Biomedical subjects

S Pechlaner

Publications and source records attributed to S Pechlaner.

At least 55 records · Page 3Linked to original sources

PubMed1996

[Rupture or stress injury of the flexor tendon pulleys? Early diagnosis with MRI].

Eighteen extreme rock climbers underwent primary clinical and MRI examination because of recent closed injuries to the flexor tendon pulleys. Follow-ups were after approximately 36 months on the average. The recent injuries, which are difficult to diagnose clinically, could be ascertained by means of MRI: This type of injury seems to occur more frequently than is currently diagnosed. Eight patients with overuse syndrome and eight patients with a short pulley rupture were treated conservatively. In two patients with long pulley rupture, the pulleys were reconstructed by means of a tendon graft using Kleinert's technique. Clinically manifest bowstringing or flexion contracture after treatment could not be ascertained on any one of the patients. All except for one showed an almost normal range of motion. By means of control MRI it was, however, possible to ascertain minor bowstringing and scars in most patients. Clinically, this partial instability manifested by lasting swelling. What was most disturbing, however, was reduced strength and the subjective feeling of insecurity during climbing.

Adolescent↗

PubMed1995

[Fractures of the hand skeleton].

The complex anatomical conditions of the hand pose special problems for fracture treatment. On the one hand length and axes as well as rotation of the fractured bones have to be reestablished in order to prevent functional impairment. On the other hand operative possibilities are limited by the overlying vessels, nerves and tendons. Certain types of fractures are successfully treated by conservative means. Disadvantages are the long time of immobilisation and sometimes clumsy bandages. Other types of fractures require operative treatment in order to accomplish correct reduction. In addition stable internal fixation may reduce the time of immobilisation, but the surgical trauma and bulky implants may deteriorate functional results.

Carpal Bones↗

PubMed1994

[Diagnosis of the ulnocarpal complex in MRI cineradiography].

73 patients with persistent ulnar wrist pain of undetermined origin were examined by Magnetic Resonance Imaging (MRI). A series of 15 coronal slices was acquired using a T2* weighted gradient echo sequence. With repetitive measurement of those three slices that showed the triangular fibrocartilage complex (TFCC) best, the carpus was imaged 12 times during radial-ulnar deviation in increments of five degrees. The single images were combined according to their slice positions and continuously displayed on an image workstation, allowing for kinematic evaluation. Three different types of impingement of the TFCC were identified.

Adolescent↗

PubMed1993

[Destabilization of the discus articularis with rupture of the ulnar styloid apex in distal radius fracture. Diagnosis with dynamic MR].

An avulsion of the ulnar styloid apex led--because of a simultaneous rupture of the ulnar collateral ligament and a rupture of the disc's insertion in the fovea ulnaris--to a displacement of the triangular fibrocartilage. During movements in the frontal plane, the latter underwent a deformation, was displaced, compressed and blocked ulnar abduction. This pathology and the ulnar impingement could be observed in a "MRI-movie".

Adult↗

PubMed1993

[Distal intra-articular radius fractures. Indications for and technique of open reduction and plate osteosynthesis].

In the past few years we have seen vast changes in both the assessment and the management of fractures of the distal radius. This is attributable to several factors. On the one hand, conservative treatment has shown poor results in a considerable number of patients, and on the other hand, more and more young patients are presenting with this common lesion. Furthermore, the spread of new methods of osteosynthesis and of modern materials, such as implants, etc., have greatly improved the results of operative procedures, even in complicated fractures of the radius. Therefore, in certain types of fractures far better functional results can be achieved by open reduction. Particularly in intra-articular fractures of the distal radius with or without compression zones and/or injury to the ligaments closed manipulation and subsequent immobilization by plaster is only partially successful. To achieve successful repair of the complex mechanisms in the wrist and the distal radio-ulnar jacket (DRU) joint, these fractures mostly require open reduction and plate fixation including additional support for the articular surface by a cortico-cancellous bone graft from the iliac crest. This enhances the stability of the reduced fragments and facilitates early mobilization which, in turn, greatly improves the functional results. In palmar displaced fractures a palmar approach is employed for both surgical repair and plate fixation, while dorsal compression fractures are reduced, filled and stabilized using a dorsal approach. In this study a special operative procedure for intra-articular comminuted fracture is described. A palmar approach is employed for fracture reduction, while the compression zone is filled by bone graft via an additional dorsal incision.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1992

[Isolated injuries of the pulley of the finger flexor tendon sheath--injuries in extreme climbing sports].

Injuries of pulleys are quite common in mountain climbing. The clinically diagnosed rupture of a pulley can now be verified by MRI. Partial ruptures, which in MRI always showed as scars, can frequently lead to intrinsic bow-stringing. The injuries were primarily treated non-surgically. With regard to chronic, recurring cases or large ruptures, however, annular ligament plastics have to be considered. As a prophylaxis we recommend special training exercises for climbers on wide ledges with changing exertion patterns and a tape-bandage for the fingers. During climbing, the PIP-joint should best not be strained in an obtuse angle. Warming-up and stretching exercises before climbing are absolutely necessary.

