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Biomedical subjects

R Stober

Publications and source records attributed to R Stober.

At least 19 recordsLinked to original sources
PubMed1998

[Modified Krukenberg-plasty with callus distraction of the stump and complete skin closure of both forearm branches].

In 1917, Hermann Krukenberg first reported on the conversion of a forearm stump into tongs by separating the ulna and radius in a bilateral forearm amputee. Up to now, this technique still has its indication in patients with bilateral loss of the hand or forearm. The main problem is still the coverage of both forearm branches with sensitive skin, especially when the muscles are preserved for surface management and strength. The two case reports of bilateral amputation injuries of the upper extremities illustrate our modification of the Krukenberg procedure. First, callus distraction of the short forearm stump by an external fixator was used in one case. After implantation of tissue expanders, enough sensitive skin was gained to resurface both arms of the Krukenberg forearm during a second procedure in both patients nearly completely.

Adult↗
PubMed1997

Diagnostic validity of ultrasound in patients with persistent wrist pain and suspected occult ganglion.

Until recently, the presence of occult ganglions could be determined only by surgical exploration. This prospective study investigated the reliability of ultrasound in the diagnosis of occult ganglions in a patient series over 4 years. The sensitivity, specificity, and accuracy of ultrasound, as well as its positive and negative predictive values, were determined in 83 patients suspected of having an occult wrist ganglion and who had persistent pain and consented to an operation. Examinations were carried out with a 7.5-MHz linear probe and spacer. Outcome of surgery and histologic examination served as the gold standard in 168 patients who had undergone ultrasound; 89 underwent surgery. In 83 patients for whom enough information was available to allow statistical assessment, sensitivity, specificity, and accuracy rates of 88%, 85%, and 87% were respectively obtained. In dorsal wrist ganglions (75%), better results were obtained: a sensitivity rate of 93%, a specificity rate of 86%, and an accuracy rate of 91%. It was concluded that ultrasound of the wrist can be used as a first-line imaging procedure in clinically inconclusive situations and that ultrasound evidence of an occult dorsal ganglion is a reliable indicator for surgery.

Adult↗
PubMed1996

[Covering soft tissue defects].

In the past, the main emphasis in the treatment of complex limb injuries was placed upon the reconstruction of bony defects. Recently, however, reconstructive soft-tissue procedures have gained the attention they deserve. The salvage of a severely injured extremity depends rather on the feasibility of reconstructive surgical tissue procedures than on restoration of the bony defect. Sufficient vascularity is an essential condition for fracture healing and the prevention of post-traumatic complications like osteomyelitis and pseudarthrosis. If primary closure of a soft-tissue defect is not possible, preliminary covering has to be obtained with artificial skin replacement (vacuum sealing) until definitive covering with muscle or musculocutaneous flaps can be achieved. With the microvascular restorative techniques available today even complex soft-tissue problems can be solved. Nevertheless, an appropriate infrastructure and a trained and skilled surgeon are essential.

Amputation Stumps↗
PubMed1996

[Results of basal joint arthrosis treatment with trapezectomy and Epping suspension-plasty. Clinical follow-up].

Advanced osteoarthrosis of the trapeziometacarpal joint is usually accompanied by subluxation of the base of the first metacarpal, which is due to an instability of the first intermetacarpal ligaments. The repair of these ligaments is, therefore, of fundamental importance. In this way, instability and also proximalization of the thumb can be prevented while function is restored. Suspension arthroplasty using the Epping technique is one of the possible surgical options. It has been practised at the Cantonal Hospital in St. Gall (Switzerland) since the end of 1987. In this paper, the results of 51 arthroplasties in 49 patients with osteoarthrosis of the first carpometacarpal joint followed up for 32 months after operation are presented. An analysis of the results using both objective and subjective criteria shows that trapezectomy and suspension arthroplasty by Epping's method were able to eliminate or significantly reduce pain in a large majority of the patients. Furthermore, the function of the hand, which had been severely limited before the operation, was almost completely restored. Possible aetiologies of osteoarthrosis of the trapeziometacarpal joint and different therapies are discussed.

Adult↗
PubMed1995

[Microvascular flap surgery in arterial occlusive disease].

