PubMed Health⌕ Search

Biomedical subjects

S Pechlaner

Publications and source records attributed to S Pechlaner.

70 records · Page 4Linked to original sources
PubMed1987

[Alternative surgical method in pseudarthroses of the scaphoid bone. Prospective study].

Follow-up of 197 patients with scaphoid nonunion treated by Russe I and Russe II bone grafting procedures showed that in longstanding cases with pseudarthrosis and in cases with severe necrosis bony union is often not achieved. The reason for this lack of success is the bad vascularity of the damaged scaphoid. In these cases (25 cases performed over 19 months) with an unfavorable operative prognosis we have inserted into the scaphoid after resection of the pseudarthrosis or the necrotic bone, a corticocancellous graft from the iliac crest, isolated on its vascular pedicle. The vascular pedicle has been anastomosed under the microscope to the radial artery and one of the accompanying veins. This procedure guarantees a much better vascularity of the bone graft. Our results in the 25 cases are very encouraging. Possible complications and their avoidance are pointed out. This new operative technique should not replace other common procedures but it might be the treatment of choice in selected cases.

Adult↗
PubMed1987

[Pseudarthrosis of the scaphoid bone. Experiences in 240 cases].

The results after treatment of 197 non-union of scaphoid fractures are reported. The operative technique of Matti-Russe, called also Russe I, has proved successful in cases in which the fracture is located in the middle or distal third of the scaphoid or where there is a viable small proximal fragment. Bone healing depends more on the age of the pseudarthrosis than on the age of the patient. In 86% of 83 cases the technique of Russe I was successful and in this group the period between accident and treatment was no longer than two years. After a period of more than four years after the accident the success rate is only 54%. The combination of the technique of Russe I with styloidectomy of the radius diminishes the number of good results. The operative technique known as Russe II assumes a good blood supply of the distal fragment of the scaphoid. In 15 cases, after resection of the necrotic small proximal fragment of the scaphoid, a fungiform bonegraft from the iliac crest was placed in the cavity and the success rate was 80%. The findings after palliative treatment of 43 non-unions of the scaphoid are based on subjective criticisms by the patients. The denervation of the wrist and the wrist arthrodesis were done in 28 cases. After resection of the necrotic proximal fragment, a tendon interposition arthroplasty was performed in nine cases, and in six cases a prosthesis for the proximal part of the scaphoid was implanted.

Bone Transplantation↗
PubMed1986

[Long-term results after conservative and surgical treatment of fractures of the distal end of the tibia].

This is a clinical and radiological follow-up on 78 patients with 84 Pilon tibial-fractures which were treated in our hospital between 1970-82. The fractures were arranged in three types after the classification of Rüedi, Matter, Allgöwer. 49 conservatively treated fractures were compared with 35 cases operated upon. The radiological follow-up focussed on posttraumatic development of arthrosis, the mobility of the ankle as well as on the posttraumatic result of reduction. The patient's own assessment concerning the result was found out by means of a questionnaire. The comparison of the fracture type I and II showed almost the same development of arthrosis after conservative and operative treatment, but the operated fractures of type III resulted in 33% in heavy arthrosis, whereas the cases treated conservatively showed heavy arthrosis in 50%. A close correlation exists between the quality of operative reduction and the development of arthrosis. A postoperative incongruity of the articular surface is followed by heavier arthrosis than a comparable incongruity after conservative treatment. An indication of an open reduction is given only if anatomical reconstruction can be predicted.

Adolescent↗
PubMed1985

[Suture and functional after care of flexor tendon injuries of the hand by the Kleinert method. Experiences and results following 346 flexor tendon sutures].

The restitution of flexor tendon injuries of the hand according to the tissue-sparing method and functional follow-up treatment indicated by H. Kleinert and his collaborators has become very important in the acute treatment of fresh injuries of the hand. Having applied this method in the treatment of 176 patients suffering from 346 separated flexor tendons in 235 fingers, we are now able to present the limited indication. The surgical proceeding and the complications occurred are described, and the results found in the cases submitted to a follow-up examination (141 patients, 284 resutured flexor tendons in 194 fingers) are presented.

Adolescent↗
PubMed1984

[Tendon rupture as a complication after osteosynthesis of distal radius].

Close contact between extensor and flexor tendons to the bone structure of the wrist and distal radius shaft implies the possibility of alteration concerning the tendons' slide way and tensile direction in case of osteosynthesis in this region. Even a slightly damaged screw is mechanically capable of irritation and can be made responsible for a scrub-necrosis of an above tendon. The metal implant has to be selected in consideration of both the demands of the fracture and a free and natural tendons pathway. This is discussed by means of two implant-induced scrub necroses of the long pollex extensor and flexor tendon.

Adult↗
PubMed1982

[Injuries of the ulnar ligaments of the thumb joint].

In the introduction of the paper the significance of the stability of the ulnar ligament mechanism of the thumb and different causes of injuries to it are discussed. The author analyses 741 lesions of the ulnar ligament of the thumb MP joint from a series of 9838 skiing injuries. A special classification of the injuries to the ulnar ligament mechanism of the thumb MP joint is presented, on the basis of which guidelines for conservative and operative treatment as well as possible complications in case of conservative treatment of the different types of injuries are discussed. In conclusion operative and follow-up results of 126 cases are presented.

Finger Joint↗
PubMedDate not supplied

Disruption of the finger flexor pulley system in elite rock climbers.

We treated 13 elite rock climbers for isolated disruptions of the pulleys of the long fingers. Diagnosis and treatment were based on the clinical finding of bow-stringing, which was confirmed by magnetic resonance imaging. Eight patients had bowstringing indicating incomplete disruption of the major pulley A2 and were treated nonoperatively (group A). Five patients showed bowstringing indicating complete disruption of the pulley A2. After failed nonoperative treatment, the pulleys were reconstructed (group B). The mechanism of injury and clinical and subjective results were evaluated. At a 31-month follow-up (range, 18 to 43 months), loss of extension in the proximal interphalangeal joint measured 5.6 degrees (range, 0 degree to 10 degrees) in group A and 4 degrees (range, 0 degree to 10 degrees) in group B. Circumference of the finger section was increased 4.2 mm in group A (range, 0 to 10 mm) and 4.8 mm in group B (range, 0 to 10 mm). Grip strength decreased 20 N in group A (range, 10 to 50 N) and 12 N in group B (range, 10 to 30 N). Four patients in group A and one in group B had bowstringing at clinical evaluation. On follow-up magnetic resonance images, bowstringing remained unchanged in group A but was reduced in all patients in group B. Good subjective results were seen in both groups.

Adult↗