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Biomedical subjects

R Berbig

Publications and source records attributed to R Berbig.

14 recordsLinked to original sources
PubMed2000

[Timing of the surgery of rupture of the anterior cruciate ligament. Effects of acute or delayed surgery on arthrofibrosis rate and work disability].

The optimal time to perform acute ACL reconstruction with respect to arthrofibrosis is discussed. Most authors prefer delayed surgery. The definition of the term "acute" varies between 48 hours and 4 weeks. In this study the limit was set at 60 hours. Acute ACL reconstruction was performed in 39 patients and delayed surgery in 35 patients after they had regained full ROM. The incidence of arthrofibrosis was not higher in the acutely operated group whereas overall inability to work was 44% lower in this population. When the indication is clear, we think that acute ACL reconstruction may be performed within 60 hours without a higher risk of postoperative development of arthrofibrosis. Nowadays, this strategy should also be considered for economic reasons.

Adolescent↗
PubMed1999

[Arthroscopic repair of the medial retinaculum after first time dislocation of the patella].

Between March 1994 and December 1997, an arthroscopic repair of the medial retinaculum after first time dislocation of the patella was performed 38 times in 34 patients. The operative technique is being described as well as the results after an average follow-up of 25 months in 31 cases. In the group with radiologically determined predisposing factors (n = 20) as many osteochondral flakes were found as in the group without these factors, but there were significantly less chondral lesions on the lateral femoral condyle and the medial patellar facet. There were no complications during hospitalization, although in 3 (10%) cases a redislocation occurred during follow-up. According to the subjective Turba Score, 84% of the patients showed a good or very good, and 16% a fair result, including cases with redislocation. The arthroscopic repair of the medial retinaculum after first time patellar dislocation is a minimal invasive method with very low peri- and postoperative morbidity. The redislocation rate can be reduced to at least 50% compared to the published data on conservative treatment.

Adolescent↗
PubMed1998

Modified Elmslie-Trillat procedure for instability of the patella.

The purpose of this study was to determine whether or not the modified medial transfer of the ligamentum patellae in case of objective instability of the patella is an adequate therapy and if it is possible to improve the patellar congruence angle by this method. Between October 1987 and April 1993, 41 operations were performed in 37 patients with medialization of the medial third of the ligamentum patellae with the corresponding part of the tibial tubercule. Four patients needed a bilateral operation; the two interventions were not performed at the same time. Thirty-six operated knees (88%) were examined at a median clinical and radiological follow-up of 62.8 months (+/- 15.8 SD). For evaluation, the objective and subjective Turba score was used, and pre- and postoperative X-rays were compared. The patients' average age at the time of intervention was 23.2 years (+/- 7 years SD). The operation was performed 39 times for recurrent dislocation or subluxation, for patella alta with cartilage tissue damage, and for first time traumatic dislocation. The only postoperative complication was a temporary peroneal paresis. There were no redislocations seen at the follow-up. One patient with repeated subluxations underwent an additional lateral release combined with a repair of the medial retinaculum. In all other cases, the Turba score showed good or excellent results (subjective 1.9; objective 0.8), the patellar congruence angle was significantly improved (P < 0.001), and there were no medial subluxations. We conclude that the transfer of the medial third of the ligamentum patellae for objective instability of the patella is a minimally invasive and adequate technique to improve significantly a pathological patellar congruence angle.

Adolescent↗
PubMed1998

[Long-term peridural anesthesia and minimally invasive therapy of arthrofibrosis of the knee joint].

We report on our experiences with continuous epidural anesthesia after arthrolysis of the knee joint. The restoration of knee motion is the main goal of our treatment regimen which includes daily passive full mobilisation of the knee joint with a continuous epidural catheter after arthroscopic lysis and a functional after treatment with full weight bearing. From December 1992 to November 1996 32 arthroscopic lysis have been performed at the Surgical Department of Triemli Hospital in Zürich, Switzerland. The indications for prior knee surgery included 22 ACL reconstructions, 4 sustained fractures about the knee and 6 miscellaneous etiologies. Arthroscopic lysis was performed for any failure in improving knee motion despite intensive physical therapy. According to Gassen et al. [4] we found one (3.1%) very severe, 5 (15.6%) severe, 12 (37.5%) moderate and 14 (43.8%) minor cases of arthrofibrosis. After 8 months on average, a second lysis had to be performed in six cases. All had an ACL reconstruction as prior surgery, in four out of these six patients only physiotherapeutic after treatment was performed after the first lysis, 2 patients developed a symptomatic patella baja. At the end of the treatment after 10 months on average, 16 (50%) cases showed a very good, 7 (22%) a good, 5 (16%) a satisfactory and 4 (12%) a poor result concerning range of motion. We think that a daily passive full mobilisation under regional anesthesia with a continuous epidural catheter is the key to hold the intraoperatively reached range of motion especially for moderate to very severe cases of arthrofibrosis.

