Biomedical subjects

R E Hilgert

Publications and source records attributed to R E Hilgert.

7 recordsLinked to original sources

PubMed2006

Value of fat-suppressed proton-density-weighted turbo spin-echo sequences in detecting meniscal lesions: comparison with arthroscopy.

PURPOSE: To evaluate fat-suppressed (FS) proton-density-weighted (PDw) turbo spin-echo (TSE) magnetic resonance imaging (MRI) compared to arthroscopy in the detection of meniscal lesions. MATERIAL AND METHODS: In a prospective study, 31 knee joints were imaged on a 1.5T MR scanner before arthroscopy using the following sequences: (a) coronal and sagittal FS-PDw TSE (TR/TE: 4009/15 ms); (b) coronal T1w SE (TR/TE: 722/20 ms), and sagittal PDw TSE (TR/TE: 3800/15 ms). Other imaging parameters were: slice thickness 3 mm, FOV 160 mm, matrix 256 x 256. A total of 186 meniscal regions (62 menisci; anterior horn, body, posterior horn) were evaluated. Standard of reference was arthroscopy. Sensitivity, specificity, negative predictive value (npv), positive predictive value (ppv), and accuracy were calculated. RESULTS: Arthroscopically, meniscal lesions were detected in 55/186 segments (35 medial and 20 lateral meniscal lesions). Sensitivity, specificity, npv, ppv, and accuracy for combination of coronal and sagittal FS PDw TSE were 91.4%, 98.3%, 95%, 97%, and 93.5% for the medial meniscus, and 90%, 98.6%, 97.3%, 94.7%, and 96.8% for the lateral. The results were comparable to the combination of coronal T1w SE and sagittal PDw TSE for the medial (88.6%, 98.3%, 93.4%, 96.9%, 91.4%) and the lateral (90%, 95.9%, 97.2%, 85.7%, 92.5%) meniscus. CONCLUSION: FS PDw TSE-MR sequences are an excellent alternative for the detection of meniscal lesions in comparison with diagnostic arthroscopy.

Adolescent↗

PubMed2005

[Technique for percutaneous iliosacral screw insertion with conventional C-arm radiography].

BACKGROUND: During percutaneous iliosacral screw fixation, fluoroscopy with a conventional C-arm X-ray unit is still the standard procedure for intraoperative orientation. Lateral sacral images in combination with the inlet and outlet view are always necessary. Nevertheless, the complex pelvic anatomy makes it difficult to prevent malpositioning of screws. OPERATIVE TECHNIQUE: Defining the correct entry into the bone is the decisive step for ideal screw placement. The better this is defined, the larger safety margins will be concerning cortical perforation by the screws. In the lateral view, an entry ventral to the sacral canal has to be avoided as well as an entry into the cranial half of the first sacral vertebra. To improve the surgeon's three-dimensional orientation with the help of his personal experience and two-dimensional images, it is recommended to place the tip of the screws in the center of the sacrum (in AP view) whenever possible. Routinely performed postoperative CT imaging of 24 screws, consecutively implanted according to the standards described, revealed no case of malpositioning. CONCLUSION: Standard X-ray views in combination with standardized aiming of screw entry position and final screw thread position enable the surgeon to find the "safe zone" for iliosacral screw insertion and to prevent iliosacral screw malpositioning with high accuracy.

Bone Screws↗

PubMed2004

[Injury pattern caused by aggressive inline skating].

In order to evaluate the special injury pattern of aggressive inline skating, a field study was conducted in a local, non-commercial skate park equipped with all the typical features like ramps, halfpipes, gully areas. 66 unselected aggressive inline skaters were randomly enrolled and interviewed concerning their skating habits and their skating injury history. Average age was 15 (10 to 41) years, skating was performed since 2.1 (0.1 to 6) years, as aggressive skating since 1.3 (0.1 to 4) years. Medical treatment in a doctor's practice or in a hospital had been necessary in 66 cases, averaging 1.4 times per skater and year, averaging one injury per 586 hours of aggressive skating. The injury pattern reflected the regions typically injured in fitness skating, too, with a higher percentage of injuries concerning knee, tibia and ankle region. The use of protective devices varied from 41 % (wrist guards) to 94 % (knee pads), with an average of 69 %. Only 32 % of skaters wore all protective devices. As the personal thrill is an important motivation for aggressive skating, safer skating campaigns are quite unlikely to decrease the risk of injury in aggressive skaters.