Athletic Injuries↗

PubMed1992

[Dorsal compression fractures of the distal radius metaphysis. Long-term follow-up with conservative therapy].

Conservatively treated compressed fractures of the distal radius dorsal metaphysis healed despite primarily good reduction and consequent treatment with a decrease in dorsal length. The amount of this decline depends on the primary loss of dorsal length. If the fracture showed a loss of dorsal length at the time of the accident of up to 2 mm, the long-term results were almost anatomical. If there was primarily a larger loss of dorsal length, a decline of the distal fragment into the dorsal cave resulted. Most of the dorsal length regained after reduction was lost when the cast was removed. The long-term follow-up examinations were made after about 9 years.

Adolescent↗

PubMed1992

[Plate osteosynthesis of the radius. Own implant and technique].

In 1989 and 1990, 46 acute distal radius fractures with die-punch compression cavities underwent open reduction and internal fixation using a new compression plate and surgical technique. In 34 of these patients, functional and radiological results after plate removal were studied. Surgical exposure was palmar or dorsal, or combined palmar with a supplementary dorsal incision, depending on the location of the compression cavity and the extent of fracture dislocation. A cortico-cancellous graft from the iliac crest was fitted into the compression cavity, thus supporting the reduced joint surface against the radius shaft. Superior maintenance of the reduction was achieved using cortico-cancellous instead of simple cancellous graft. A new titanius radius reconstruction plate was used for internal fixation. This two-fold support of the fracture allowed for earlier wrist mobilization.

Adolescent↗

PubMed1991

[Snowboarding injuries].

This retrospective study includes 59 people treated at our trauma centre for snowboard accidents that happened in the 1989 winter season. 22 People were severely injured. 2 people died due to a polytrauma. One fracture of the cervical vertebrate column was followed by complete hemiplegia. Reasons for these accidents were a lack of knowledge how to behave outside the marked alpine regions, as well as lack of technical equipment and theoretical education.

Adolescent↗

PubMed1990

[Closed tendon injuries of the hand].

Cases of subcutaneous tendon ruptures of the hand were compiled over a period of 10 years; the lesions were all traumatic rather than due to degenerative illness. The 914 injuries fall into two categories: 867 extensor and 47 flexor tendon ruptures. The localisation of the lesions is most often distal. The extensor tendon lesion is accompanied more often by a ruptured bony fragment; the distal flexor tendon is mostly torn-off bony fragment. The extensor tendon ruptures can be subdivided as follows: distal injuries of the extensor aponeurosis in the DIP joint (751 cases), IP joint (31), tractus intermedius (27), ext. carpi radialis longus (5) and brevis (1), ext. carpi ulnaris (6); proximal ruptures of the ext. pollicis longus (42), ext. digitorum communis II and indicis (1 each) and ext. carpi radialis longus and brevis (1 each). The flexor tendon lesions are as follows: distal injuries to flex. digitorum profundus (32 cases), flex. pollicis longus (9), and the opponens pollicis, which is classified under this heading (2). Proximal lesions to flex. pollicis longus (2) and flex. digitorum profundus and superficialis (1 each).

Hand Injuries↗

PubMed1990

[Reconstructive surgical procedures in scaphoid pseudarthrosis].

Operative procedures for application in scaphoid nonunion are limited by secondary changes of wrist and carpus. The choice of treatment is determined by the degree of vascularization of the fragments. Bony union can be achieved by means of an autogenous free bone graft if there is adequate vascularization of at least one fragment. In the case of extensive impairment of the blood supply, a bone graft on a vascular pedicle is recommended. The postoperative stability of the fragments is of decisive importance for consolidation of the nonunion. The localization and orientation of the nonunion and the extent to which the blood supply is impaired determine the choice of treatment. The standard methods of operation are demonstrated. Our results and experience with the techniques of Matti-Russe I (86 cases), Russe II (18 cases), the Pechlaner-Hussl vascular pedicle bone transplant (35 cases) and the Herbert screw (18 cases) are reported.

Bone Transplantation↗

PubMed1989

Revascularization of a partially necrotic talus with a vascularized bone graft from the iliac crest.

A 16-year-old patient had a compound dislocation of the right talus. Following primary treatment, which included a subtaler screw arthrodesis, the talus developed clinical, radiological, and isotope scan signs of necrosis. In spite of a walking caliper to prevent weight bearing on the ankle, the talar articular cartilage of the ankle joint also showed signs of degeneration. The talus was revascularized with a vascularized corticocancellous iliac crest bone graft. Six months postoperatively, there were clinical, radiological, and bone scan signs of significant revascularization. The patient is free of pain and able to walk with full weight bearing on the foot.

Adolescent↗

PubMed1989

[Osseous avulsion of the opponens pollicis muscle. Case report of a rare injury in skiing].