Adult↗
PubMed1997

[Ultrasound findings after shoulder dislocation].

AIM: Sonography of the shoulder is an effective method for detecting tears of the rotator cuff and bone lesions. The purpose of this study was to evaluate prospectively the sonographic findings after shoulder dislocation. METHODS: Sonography was performed on 208 patients with 210 shoulder dislocations, which were all verified by radiography. RESULTS: We diagnosed 62 rotator cuff lesions (29.5%), which were all in the group with traumatic shoulder dislocation. The incidence of tears in patients with first traumatic dislocation (n = 134) was 36.5%. 12 tears (21.8%) of the rotator cuff were noted in recurrent dislocations (n = 55). 23 fractures or bony avulsions of the greater tuberosity of the humerus (11%) and 168 Hill-Sachs lesions (80%) were seen. CONCLUSION: Sonographic examination of the shoulder revealed a significant amount of information that would remain undetected without the aid of expensive and/or invasive diagnostic tools.

Adolescent↗
PubMed1994

[Isolated fracture of the lesser tuberosity of the humerus: case reports and review of the literature].

Only 17 cases of isolated avulsion fracture of the lesser tuberosity have been reported in the literature since Hartigan's report in 1895. Whereas in children, conservative treatment is almost successful, in adults operative restoration is the method of choice in order to obtain full painless range of motion with normal strength of muscle control. Surgical excision of the fragment of lesser tuberosity after failed conservative treatment may relieve the patient's symptoms. Three own cases and a review of the literature are discussed.

Adult↗
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

[Preoperative ERCP and laparoscopic cholecystectomy for treatment of choledocholithiasis].

Out of 110 patients suffering from gallstone-related symptoms, 21 underwent ERCP prior to laparoscopic cholecystectomy. Indications for this combined treatment were laboratory signs of cholestasis (36%), pancreatitis (29%), pathological IVC (18%), sonographic evidence for bile duct dilatation (10%) and cholangitis (7%). Local and general complications were not increased neither intraoperatively nor postoperatively. Median duration of postoperative hospital stay was four days for ERCP-treated patients as compared to three days for patients subjected to laparoscopic cholecystectomy only. In summary treatment of choledocholithiasis by a combination of preoperative ERCP and laparoscopic cholecystectomy offers the following advantages: high patient comfort, low incidence of complications and short hospitalization compares favourably with conventional common bile duct exploration.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1993

[Preoperative arthroscopy in fresh complex internal knee injuries].

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

Adolescent↗
PubMed1992

[The gallbladder with severe pathologic changes: a contraindication for laparoscopic cholecystectomy?].

In the beginnings of laparoscopic cholecystectomy a severe pathological alteration of the gallbladder or stones of the common bile duct were regarded as relative contraindications to the method. However increasing experience and improve technic have shown, that even a severe pathology of the gallbladder such as chronic cholecystitis with wall thickening, acute or subacute inflammation or a porcelaine gallbladder can be laparoscopically managed. Operation time in such cases is longer, but median hospital stay is the same as in uncomplicated cases. However postoperative morbidity may be increased. For patients with CBD stones preoperative ERCP with papillotomy followed by laparoscopic cholecystectomy some days later offers a treatment with low morbidity and optimal comfort for the patient.

Adult↗
PubMed1989

[Retroperitoneal liposarcoma. Clinical aspects, diagnosis, therapy and prognosis].

Retroperitoneal liposarcoma is a very rare tumor. There are about 250 cases in the world literature. This article discusses our four cases and the literature concerning this rare disease. The emphasis will be on the epidemiology, pathology, clinical presentation, diagnostic evaluation, therapeutic approach, and ultimate prognosis.

Aged↗
PubMedDate not supplied

Primary anterior shoulder dislocation and rotator cuff tears.

In a prospective controlled study 167 patients with 167 primary traumatic anterior shoulder dislocations underwent early ultrasonograpic evaluation for rotator cuff tears. We found 53 (31.7%) full-thickness cuff tears in this group. Compared with a group of 93 healthy volunteers, we found with statistical significance more cuff tears in the patients aged < 60 years. Women ruptured the cuff more often than men. If the patient is not able to elevate the affected arm more than 90 degrees in the scapular plane 2 weeks after the dislocation, there should be a high suspicion of rotator cuff tear (76.7%). For early detection of relevant rotator cuff lesions, we recommend shoulder ultrasonographic examination and measurement of active elevation after each traumatic shoulder dislocation in the above mentioned age group.

Adolescent↗