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Biomedical subjects

R Brückl

Publications and source records attributed to R Brückl.

At least 19 recordsLinked to original sources
PubMed2000

[Pretherapeutic diagnosis of fibrous dysplasia].

A safe differentiation of fibrodysplastic lesions from "real" bone tumours is of high importance because a fibrous dysplasia often requires no further therapy. While polyostotic involvement of fibrous dysplasia can be safely diagnosed before therapy, in monostotic disease differential diagnostic problems may occur. In the present investigation only in 6 of 14 mon- and biostotic lesions caused by fibrous dysplasia a correct diagnosis could be established by radiologic methods. However, in all cases of fibrous dysplasia malignancy could be excluded by radiology and the false diagnosis had no therapeutic consequences.

Adolescent↗
PubMed1987

Peripheral arterial occlusions: a 6-year experience with local low-dose thrombolytic therapy.

Early and long-term results of treatment with local low-dose thrombolysis in 554 patients with 564 peripheral arterial occlusions are reported. Of 92 embolic occlusions present for 2 months or more, 59 (64.1%) were recanalized with a cumulative patency of 89.5% after 5 years. Of 472 thrombotic occlusions present for up to 6 months and more, 254 (53.8%) were successfully treated with a cumulative patency of 58.8% after 5 years. The hospital mortality and amputation rate were 1.6% and 1.95%, respectively. The average age of the patients was 69.1 years and more than half of those treated had stage III or IV disease. A 6-year experience with local low-dose thrombolytic therapy has completely confirmed its efficacy and has led to improvements in technique, which are described. The doses of streptokinase and urokinase needed for a successful result have been substantially reduced and the duration of treatment shortened. The number of complications has also been reduced. Differential therapeutic considerations compared to vascular surgery are mentioned. The results should motivate a reconsideration of the diagnostic and therapeutic measures to be used in the treatment of peripheral arterial occlusions.

Adolescent↗
PubMed1986

[Rippstein and Müller roentgenologic determination of the actual femoral neck-shaft and antetorsion angle. 1: Correction of the conversion table and study of the effects of positioning errors].

The femoral neck-shaft angle (CCD) and the angle of torsion (AT) are angles in space; in commonly used radiographs the angles are not portrayed in their actual true size (rCCD, rAT) but in their projected size, which deviates somewhat (pCCD, pAT). The formulas required for the conversion are explained in detail and the previous conversion tables have been corrected. The effects of minor deviations (5 degrees, 10 degrees and 20 degrees, increased/decreased abduction or flexion, exterior/interior rotation) from the prescribed position of the patient have been calculated and are displayed in diagrams. It is evident that determination of the angles according to Rippstein and Müller can be influenced to a considerable extend by minor discrepancies (+/- 5 degrees -10 degrees) in the positioning of the patient. If there are high AT-angle values or positioning of the patient causes problems, and where determination of the angle would involve major therapeutic measurements, another procedure will have to be used that should be almost independent from discrepancies in the positioning of the patient.

Biometry↗
PubMed1986

[Roentgenologic determination of the actual femoral neck-shaft and antetorsion angle. 2: Alternatives to the Rippstein and Müller procedure].

The method developed by Rippstein and Müller allows mathematically exact determination of the femoral neck-shaft angle (CCD) and the angle of torsion (AT); at a deviation of 5 degrees--10 degrees from the prescribed position of the patient considerable errors (up to more than 15 degrees) can occur. For this reason two alternative methods are cited and described in detail: cinematographic determination of the CCD and AT angle according to Schwetlick and the combination of determination of the AT angle in exterior rotation according to Rogers and an anteroposterior roentgenogram of the pelvis and hips in interior rotation of the size of the AT angle. Both methods are also mathematically exact, but, in addition almost independent from minor deviations in the positioning of the patient. It is advisable to apply one of the cited methods in cases of high AT-angle values (much greater than 30 degrees), in cases where the placing of the patient is difficult and where the determination of the angles would require major therapeutic measurement.

Biometry↗
PubMed1984

Osteochondrosis dissecans of the knee. Results of operative treatment in juveniles.

