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V Echtermeyer

Publications and source records attributed to V Echtermeyer.

At least 19 recordsLinked to original sources
PubMed2003

[Angularly stable radius plate: progress in treatment of problematic distal radius fracture?].

Fractures of the distal radius represent one of the most common fractures and have high socioeconomic relevance. Using the volar approach to avoid the soft tissue problems associated with dorsal plating, we treated a consecutive series of 49 displaced intra-articular distal radius fractures with a new fixed-angle internal fixation device. According to the AO classification, there were 21 C1, 19 C2, and nine C3 fractures. A retrospective study was carried out to obtain the functional results after open reduction and plate osteosynthesis. Loss of correction between postoperative and follow-up radiography was 1 degrees in volar tilt and radial inclination. The radial shortening was 1 mm. Wrist motion at final follow-up examination had recovered to an average of 80% of that at the normal, contralateral site. Overall outcome according to the Gartland and Werley scales showed 35% excellent, 50% good, and 15% fair results. Using the Martini score, we obtained 85% excellent and good results. The DASH score represented high subjective satisfaction.

Adult↗
PubMed2002

[Diagnosis and surgical therapy of diffuse pigmented villonodular synovitis of the hip joint].

Pigmented villonodular synovitis (PVNS) of the hip is a monoarticular proliferative process involving the synovial membrane. A chronic inflammation as well as a neoplastic process have been proposed in the literature. PVNS is usually found in adults aged 20-50 years, without sex predilection. The knee is by far the commonest location, followed by the hip. We present a detailed case report of a 25-year-old man with PVNS of the hip. The physical examination was completely normal. Radiographs of the hip show erosions in the head and neck of the femur and the acetabulum. Magnetic resonance imaging showed a suspected malignant soft tissue mass involving the hip joint. The diagnosis of PVNS was confirmed by arthroscopy and biopsy, and the treatment of choice was an open synovectomy. One year after the operation the clinical examination was normal.

Adult↗
PubMed1997

[MRI arthrography--improved diagnosis of shoulder joint instability].

In a prospective study, we examined 34 patients with shoulder instabilities and 5 patients with unclear chronic shoulder pain (4 females, 35 males; 18-56 years of age, median 28 years) by CT arthrography and MRT arthrography from August 1994 through December 1995. No complications were seen when gadolinium-DPTA was applied intra-articularly. Twenty-three patients were followed up by operation and/or arthroscopy; 20 patients underwent a modified, open Bankart operation. In this paper, we present a new classification for damage of the anterior capsule and labrum. MRT arthrography showed better results in judging the anterior labrum and in determining the degree of damage to the labrum (sensitivity, specificity and accuracy 100%) in comparison with CT arthrography (sensitivity 90%, specificity 100%, accuracy 91%). Furthermore, MRT arthrography gave clearer results than CT arthrography regarding SLAP and cartilage lesions. Thus, MRT arthrography has proved to be a very exact method for diagnosing shoulder instabilities and is superior to CT arthrography in diagnostic accuracy.

Adolescent↗
PubMed1997

[Compartment syndrome. Exclusively the result of increased pressure in the muscular compartment?].

The compartment syndrome (cs) is characterized by an increased tissue pressure in a limited space. Pathophysiologically, it is a multifactorial disease that is potentially induced by an initial trauma and develops according to the existence of cofactors. Cofactors are, for instance, the circulation of the patient and the initial treatment of the impending cs. In particular, the microcirculation is altered with endothelial destruction, development of a capillary leak, protein loss from intravasal space and the development of an interstitial and intracellular third space. An impaired drainage of the lymphatic and venous system causes a venous infarction. An arterial infarction results if the tissue pressure exceeds the arteriolar pressure. An accompanying ischemia reperfusion mechanism increases the trauma load. In disadvantageous cases, the patients are in danger of developing a multi-organ deficiency syndrome (MODS) by an uncontrolled inflammatory reaction, by intravasal volume loss and by a myonephropathic systemic reaction. Clinically, the patients suffer a disproportionate amount of pain, followed by neurological signs. Especially in noncompliant patients, tissue pressure measurement is useful. Resuscitation of the circulation as well as splitting of casts is important. In case of a manifest cs, dermatofasciotomy has to be performed as an emergency operation. Even if cs is diagnosed early and fasciotomy is carried out early, the development of sequellae cannot be avoided in every single case.

Compartment Syndromes↗
PubMed1997

[T-plate osteosynthesis in dislocated proximal humerus fractures].

