was used for calcaneal and tibial head traction, segment transport and temporary stabilization in cases of tibial infection. Only after long-term application of the fixator was local infection at the pin site observed. There were no other complications. The new pinless fixator is a valuable addition in the treatment of fresh tibial fractures, in particular, in those cases which cannot be primarily treated due to contributing factors whether local or general.

Adult↗
PubMed1994

Arthroscopically assisted treatment of lateral tibial plateau fractures in skiers: use of a cannulated reduction system.

A prospective study was performed on 16 patients with lateral tibial plateau fractures. All injuries were associated with alpine or cross-country skiing. Included in the study were those patients with an articular surface depression of > or = 2 mm with radiographic findings consistent with the AO/ASIF classification of tibial plateau fractures (41 B2.2/B3.1). A combined procedure was performed with arthroscopic visualization of the knee joint and utilization of a cannulated plateau elevator. All fractures were reduced with this device with subsequent autogenous bone graft and, when indicated, transverse cancellous lag screw fixation. Follow-up was 1-6.5 years for the 16 patients, with all but two reporting resumption of activity to preinjury levels.

Adult↗
PubMed1994

Pinless calcaneus traction: a preliminary report.

Calcaneus traction with a Steinmann-pin or K-wire inserted into the dorsal aspect of the calcaneus is a common temporary procedure in fractures of the lower leg when internal fixation has to be delayed. Infection due to this simple manoeuvre is rare, but is a very serious complication. In 1991, a so-called pinless external fixator was introduced in clinical trials, based on the idea of external fixation without transosseus pins, thus preserving local blood supply and lowering the risk of pin track infection. This pinless clamp also represents a handy tool for calcaneus traction. We have used this pinless clamp for calcaneus traction in 39 patients without any major problems or complications. Of these, 29 patients were scheduled for delayed internal fixation, and in 10 patients this clamp was used intraoperatively in closed tibial nailing for traction on the fracture table. Tips and tricks for the use of this pinless clamp, and its advantages and disadvantages are discussed.

Adolescent↗
PubMed1994

[Clinical results with the limited contact DCP plate of titanium--a prospective study of 504 cases].

From the beginning of 1988 to July 1991, ten Swiss and German clinics undertook to document all cases of internal fixation using the titanium LC-DCP as part of a prospective multicenter study. The follow-up period was 14.2 months on average. The clinical results of 504 fixations were convincing. The follow-up rate was 72%. Of these, 95% healed without complication. The most frequent complication was delayed healing which occurred in 2.5% of cases. The infection rate was low (1.1%). A separate comparison of DCP fixations on the tibial shaft in 1984-1988 demonstrated the obvious biological compatibility of the new plate and shows that excellent results can be obtained using plate fixation.

Adult↗
PubMed1994

[Epidemiology of internal knee injuries in Alpine skiing].

The incidence of sport injuries in Switzerland is twice as high compared to traffic injuries. Soccer and alpine skiing play the most important role in sport injuries. For the last twenty winter seasons all winter sport injuries were analysed at the hospital of Davos. About 85% are injuries caused by alpine skiing resulting in a total of 24,684 for the last twenty years. There is a great decline in the incidence of lower leg fractures with a contrary development of knee injuries. The treatment-quotient (amount of knee injuries in alpine skiers per 10(4) kilometers of vertical drop skied) has increased over the last seasons. Nowadays one part of four skiing injuries is an injury of the knee ligaments. In skiing areas favored by beginners, we have observed an incidence of knee ligament injuries three times as high compared to other areas. Since 1986 we have evaluated 206 patients operated for knee ligament injuries, 44% with unidirectional and 56% with multidirectional instabilities. We report about the preoperative data.

Adolescent↗
PubMed1994

[Skier's thumb injury in the child].

Acute rupture of the ulnar collateral ligament (UCL) of the metacarpophalangeal joint of the thumb (skier's thumb) is a common skiing injury in adults. Do we find this injury in children? Of the 302 skier's thumbs during the last 4 years we found 24 (8%) injuries in children (mean age 13.4 years) with open growth plates. They had the following diagnosis and consecutive treatment: 5 partial ruptures of the UCL, 3 Salter I and 6 Salter II fractures with radial fragment of the proximal phalanx I; all these had conservative treatment. In addition one had a Salter III fracture with open reduction and fixation, 6 avulsion fractures, which were treated twice operatively and 4x conservatively and 3 ruptures of the ligament which needed reconstruction. Supposing the trauma mechanism in adults, we see a different, age-dependent injury pattern in children. The younger had Salter-I- and Salter-II-lesions of the proximal phalanx, where as the adolescents showed avulsion fractures and ruptures of the UCL as seen in adults. The follow-up of 17 cases minimally 1 year after the accident showed in 12 a full recovery, in 4 cases small subjective symptoms but full function and in 1 case an ankylosis of the MCP-joint following a postoperative infection.

Adolescent↗
PubMed1994

[Ruptured cystadenoma of the pancreas].

There are many potential reasons for an acute abdomen. Very rare is a rupture of a cystadenoma of the pancreas. We describe such a case of an 85-year old woman, who was treated with an internal drainage of the cyst with a Roux-Y-loop, as at the time of the emergency operation the histological diagnosis was not known. As for the age of the patient and her general condition a secondary procedure with total resection of the mucinous cyst was not carried out. The post-operative course was uneventful up to three months, when the patient died in a geriatric home due to a antibiotic-resistant urosepsis. Literature is reviewed and our case is discussed in respect to recent publications.

Abdomen, Acute↗
PubMed1993

[Preoperative arthroscopy in fresh complicated internal knee lesions].

In a prospective study, 197 preoperative arthroscopies were carried out on 194 patients with fresh severe internal lesions of the knee. The injuries are analyzed, with reference in particular to diagnosis and treatment of additional meniscus lesions. Advantages and disadvantages of the procedure are discussed.

Adolescent↗
PubMed1993

[Arthroscopically guided osteosynthesis of lateral tibial plateau fractures].

A prospective study was performed on 16 patients with lateral tibial plateau fractures. All injuries were associated with alpine or cross country skiing. Included in the study were those patients with a 2 mm or greater articular surface depression with radiographic findings consistent with the AO/ASIF classification of tibial plateau fractures, 41 B2.2./B3.1. A combined procedure was performed with arthroscopic visualization of the knee joint and utilization of a cannulated plateau elevator. All fractures were reduced with this device with subsequent autogenous bonegraft and when indicated, transverse cancellous lag screw fixation. Followup was from 1 to 6.5 years for the 15 patients with all but two reporting resumption of activity to pre-injury levels.

Adult↗
PubMed1993

[Epidemiology of winter sport injuries].

The region Davos/Klosters is a big wintersport area in Switzerland, where more than 5 million kilometers of vertical drop are skied per year. Over the last 20 years 28,777 patients with wintersport accidents have been treated in the 100-bed hospital of Davos, 85% of these patients have sustained their accident while skiing. An analysis of these datas show an increase of ski accidents as well as an increase of the distance skied. Especially an increase in snowboard accidents is noted over the last few years with a preponderance of lesions of the upper extremity. Injuries of the head, the trunk and simple skin lacerations remain stable over that period. Injuries of the upper extremity are increasing, whereas lower extremity lesions are slightly decreasing. There is a significant decrease of fractures of the leg, while at the same time an important increase of knee injuries is noted. Young patients below 20 years and those between 31 and 40 years of age sustained less accidents over the last 20 years, while the rest of the alpine skiers remain more or less stable in their accident incidence.

Adolescent↗