PubMed Health⌕ Search

Biomedical subjects

V Nutz

Publications and source records attributed to V Nutz.

At least 19 recordsLinked to original sources
PubMed1994

[Effect of femur stabilization in course of polytrauma in craniocerebral trauma].

A retrospective study of 40 patients with polytrauma classed according to the Hannover polytrauma score (PTS) as II and III including a brain injury and a femur fracture underwent a retrospective study. Patients who died early of brain injury were excluded. In 6 of 18 patients with PTS III, and 5 of 22 with PTS II, death supervened after more than 1 week, in most cases of pulmonary complications. Patients with PTS II needed artificial ventilation for an average of 7.7 days, and those with PTS III of 11.4 days. In 18 patients an immediate femur fixation was performed, in 7 patients a secondary (from the 2nd to 7th day), and 7 in patients a tertiary (after the 7th day) femur fixations, 8 patients required no operative femur fixation. In most cases internal fixation with plates (n = 24) was performed, while medullary nails and fixateurs externes were used in 4 cases each. Patients with secondary operative femur fixation had a worse outcome than patients with primary or tertiary operation: they lethality and the rate of pulmonary complications were higher, and artificial ventilation was more often needed. This difference was significant especially in the PTS II group, and is also seen between patients in whom the same operative procedure (plate osteosynthesis) was implemented. Medullary nailing led to a worse, and use of the fixateur externe to a better general outcome. On the other hand, patients subjected to secondary operations had no wound infections, as against 3 cases of wound infections following primary operations (including 7 on open fractures) and 1 following tertiary operations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Doppler ultrasound measurement of blood circulation in the lower extremity of man. I. Normal values at rest and changes in trauma and vascular diseases].

A duplex ultrasonographic system was used to examine the common femoral artery in left and right legs of 49 fit young men and 15 fit young women, to find out the normal blood flow in the human leg during rest. By this method the diameter of the vessel and the time average velocity could be measured and the blood flow calculated. Each person underwent three examinations of each leg after 10-min rests. The average diameter of the common femoral artery was 91 +/- 10 mm (95 mm in the men and 80 mm in the women), the average blood flow 226.2 +/- 82.1 ml/min (235.9 ml/min in the men and 189.6 ml/min the the women). Compared with other methods used for femoral blood flow studies, we found the duplex ultrasound system reliable, non-invasive, and infinitely repeatable. This method therefore also seems appropriate for clinical studies. In a few tests carried out in trauma patients we found a pronounced increase in blood flow after a few days, and also an expected increase in a patient with arterio-venous fistula and an expected decrease in one with arterial occlusive disease. These examinations were performed to establish a method for further examinations of long-lasting blood flow alterations in trauma patients, which will be reported in another paper.

Adult↗
PubMed1992

[Doppler ultrasound measurements of blood circulation of the lower extremity in man. II. Hemodynamics after trauma and operation].

A duplex ultrasound system was used to examine the blood flow of the common femoral artery in ten young patients with fractures of the lower extremities. Two patients had fractures of both legs. In eight patients the blood flow in the injured leg was comparable with that in the not injured leg. The flow alterations were measured on 3-7 different days over a period of 6-224 days after trauma. All patients showed a significant (to twice or three times that before injury) increase in blood flow in the injured leg a few days after trauma and/or operation, whereas the blood flow in the uninjured leg remained the same or even decreased a little. In the case of undisturbed fracture healing the change in blood flow disappeared within 8-12 weeks, corresponding to fracture consolidation. When fracture healing was delayed and/or further operations on the injured leg were necessary, the blood flow was increased for much longer. The hemodynamics of an injured extremity are compared with those reported elsewhere in the literature. The increased demand for oxygen or energy can explain the changes only in part. Another function of the reflective increase in blood flow could be the temperature increase in the extremity.

Adult↗
PubMed1990

Fractures of the pelvis: problems and results of surgical treatment.

Pelvic fractures have been the domain of conservative treatment and reduction by closed methods for a long time. In the last decades advances in classification and understanding of these often very complex fractures have been made. They are now discriminated into fractures of the apophysis, acetablar fractures and fractures of the pelvic ring. By a better understanding of the functional biomechanics and the morphological changes a number of clear and valid indications for operative procedures has been worked out. Certain pelvic ring disruptions and acetabular fractures can be stabilized after open reduction and provide better functional long time results. As the surgical approach and operative technique can be rather difficult and the concept has to be fitted to the individual case it is almost impossible to give general guidelines for the surgical management.

Acetabulum↗
PubMed1989

[Effect of surgical timing and circulatory stability of various femoral shaft sections on fracture healing].