In the elderly, occlusive arterial disease is a contributing cause of posttraumatic soft-tissue defects of the lower limb. The reconstructive possibilities by microsurgical flap transplantation available are presented on the basis of 22 patients treated. Four failures were due to an almost or completely occluded peripheral outflow. Vein bypass was combined twice with an arterio-venous fistula, but occluded nevertheless.

Adult↗
PubMed1994

[Reconstruction of grip function in bilateral complex explosion injury].

Evaluation, therapeutical possibilities, and surgical planning for the restoration of bilateral grip function are described, based upon the case of a blind patient presenting after severe bilateral explosion injuries of the hand with grade 3-4 loss of thumbs and fingers. Finally, the given level of amputation and remaining components of the hand together with toe transplantation permitted restoring of power grip on one side and fine grip on the other side in combination with bone and soft-tissue procedures.

Adult↗
PubMed1989

[Thoracic outlet syndrome].

The thoracic outlet-syndrome (TOS) results from compression of the brachial plexus at the superior thoracic aperture. Sometimes it is accompanied by vascular symptoms. Every non typical peripheral compression syndrome, recurrent compression symptomatology or the presence of several irritable nerve segments should let TOS enter into the diagnostic considerations. Diagnosis is not simple and requires a synoptic approach using several investigations. Initial therapy is conservative. Surgical management implies good knowledge of anatomy and possible anomalies of the upper thoracic aperture.

Adult↗
PubMed1989

[Concomitant carpal injuries in radius fractures. Nature and incidence, analysis of the last 10 years].

Carpal involvement was detected in 47 cases amongst 2828 radius fractures in the last ten years at the St. Gallen Cantonal Hospital. A radiological correlate of this carpal involvement was found retrospectively in 18 cases. The number is likely to be very much higher with increased attention to this injury! The significance of exact diagnosis is underscored by the observation that the concomitant carpal lesion predominates in the further course and determines the fate of the wrist a long time after the radius fracture has healed up.

Carpal Bones↗
PubMed1989

[F. P. Weber syndrome of the hand. Clinical aspects--diagnosis--therapy].

The syndrome of congenital arteriovenous fistula with proportional giantism is named after Frederik Parkes Weber. Its special localization in the hand is presented and the extension of surgical skeletalization into the microsurgical domain is discussed. The author reports on eight own cases and five skeletalization operations.

Adult↗
PubMed1987

Experimental studies of the porosity of the alloplastic vein replacement.

The vena cava inferior was replaced by alloplastic vein replacement materials in 60 beagle dogs divided in 6 groups. The wall-porosity varied from 50 to 280 ml/cm2 per minute in the textile prostheses (water porosity) (Groups 1-3), and from 30 to 60 micron fibril length in the expanded PTFE-prostheses. All textile prostheses (woven or knitted) are clearly inferior of expanded PTFE-prostheses. The fibril length of 60 micron represents an improvement in comparison with a length of 30 micron regarding the patency rate and the incorporation process, but it needs a special external support.

Animals↗
PubMed1987

[Total or subtotal amputation of a long finger with destruction of the metacarpophalangeal joint--regaining function by replantation?].

Destruction of the metacarpophalangeal joint represents one of the most unfavourable situations making it extremely difficult to attain useful finger function after replantation. Single fingers damaged in this way may therefore not be replanted. If several long fingers are affected, a slight residual mobility in the metacarpophalangeal joint can be attained by joint reconstruction or prosthesis implantation. If the thumb is destroyed at the same time or is not supplied along with the severed hand, heterotopic replantation of a long finger of which the metacarpophalangeal joint has been destroyed is a way of attaining an adequate thumb length.

Adolescent↗
PubMed1986

[Indications for immediate and delayed amputation in severe soft tissue and skeletal injuries of the distal tibia].

Primary amputation of the lower extremity has become rare in the last years due to the advances in rigid fixation of the bone, plastic and microsurgical techniques and aseptic surgery. Primary amputation is indicated in the presence of non-reconstructable lesions of vessels and/or nerves, secondary amputations when vascular, neural or septic complications occur.

Amputation, Surgical↗