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Biomedical subjects

U Frankl

Publications and source records attributed to U Frankl.

17 recordsLinked to original sources
PubMed1991

Reflex sympathetic dystrophy of the patellofemoral joint.

Eighteen patients with a diagnosis of reflex sympathetic dystrophy (RSD) affecting the knee were reviewed. Minor isolated injuries and operations about the knee triggered the original episode. The symptoms, regardless of location and mechanism of injury, occurred in the patellofemoral joint. Roentgenographic features of patchy demineralization and abnormal uptake on a 99mTc scan were typically located in the patella and corresponding femoral articular surface. At the initial stage of the syndrome, pain, hypersensitivity to touch, and inhibition of the quadriceps muscle were the most prominent features. In the later stages of the syndrome, functional instability due to quadriceps weakness created dependence on a knee brace or crutch support. Six patients whose RSD was initially misdiagnosed underwent numerous unsuccessful surgical procedures. In three of these patients, the knee was ultimately fused. All patients had an initial isolated knee injury (usually after minor trauma), and prolonged periods of immobilization and a cast, and 12 of the 18 patients were involved with workers' compensation. Early diagnosis and prompt treatment with an epidural block, followed by intensive physiotherapy, are recommended. A personal doctor/patient relationship that offers guidance and encouragement is key to successful management of this syndrome.

Accidents, Occupational↗
PubMed1991

Rotator cuff pathology. Arthroscopic assessment and treatment.

The results of 50 operative arthroscopies for impingement syndrome were reviewed. Preoperative arthrography was correlated with arthroscopic findings, which were pathologically graded. Results of arthroscopic surgery were assessed. Preoperative arthrography predicted 78% of the complete tears of the rotator cuff and only 25% of the partial tears. Of 40 shoulders followed for at least one year postoperatively, 87.5% had satisfactory results. Arthrography was not as reliable as arthroscopy in predicting partial tears of the rotator cuff. Arthroscopy permitted detailed intraarticular and subacromial visualization and classification of partial and complete tears of the rotator cuff. The early results of arthroscopic acromioplasty and debridement are comparable to those obtained with open operations.

Adolescent↗
PubMed1990

Pulled elbow and hypermobility of joints.

Pulled elbow and hypermobility of joints are frequently seen in young children, the latter occurring in 5% of the general population. A group of 100 children with pulled elbows, composed of 64 girls and 36 boys with a mean age of 25.5 months, and their parents were checked for joint hypermobility in a prospective study over a period of two years. Results were compared with a normal (non-pulled elbow) control group of 30 children. The prevalence of hypermobility among children with pulled elbow was 73%, which is 23% higher than in normal children of similar age. The main differences in hypermobility between the groups were noted in elbows and knees. There was no significant difference between girls and boys. In 48% of the cases of children with pulled elbows, at least one of the parents had hypermobility, whereas only in 10% of the control group were parents hypermobile. The association between pulled elbow and hypermobility indicates that pulled elbow can be considered one of the effects of this condition. Since not all patients with pulled elbows were hypermobile nor did they have parents with hypermobility, other factors may be relevant, such as variations in the anatomy of the radial head and surrounding structures in combination with the degree of violence involved.

Adult↗
PubMed1989

Arthroscopy of the painful dysfunctional total knee replacement.

Arthroscopy of the painful failed total knee arthroplasty has rarely been reported. The indications and results in terms of diagnosis and treatment of pathologic conditions in 13 knees after total knee arthroplasty are reviewed. Arthroscopy established the diagnosis for pain in 12 of 13 knees. Several problems were commonly encountered, including arthrofibrosis and fracture of the polyethylene button. Arthroscopic surgery for arthrofibrosis was successful in improving range of motion and knee-rating score.

Aged↗
PubMed1987

Another look at the pertrochanteric fracture of the femur: the relationship to osteoporosis.