Between 1976 and 1986 in our clinic 273 patients aged 3 to 93 years underwent operation of the femur shaft because of fracture. 79% had multiple injuries. 254 with 269 fractures survived. 52 out of them had open fractures. All operated fractures were analysed concerning fracture type, fracture localization and timing of operation. We saw 36 complications (13.4%), 13 bone infections (4.8) and 23 non-unions (8.6%). 40% of the patients were operated immediately, 23.4% within the first week. Early operation of closed fracture showed 11.5% complications, operation within the first week showed 14% complications, and delayed operation only 5.7% complications. We saw 7 infections (3.5%) and 20 non-unions (9.9%) after 202 fixations with AO-plates, and 2 infections (4.3%) and one non-union (2.2%) after 46 Küntscher-nailings. Multi-fragment fractures showed considerably more complications (15%) than other types. 23 fractures in the transition from the middle to the distal third had the highest complication rate (13% infections and 21% non-unions) followed by 115 fractures in middle part with 4.3% infections and 9.6% non-unions. Fixation of multiple-fragment fractures in the transition from the middle to the distal third with AO-plates had the worst rate of non-unions of all (4 out of 16). The reasons for the different complication rates are discussed. The striking increase of complications from proximal to distal shaft regions is explained by different blood flow alterations in femur diaphysis found in former experiments.

Adolescent↗
PubMed1988

[Differential circulatory value of various femoral shaft areas--experimental studies in rabbits].

15 rabbits underwent osteotomia of the left femur including lesion of the medullary vessels, 5 times in the proximal, 5 times in the middle, 5 times in the distal diaphysis. Changes in blood flow before and after osteotomia were measured by the "tracer microspheres" -method in the proximal, middle, and distal diaphysis of the femur and the tibia, in the marrow of femur and tibia, in the m. rectus femoris, and the m. tibialis anterior. After lesion of the femur diaphysis a significant reduction of blood flow was found in all tissues of the left leg which must have been caused by arterial spasm. In the diaphysis and marrow of femur, however, the reduction of blood flow was even greater and showed a characteristic pattern concerning the lesion of the medullary vessels. Osteotomia in the proximal diaphysis led to a greater reduction of blood flow in diaphysis and marrow than osteotomia in the middle and distal diaphysis did. The alteration of the diaphysis blood flow is different in the proximal, middle, and distal part in all cases of osteotomia. The characteristic pattern of diaphysis blood flow alteration by osteotomia can be explained by topography of the femur vessels. Their relations to clinical observations are discussed.

Animals↗
PubMed1988

[Computed tomographic studies of fracture healing].

The CT appearances of healing fractures were studied following tibial osteotomy in a dog. Traditional radiological investigations and CT were carried out until healing was complete; CT showed callus on the ninth day, whereas radiographs only showed it after 19 days. After 32 days, callus filled nearly the entire medullary cavity. Similar observations were made in several human situations. CT demonstrates interposed material in the fracture very clearly, even if there is marked callus formation within the fracture.

Adult↗
PubMed1987

[Hyperlactacidemia in intestinal ischemia. I. Theoretical considerations].

Acute interruption of the blood flow of the bowel is a very severe disease. The very high lethality mainly depends on the difficulties in diagnosis. Laboratory findings were not considered until now. Earlier investigations have demonstrated the bowel's high demand for blood and oxygen and a specific high vulnerability by ischemia. Therefore anaerobic metabolism of the bowel should cause a high lactacidemia, even before necrosis.

Animals↗
PubMed1987

[Hyperlactacidemia in intestinal ischemia. II. Experimental principles].

Looking for an early laboratory parameter in diagnosis of acute bowel ischemia, we caused an acute ischemia of the rabbit bowel by clamping the superior mesenteric artery. The blood tests showed a significant increase of lactate during 80 min of ischemia. This lactate excess continued nearly 40 min after revascularization of the bowel, but disappeared nearly completely after 90 min. Neither the laparotomy without clamping the superior mesenteric artery, nor the experimental clamping of the a. femoralis communis led to a lactacidemia. The lactacidemia in our experiments is compared with clinical observations in acute bowel diseases and vascular surgery with clamping of the aorta. The reasons of the specific high lactate excess of bowel ischemia are discussed. The fast increase of the lactate following mesenteric vascular occlusion and the rapid normalisation of lactate after recovery demonstrate a sensitive method in the diagnosis and controlling the treatment of acute bowel diseases with an insufficient blood supply.

Animals↗
PubMed1987

[Therapeutic problems of acetabulum fracture in polytrauma].

Fractures of the pelvis and the acetabulum now occur more frequently in multiple injured patients. Anatomical and biomechanical considerations have led to special classifications of acetabulum fractures and to clear indications of operative stabilization. Because of the difficulty of operation including good preparation the biomechanical concept in treatment often must be modified, especially in patients with multiple injuries. 12 multiple injured patients with acetabulum fractures underwent operative stabilization of this fracture during the last 2 years. Nearly all types of fractures were seen. The acetabulum fractures more frequently showed difficult forms than otherwise reported. Sometimes the severe condition of the patient prevented an optimal treatment according to biomechanical points of view. Very often the operation was considerably delayed by general or local problems of the patient. The concept in diagnosis and indication of operation and the problems of operative treatment are demonstrated by the aid of several cases.

Acetabulum↗
PubMed1985

[Plasma cell granuloma of the lung].

Plasma cell granuloma is a rare, benign and usually solitary round tumour of the lung. Although uncommon, it is found relatively more frequently among children and adolescents. The lack of symptoms and absence of characteristic features make diagnosis difficult. In adults, the differentiation from bronchial carcinomas is particularly difficult because of their radiological similarity. Consequently, thoracotomy and excision of the tumour is the treatment of choice.

Aged↗