Two cases in which the M. opponens pollicis was ruptured with a bony fragment are reported. In each case the injury, which occurred in young people (24-29 years of age), was the outcome of a fall during alpine skiing, whereby the hand hit the icy slope. Operative treatment was necessary due to the intense subjective pain which followed a significant thenar hematoma.

Adult↗

PubMed1989

[Corrective osteotomy following peripheral radius fractures. Method and results].

Malunion of distal radius fractures leads, especially in those patients who are manually employed, to functional disability of the hand. Painful impingement on the ulnar side of the wrist results in decreased range of motion in pronation/supination and loss of strength. By reconstructing as precisely as possible the axial and longitudinal relationship of the forearm bones, the desired congruence of the distal radioulnar joint can be achieved, this improving greatly the strength and function of the hand. Indications, point of time, as well as technique in operating will be presented in short form in 42 of our own cases: complications will also be discussed. The roentgenographic and functional results, as well as the subjective evaluation from 33 patients whose operations took place longer than a year ago, before and after the malunion correction, will be listed according to our postoperative examination protocol for radius fractures. In all three parameters positive results could be shown, especially in the patient's subjective analysis. Notice will be taken on the special difficulties in position corrections in cases in which the ulnar side fragment is dislocated.

Adult↗

PubMed1988

[Distal radius fractures--forms of fracture and injury pattern].

Fractures at the distal end of the radius are the most frequent fractures. There are still many therapeutical problems. The success of conservative or operative treatment depends mainly on the different types of fractures. In order of compare end results and to recommend therapy, it is necessary to define different fracture types, based on practical classification. A classification of fractures at the distal end of the radius is presented, with localization and reference to the extent of injury with consideration of lesions of the radiocarpal joint and indirectly to the distal radio ulnar joint. In the period of growth five types of injuries are differentiated. In adults three main groups, depending on the involvement of the radio-carpal joint are described. These are subdivided according to dislocation. The fractures types were classified by using X-rays of cases over a period of several years. With this classification the pattern of injury of 593 fractures of the distal end to the radius, treated in 1980 in our clinic, was analysed.

Humans↗

PubMed1987

[Hand injuries in Alpine skiing].

In the Innsbruck University Clinic for Traumatology during the years 1978-1985, altogether 17,999 patients received initial treatment for injuries incurred through Alpine skiing. 3240, or 18% of these injuries were trauma to the hand. The most frequently injured area was the thumb, with 1995, or 61.6% of the cases. The most common hand injury in skiing is the socalled "ski thumb", the lesion of the ulnar ligament of the metacarpal-phalangeal joint. Finger injuries accounted for 262 cases, or 8%. The capsule-ligament lesions predominated, especially the palmar capsule lesion of the proximal interphalangeal joint. The most common ligament lesion was the rupture of the radial collateral ligament of the metacarpal-phalangeal joint of the small finger. The metacarpal region was involved in 192 (6%) of the patients. The 4th and 5th metacarpal fractures were often combined with volar dislocation of the caput; the 2nd and 3rd metacarpals showed more often torsion fractures. Luxated fractures were found in all carpal-metacarpal joints. Carpal injuries were the least common, with 2.2%; the bony and ligamentous injuries in this region were, however, more serious. 40 scaphoid fractures were found, along with fractures of the triquetrum, trapezium, hamatum, and pisiform, as well as luxations and luxated carpus fractures. The injuries of the wrist are worthy of more attention. They include lesions of the distal radial-ulnar joint and distal radius fractures, and made up 22.2% of all hand injuries. More emphasis should be placed on diagnostic, therapeutic, and prophylactic measures for these injuries.

Athletic Injuries↗

PubMed1987

[Wrist para-articular radius fractures in winter sports].

Winter sport is of great importance in the Alpine countries. In 1980 3600 persons (10.24%) of all new admittances hospitalized in our hospital were injured when practicing winter sports. In 1983 they lessened to 2597 (7.73%) and in 1985 2999 (5.74%). Analysis of all injuries caused by winter sport activities shows that the number of injured persons is decreasing, severity of the injuries however, increasing. A comparison of the distal radius fractures in 1980, 1983 and 1985 indicates that extraarticular metaphyseal fracture types have decreased, intraarticular fracture with multiple fragments however, have increased. Mainly younger patient suffer from severe fractures. We regard the high pace-risk of the age group as the main course of this fact.

Adolescent↗

PubMed1987

[Traumatic scapho-lunate dissociation. Functional analysis, surgical therapy and results].

The traumatic scapho-lunate dissociation represents a heavy lesion of the carpal ligaments. The instability and incongruity of the joint causes a considerable loss of the function of the hand. The mechanical situation of the proximal carpal row is demonstrated on the base of anatomical investigations and the mechanism of the accident in a subluxation-rotation injury is shown. The therapeutic consequences are pointed out and the author's own operations procedure (reconstruction of ligaments) with results is presented.

Carpal Bones↗