From 1988 through 1995 we operated 48 patients with dislocated humeral fractures using the T-Plate (median age 66 years [20 to 90 years], 32 male, 16 female). After a median 22 months (9 to 60 months) 33 patients were followed up clinically and radiologically. Six patients had suffered a 2-part fracture, 17 a 3-part fracture, and 10 a 4-part fracture. Judged by the Constant score 6 patients reached a very good result, 8 had a good result, 4 a satisfactory and 15 a poor result. Radiologically we saw an arthrosis in 31%, an axial deviation in 50%, and a dislocation of the fragments in 72%. The rate of necrosis of the humeral head was 39%. MRI (17 patients) provided additional relevant information about soft tissue and bone quality and is valuable in the early detection of necrosis of the humeral head. Functionally poor results correlated rather to dislocated fragments and persisting axial deviation than to the type of fracture or the necrosis of the humeral head. The T-plate osteosynthesis is one way to treat dislocated fractures of the proximal humerus, if early operation, correct reposition, and biological principles are respected.

Adult↗
PubMed1997

[Acromioclavicular joint injuries: efficient therapy from the economic viewpoint].

The results of surgical treatment with tension band wiring versus conservative therapy with bandages are described in a retrospective study. Operative therapy is associated with complications in 32.3% and two occasions of hospitalisation. The advantages of conservative therapy are obvious: it is easy and comfortable for the patient; there are no complications and low costs, and it is associated with a shorter temporary disablement. Therefore, conservative therapy is our standard, and surgery is performed only for Rockwood IV-VI lesions and in exceptional cases.

Acromioclavicular Joint↗
PubMed1997

German rescue system--an overview.

Aim of the report is to show the structure, organisation and legal aspects of the rescue system of the Federal Republic of Germany. The laws are the basis of the rescue system in each of the sixteen federal countries. The governments of the countries delegate their tasks to the administrative districts. Several organisations like German Red Cross, the Fire Brigades; societies like Arbaite-Samariter-Bund, Johanniter-Unfall-Hilfe, Malteser-Hilfsdienst take part in the rescue system with a great number of paid professional people and volunteers with a more or less professional education. Who is Who in the rescue system? Who is responsible for medical education and what is the difference between the rescue system and the "doctor on emergency call"? Both systems exist side by side, but they are very different from one another. The "doctor on emergency call" is private organised by the board of general practitioners and is responsible for "all day" emergency cases on weekends and during the night. The task of the countries and districts is to care for the rescue services, and they should only be used for severe injuries and illness. Most of the physicians taking part in the rescue services belong to hospitals and have no financial interests in their duty.

Emergency Medical Services↗
PubMed1996

[Current status of treatment of Achilles tendon ruptures. Results of a nationwide survey in Germany].

In a standard questionnaire distributed nationwide, we questioned staff from 1307 clinics (surgical, trauma-surgical, orthopedic), of which 787 clinics (60.2%) answered by letter. In 698 clinics (88.7%), operation is considered the standard therapy. Seventy-five clinics (9.5%) use both conservative and operative therapy (average postoperative rate of complication 3.5%). Only 14 hospitals (1.8%) treat strictly conservatively. The average rate of reruptures is 1.6% in the operated group (77.7% postoperative plaster cast fixation) regardless of postoperative treatment; the conservative group (96.1% functional treatment) showed 2.7% reruptures. Thus, operation is the standard therapy for fresh ruptures of the Achilles tendon in Germany. However, there seems to be a trend towards conservative functional therapy.

Achilles Tendon↗
PubMed1996

[Bilateral luxatio erecta of the shoulder joint--a rare injury. Management and therapy in polytrauma patients].

The case of a 36-year-old male patient is reported who fell from 20 m, sustaining injuries to the abdomen and pelvis and fractures of both arms and the left leg as well as erect dislocation of both shoulders (luxatio erecta humeri). The injury on the right was subcoracoid, that on the left subglenoid-a compound dislocation of the humerus head through the axilla. Based on this case and the pertinent literature, the pathophysiology, diagnosis and treatment of this rare injury are discussed. After immediate closed reduction, soft tissue damage, fractures or neurovascular lesions should be operated on as soon as possible.

Adult↗
PubMed1994

[Intervertebral disk-induced diseases (BK Nr. 2108, 2109, 2110). The so-called exacerbation and assessment of work disability].