This paper reports the results of 33 juvenile and 28 adult patients who were operated on for osteochondrosis dissecans of the knee. The average period of observation was 4.7 years. The results were compared according to age and stage of disease. The age of the patient at the time of operation doubtlessly has the greatest influence on prognosis. Juveniles operated on in stage II or III have a particularly good prognosis. From stage IV on it does not seem reasonable to try to preserve the dissecate. In the case of juveniles, metabolic or endocrinological diseases do not appear to be of any relevance, whereas mechanical factors like overstress during sports, hereditary ligament laxity, or deviations of the axis of whatever origin all seem to have some influence.

Adolescent↗
PubMed1981

[The "hip value" as a criterium for the operative treatment of CDH in juveniles (author's transl)].

Planimetric measuring was performed at the X-rays of the pelvis of 2027 mainly juvenile patients in order to determine the socalled "hip value". We were able to define a clear statistical difference between normal and pathological values. It was possible to use the hip value as a parameter for the displasia of the hip and with additional clinical data to give a prognosis about the development of pathological hips. In addition to this guide lines for corrective operative procedures could be established. Extreme displastic joints with a hip value of more than 30 need immediate operative treatment, severe displasia with a hip value above 20 should be treated operatively as soon as possible before the end of the growth period. In milder cases of hip displasia operative treatment can be delayed until the patient starts to feel pain in the affected hip.

Adolescent↗
PubMed1979

Unhooking of GSB total knee during dislocation of the patella.

This is a case report of a special and undoubtedly rare complication occurring in a hinge joint with a moving instant center such as the GSB total knee joint. The preoperative situation, the history of the incident and the operative report are being described as well as a radiological follow-up. The mechanism of unhooking of the tibial shaft from its junction with the femoral stem during dislocation of the patella is being reconstructed.

Aged↗
PubMed1979

[The growth of the juvenile hip joint. A planimetric study of x-ray films (author's transl)].

A total of 1.779 X-ray films of the pelvis done with the same technic in children and adolescents was divided into 8 different age groups between 5 and 20 years. Several planimetric parameters for the evaluation of pelvic growth were measured and statistically analysed. A growth quotient was found showing periods of limited intensive growth efforts of the human hip joint. Such growth periods were found in both sexes between 5 and 8 years, and again for girls between 9 and 12 years, for boys between 11 and 14 years. In pathologic hip joints the triradiate cartilage closes sooner. The development of the pelvic roof and the closure of the triradiate cartilage show a close relationship. By evaluating 802 normal hip joints, an acetabular form index useful for all age groups was found.

Adolescent↗
PubMed1979

[The inborn cervical block vertebra. Part I: morphology and localisation (author's transl)].

Reviewing the X-rays of 72 patients with 77 congenital block vertebrae of the spine a morphological classification of this deformity of the spine is given as well as a description of radiological signs. Four different basic types are found according to the degree of deformity. Definition and pathogenesis of the congenital block vertebra of the cervical spine are separated from acquired synostoses of vertebrae. The frequency of anatomical localisations is described as well as differences due to sex.

Cervical Vertebrae↗
PubMed1977

[Minimal internal fixation of fractures in elder children (author's transl)].

The fractures in elder children (9--17 years) need a special treatment. Regarding the exact reposition they have to be handled like the fractures of adults. Regarding localisation, morphology of the bone and the way of internal fixation they have to be treated like those of smaller children. The "Minimal-Osteosynthesis" primarily means adaptation, refixation and continuous retention. The procedure is less traumatizing, however the indication should be as strictly as in other cases. The minimal osteosynthesis is giving more respect to the growing bone. The material of internal fixation may be removed much earlier than in adults. Stability for early physical exercises is rarely necessary in children. Even different types of minimal internal fixation are possible. A number of cases are demonstrated.

Accidents, Home↗
PubMedDate not supplied

[Prevention of para-articular ossifications by radiotherapy after cementless total hip endoprosthesis implantation].