Eighty-seven pertrochanteric fractures consecutively treated between the years 1978 and 1981 are reviewed. External and internal rotation types are described relative to their aetiology. The final typing of the fracture can be made only on reduction. What we have called 'internal rotation fractures' show an excellent correlation with the unstable fracture gradings described by Boyd, as well as very osteoporotic Singh gradings (1-3). It is contended that the latter is the main factor in its production as opposed to the more common external rotation variety. An appeal is made for recognition of the fracture, its reduction by means of external rotation and adequate fixation. Early weight bearing is not advised, in order to prevent subsequent varus deformity with extrusion of the implant.

Aged↗
PubMed1983

The effect of intra-articular colchicine on the knee joint of the rat.

The effect of intra-articular injections of colchicine on the normal joint of the rat was investigated. Colchicine in varying doses was injected into the knee, while the contralateral knee was used as a control. Colchicine mainly affected articular cartilage, causing degenerative changes that appeared to be dose-dependent. It is assumed that colchicine produces an increase in the rate of synthesis of collagenase, which alters the nature of articular cartilage, making it more susceptible to wear and tear and thus producing the lesions of early osteoarthritis.

Animals↗
PubMedDate not supplied

Fat pad adhesion to partially torn anterior cruciate ligament: a cause of knee locking.

Isolated damage to the ACL was found on arthroscopic examination of 51 patients who had symptomatic knees. There were 47 male and 4 female patients. The average age of the patients was 26.5 years, ranging from 13 to 43 years. Twenty-four of the patients had isolated partial tears of the ACL, and 27 had isolated complete tears. The purpose of this study was to examine the clinical patterns and arthroscopic findings in these two groups. On examination, 12 patients were found to have locked knees. An additional six patients gave a history of knee locking. All 18 of these patients were clinically suspected of having meniscal damage; however, only partial and complete ACL tears were found at arthroscopy. Of these 18 patients who had locking knees, 15 had a partial tear of the ACL and 3 had a complete tear. Locking was involved primarily in the group with partial ACL tears (15 of 24); only 3 of the 27 patients who had complete tears described locking. Of the 12 patients who had locked knees on examination, all were found to have fibrosis and adhesions of the fat pad and the synovium adjacent to the ACL stump. All 12 of these patients had a partial tear of the ACL. The fibrosis and adhesions were histologically documented in 10 of those 12 patients. The three patients who had partial ACL tears and histories of locking were not observed to have adhesions of synovium to the fat pad, but did have an entrapped remnant of ACL between the tibial plateau and femoral condyle.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMedDate not supplied

Secondary damage to the knee after isolated injury of the anterior cruciate ligament.

Between 1978 and 1984, we examined and performed arthroscopy on 1000 consecutive patients. Ninety-eight of the 1000 had isolated ACL damage. These cases do not include patients with initial ACL injuries combined with other intraarticular damage. Diagnosis was by physical and arthroscopic examination. Examination took place an average 13.6 months after injury. Of the 98 isolated ACL injuries, 56 were complete ruptures and 42 were partial ruptures. In most cases of partial rupture, the clinical diagnosis was wrong. "Meniscal damage" was the usual diagnosis in these cases; the true diagnosis was made only by arthroscopic examination. Thirty-four of the 98 patients with isolated ACL injuries (30 men and 4 women) developed further intraarticular damage. Of these 34, 20 had complete ACL rupture and 14 had partial ACL rupture. Treatment after primary injury included physiotherapy in all patients and bracing in those whose knee was unstable during daily activities. Reconstructive surgical procedures were not performed in those patients. The time lapse from the primary to the secondary injury varied from 1 month to 20 years, with an average of 28 months. The secondary damage was caused by a secondary injury that was mild (22 cases) or developed insidiously (12 cases). Five types of secondary damage were observed: partial ACL tears that became complete--11 cases; meniscal tear--8 cases; loosening and subluxation of the anterior horn of the medial meniscus--14 cases; and fracture or damage to the articular condylar cartilage, with or without bone involvement--11 cases. It should be emphasized that the secondary damages were at times combined.

Adolescent↗