Two problems are discussed from a multitude of problems arising with the assessment of the "new" occupational diseases classified under the heading "Vertebral Column" which are of essential importance in determining the amount of compensation payment under German statutory health insurance legislation. One problem concerns differentiation of damage from already existing damage or dividing the total disease into preliminary i.e. already existing damage on the one hand and worsening or exacerbation on the other. Pathogenesis of disk-related disease does not usually allow splitting the disease into an already existing damage that is not job-conditioned and an exacerbation caused by the insured exposure to job-conditioned risk: compensation must be based on the "all-or-nothing" principle. The second problem is to assess the reduction in ability to cope with gainful employment stress. Preventive considerations will decisively influence the number of working places that can be offered as alternatives if a person has been suffering from intravertebral disk disease. Not only those jobs that require heavy physical work are barred, but also those where the worker has to remain in the same position for a prolonged time. Such disease-specific preventive considerations result in a rejection of the usual assessment criteria for intervertebral disk diseases.

Adult↗
PubMed1993

[The knee arthrometer KT-1000: value of instrumental measurement in diagnosis of complex anterior knee instability].

Clinical examination is the most accurate means of determining cruciate ligament integrity in the initial evaluation. In the case of a rupture of the anterior cruciate ligament the Lachman test has a high diagnostic accuracy, especially if the end point is absent. The Knee Arthrometer KT-1000 is a useful tool, as it is easy and fast to handle by an experienced examiner. Supplementary to noninvasive diagnostical methods it improves the confidence in clinical diagnosis. However, the importance of instrumental measurement should not be overrated even though reproducible results can be obtained. To compare the results of different studies the design has to be very similar. Although the examination conditions in this study were very homogeneous, a systematic mistake was produced. The average value of tibial displacement was significantly higher for the left knee. Data, obtained retrospectively in clinical practice, should not be used to scientifically document the results of therapeutic procedures.

Adult↗
PubMed1991

[Compartment syndrome of the foot].

Severe compression trauma of the foot predisposes to development of compartment syndrome. Special problems in complex lesions of the foot arise because of the thin layer of soft tissue coverage and the diminished blood supply to the bones of the foot, resulting in difficulties in estimate correctly the severity of the injury. Subfascial pressure monitoring is the most valuable diagnostic tool for establishing the diagnosis. The technique of decompression and fracture stabilization by K-wire osteosynthesis is described and emphasis is placed on tibial-metatarsal transfixation. Follow-up after open-wound treatment consists of a planned "second look" operation with delayed wound closure.

Adolescent↗
PubMed1991

[Compartment syndrome--indication for a treatment error?].

The compartment syndrome is a complication caused by trauma or treatment, which indicates liability especially as a result of minor injuries or treatment. According to the outstanding importance of observation of the course of treatment the careful documentation also has to be stressed. However, remaining damages give no reason for an (apparent) evidence of a failure of treatment.

Compartment Syndromes↗
PubMed1991

[Compartment syndrome. Principles of therapy].

Compartment syndrome can be classed as imminent, with moderate disturbances of muscular perfusion, no neurological symptoms and increasing tissue pressure, and manifest, with compromised circulation and loss of tissue function in the space and pathologic tissue pressure. When compartment syndrome is suspected, the most important immediate measure is wide splitting of any constricting dressings that have been applied. For decompression, the only adequate therapy, in imminent compartment syndrome, subcutaneous fasciotomy is required. The skin incision can be closed. Manifest compartment syndrome necessitates therapeutic fasciotomy, which means long incisions of skin and fascia, splitting of retinacula, excision of necrotic tissues, evacuation of hematoma and, if possible, rigid fixation of fractures. Skin closure is not permitted because of postoperative swelling, which can produce a rebound compartment syndrome. After 4-8 days edema decreases and the wound is closed by delayed sutures or a mesh graft. In the same session a second look operation for re-debridement of the tissues is done. Special problems arise in complex lesions of the foot, because of the thin layer of soft tissue coverage and the diminished blood supply to the bones of the foot. In the foot, decompression requires not only that the compartments of the short pedal muscles be opened, but also that the skin be adequately released.

Arm↗
PubMed1986

[Compartment syndrome].

Among the 4 compartments of the lower leg, the anterior and the deep dorsal compartment show the following significances: both contain important vessels and nerves, both are limited by tense osteofibrous walls. We report on 153 cases of treated compartmental syndrome of the lower leg - in 82 per cent caused by fractures - and 8 cases of CS of the foot. The frequency of irreversible late sequalae such as infection, functional loss or amputation strictly depends upon the time between injury and surgical decompression. The lowest frequency was found in those cases where decompression took place in the phase of impending compartmental syndrome.

Amputation, Surgical↗