By means of a prospective study, concerning the postoperative rate of ossification after cementless total hip replacement, it was due to prove the efficacy of radiotherapy in preventing periarticular ossification. In 1992 arthroplasty was followed by radiotherapy of 50 hip joints as regular therapy. The radiation was performed with a focal dose of 8 Gy. Patients with bilateral cementless total hip replacement and radiotherapy only at one side were of special interest in this study. Within the 24th postoperative week in 28 (56%) of the radiated hip joins no periarticular ossifications were found. In 20 (40%) we found ossifications grade 1, in 1 case ossification grade II and in 1 further case ossification grade III following the classification of Arcq. By 8 patients with former cementless total hip replacement without postoperative radiotherapy, a significant reduction of the ossification rate was found in the contralateral hip joint treated by postoperative radiotherapy. The rate of ossification was reduced by 28%. In correlation to reduction of periarticular ossification the increase on the overall range of motion in the radiated hip joins was 10.9%. By none of the patients treated by radiotherapy we found a disturbed healing process, a deep infection or an early loosening of the endoprosthesis. Postoperative radiotherapy as regular therapy for prophylaxis of periarticular ossification after Cementless total hip replacement can subsequently be recommended.

Adult↗
PubMedDate not supplied

[Surgical treatment of the snapping hip].

Snapping hip (Coxa saltans) is the abrupt sliding of the iliotibial tract over the greater trochanter. In the case of pain, which cannot be alleviated by a conservative treatment, an operation is advised. The methods of operation applied up to this day showed--especially because of their high recidive-quotas--great disadvantages. In a detailed post-operational check-up over the past 20 years the new method of "diagonal notching" (27 cases) developed at the Orthopedic Hospital München-Harlaching was compared to the old method of fixing the tract according to M. Lange (24 cases). After "diagonal notching" the snapping occurred again seven times less than after fixing the tract. After "diagonal notching" only 4% of the patients had to be re-operated, however, after fixing the tract a re-operation was necessary on 38% of the patients. 91% of the patients were relieved from their pain almost completely after "diagonal notching", compared to only 50% after fixing the tract. Considering that the "diagonal notching" offers simple technics of operation and better results than other methods, the "diagonal notching" should be used as method of choice to eliminate a snapping hip.

Adolescent↗
PubMedDate not supplied

[Treatment of osteomyelitis with PVP-iodine solution using lavage-suction drainage].

PVP-iodine was applied in this pilot study as irrigation solution containing 0.2% active ingredient for irrigation-suction drainage. It was well tolerated. The degree of iodine absorption remained within a lower region encountered with commonly available iodine-containing medications. Increased iodine levels returned to normal ranges soon after termination of treatment. Changes in thyroxine values were without clinical symptoms. No hypothyreosis was encountered. In spite of this it is recommended to control thyroid function before, during and after irrigation treatment with PVP-I in patients with a possible disposition for iodine-induction of thyroid function. Pregnancy (after the third month) and the presence of autonomous adenomas of the thyroid are contraindications because of the iodine load encountered. Palpable evidence for a thyroid enlargement is also a contraindication, except when the patient had not responded with thyroidal side reactions after prior exposure to iodine-containing contrast agents. During the irrigation treatment with PVP-I wounds became free of microorganisms. Local irritations due to the application of PVP-I were rare. The patient acceptance was excellent or good.

Adult↗
PubMedDate not supplied

[A case of atypical juvenile osteonecrosis in the medial femoral condyle].

A case of a special spontaneous osteonecrosis of the medial femoral condyle in a juvenile patient is described according to its clinical and roentgenological findings. This type of osteonecrosis has not been described yet to our knowledge. Possible pathogenetic factors are discussed in accordance to the literature. The spontaneous healing without further treatment is of special interest to our opinion as far as this case is concerned.

Adolescent↗
PubMedDate not supplied

[Results of operative treatment of osteochondrosis dissecans of the knee joint in juveniles].

This paper reports about the check-up of 33 juvenile and 28 adult patients who were operated on because of osteochondrosis dissecans of the knee. The average period of observation was 4.7 years. According to the aspects of age and the stage of the disease the results were compared to each other. The age of the patient at the moment of operation has doubtless the greatest influence on the prognosis. Juveniles operated in stage 2 or 3 have a particularly good prognosis. From stage 4 on it does not seem reasonable to try to preserve the dissecate. In the case of juveniles metabolic or endocrinological diseases do not appear to be of any relevance whereas mechanical factors like overstress at sports, hereditary ligament laxity or deviations of axis of whatever origin seem to be of larger import.

Adolescent↗