Adolescent↗

PubMed2002

[Minimal invasive treatment of massively dislocated radial neck fractures in children by percutaneous joystick reposition and Prevot nailing].

Undisplaced fractures of the proximal radius can generally be treated conservatively with good results. In children, spontaneous correction of some angular deformities can be expected during growth. Nevertheless, more severely displaced fracture types may require reduction in children, too. Open reduction and internal fracture fixation have shown to lead to a loss in range of motion frequently. A technique of percutaneous fracture reduction is demonstrated that can provide good results in cases when closed techniques have failed. A Kirschner wire is used to manipulate the fracture fragments percutaneously, which can often prevent open techniques. An additionally performed elastic-stable intramedullary nailing can add to an effective stabilisation and encourage to early physiotherapy.

Bone Wires↗

PubMed1999

Comparison of polydioxanone (PDS) and polypropylene (Prolene) for Shouldice repair of primary inguinal hernias: a prospective randomised trial.

OBJECTIVE: To compare the recurrence rates after Shouldice operation for primary inguinal hernias, using non-absorbable polypropylene or absorbable polydioxanone suture material. DESIGN: Randomised, controlled trial. SETTING: Teaching hospital, Germany. SUBJECTS: 220 male patients who had 233 elective Shouldice repairs of primary inguinal hernias, 201 of whom were followed up. INTERVENTION: Standard Shouldice procedure with 2/0 polypropylene (Prolene, n = 98) or 2/0 polydioxanone (PDS, n = 103). MAIN OUTCOME MEASURES: Recurrence rates after a minimum follow-up of 24 months (range 24-48, mean 31). RESULTS: Numbers of early complications were similar in the two groups; there were 2 wound infections in each. A total of 193 patients with 201 repairs had a documented follow-up (86%). There were 6 recurrences in the PDS group and 5 in the Prolene group, giving a total recurrence rate of 5%. This difference was not significant (Fisher's exact test, p = 1.0). CONCLUSION: Recurrence rates in both groups were higher than expected, but there was no difference between the two groups.

Absorbable Implants↗

PubMed1998

[Trendy inline skating sports. Pattern of injuries and groups at risk].

One hundred and eighty-two patients presented with 200 inline-skating injuries over a 30-month period. Of these, 14% were admitted to hospital, 10% required operative treatment. Fractures (49%), contusions/lacerations (27%) and capsular/ligamentuous injuries (16%) were the most prevalent types of injury. Children had an even higher risk of sustaining fractures (62%). Falling on the extended arm caused 44% of all injuries. Thirteen percent resulted from torque mechanisms of the leg, whereas direct trauma to elbow or knee (5% each) were uncommon injury mechanisms. Injuries of the elbow, forearm, wrist and hand accounted for 55.5% of all cases and 71% of all fractures. Head (13%), knee (9.5%) and ankle (9%) were other regions frequently involved. Protective equipment was often used only for uninjured regions, whereas the injured regions had most often been left unprotected.

Adolescent↗

PubMed1992

Soft tissue sarcomas of the extremities and trunk in the adult. Report of 124 cases.

Between 1970 and 1988 surgery was performed on 124 patients with soft tissue sarcomas of the extremities and trunk in the University Clinics of Hamburg. Liposarcoma, malignant fibrous histiocytoma, fibrosarcoma and malignant schwannoma were the most common histological types. High-grade sarcomas (G3) predominated, with 41%, while 26% were graded G2 and 33% G1. Resection with wide margins all round was achieved in only 54% of the patients. The quality of the operation proved to be only therapy-related prognostic factor. In addition, tumour grade, size, regional lymph node and distant metastasis and histological type proved to be relevant to the prognosis. With multivariate analysis, distant metastasis, grade, resectability and histological type retained prognostic significance. The efficacy of adjuvant chemo- and radiotherapy was related to the quality of the preceding tumour resection. In case of gross tumour the rate of either partial or complete response was 28% for chemotherapy and 22% for radiotherapy. The mean survival time was 102 months; the 5- and 10-year survival rates were 48% and 37%, respectively.

Adolescent↗