Biomedical subjects
Publications and source records attributed to R Rosenberger.
The authors developed a minimally invasive method with computer-assisted navigation for retrograde drilling of osteochondral lesions of the talus. Planning of the pathway and adjustment of the targeting device were performed outside the operating room. In 10 cadavers and four patients, accuracy of pin placement was in the range of 1.0-3.5 mm.
The Tinhoff-Linberg operation is a limb salvage technique that permits intercapulothoracic resection of malignant neoplasms of the shoulder with preservation of neuromuscular function of the upper extremity. A metallic interpositional device can be used to fix the humerus to the second rib, thus increasing stability and function. This device was used in a patient with a proximal humeral osteosarcoma who was also treated with radiation and chemotherapy and who has reasonably good extremity functional and is free of tumor at one year postoperatively.
Nineteen patients with spinal discontinuity syndromes resulting in paralytic spinal deformity were treated with orthoses to postpone spinal stabilization to allow for vertebral growth. All patients had some degree of sensory deficit under the orthosis. The average period of orthotic treatment for all patients was 54 months (range, 22 to 98). The initial upright curve measurement prior to treatment averaged 43 degrees, the best correction obtained during treatment averaged 26 degrees, and all curves averaged 39 degrees when the brace was discontinued or at most recent follow-up. Although pressure sores occurred, no orthosis was abandoned due to a decubitus problem. Eight patients were successfully braced until maturity, at which time they underwent one stage spinal fusion. Five immature patients are still under active orthotic treatment. Poor compliance with brace wear was documented in the cases in which unacceptable progression occurred, requiring spinal fusion prior to maturity. Successful, technically simpler, one stage stabilization procedures were made possible by the successful long-term control of these difficult spinal deformities afforded by orthotic treatment.
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Although function does not return after complete spinal cord injuries, partial recovery is possible after incomplete lesions Halofemoral traction may produce early decompression of injured neural elements in the spinal canal by anatomic realignment of the spinal column. It also acts to stabilize the very unstable thoracolumbar fracture dislocation and prevent displacement as well as further neurologic trauma. The body jacket is easy to make and apply. It allows early mobilization of patients when utilized in conjunction with the posterior spinal fusion and Harrington rod fixation.