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Biomedical subjects

W Knopp

Publications and source records attributed to W Knopp.

At least 19 recordsLinked to original sources
PubMed1996

Arthroscopic diagnosis of posttraumatic disorders of the wrist.

Arthroscopy of the wrist is a helpful diagnostic procedure in cases of painful problems that cannot be diagnosed by clinical and radiological examination. Arthroscopy of the wrist was done in 32 patients, who could not be diagnosed by clinical and radiological examination. During arthroscopy, lesions of the fibrocartilaginous disc and of the cartilage, synovitis of the joint capsule, scaphoid-lunate dissociations and a loose body were detected. As a result of arthroscopic findings, 10 operative procedures were necessary. Resection of a torn disc, local synovectomy, reconstruction of the torn scaphoid-lunate ligament and removal of a loose body were done by open arthrotomy (8 patients). In 2 patients shaving of chondral ulcers on the radial joint surface was performed, which obviated the need for an explorative arthrotomy. Arthroscopy is a simple method that enables new diagnostic possibilities in rare but difficult cases of posttraumatic pain of the wrist.

Adult↗
PubMed1996

[Arthrodesis of the wrist in arthritis].

The AO technique of wrist arthrodesis with an embedded iliac crest bone graft is a stable kind of fixation that allows early range of motion. Solid fusion with correction of the deformity and relief of pain can be achieved. A correct position in dorsal extension and ulnar abduction will improve hand function, but a decrease in grip strength must be expected.

Adult↗
PubMed1995

[Abductor digiti minimi-plasty: a local muscle flap for treatment of calcaneus fractures with limited soft tissue injuries].

Wound healing complications and osteitis following calcaneus fractures are common problems due to compromised local soft-tissue perfusion. Transposition of the M. abductor digiti minimi was successfully performed in 12 cases. The problem of soft tissue coverage could be solved by this procedure. Up to now, no negative influence on the myo-osseous architecture of the feet could be observed.

Adult↗
PubMed1994

[Functional healing of compartment syndrome of the tibia. An analysis of follow-up results].

In a retrospective review 78 compartmental syndromes, treated between 1980 and 1988, were analyzed. The mean follow-up was 42 months. 43 patients (53%) suffered an traffic accident. Direct trauma forces predominated (66 patients). The functional results after crush injuries had been worser than after contusion injuries or direct trauma forces. The functional results depended from the posttraumatic interval of decompression. The later the fasciotomy the worser the functional results had been. A wide fascial decompression is necessary. Two cases of rebound compartmental syndromes after unilateral fasciotomy reveal the skin as an important limiting factor in severe cases of compartmental syndrome.

Amputation, Surgical↗
PubMed1994

[Muscle power and shoulder joint function after removal of the latissimus dorsi muscle].

Free transplantation of the latissimus dorsi muscle has become the treatment of choice in extensive soft-tissue defects of the lower leg after trauma. However, neither the ability of the remaining muscles of the shoulder to compensate for the lost function nor the long-term effects of latissimus dorsi removal on the function of the shoulder have been objectively measured. Therefore, the postoperative shoulder function in 23 patients was compared after removal of the latissimus dorsi muscle with 23 control subjects. The evaluation included a questionnaire, physical examination, and instrumented muscle-testing (cybex system). No significant statistical differences in the function of the shoulders of all the patients and control subjects could be verified, with the exception that 16 patients exhibited weakness during isokinetic torque during extension of the shoulder in a 55 to 65 degree flexion (4.2 +/- 1.2%). The latissimus dorsi free flap can therefore be recommended as a procedure for soft-tissue coverage of extensive wounds resulting only in negligible loss of function and a slightly altered appearance of the shoulder-girdle.

Adult↗
PubMed1993

[Unreamed intramedullary nail or external fixator in complicated tibial fracture? A comparative analysis].

Sixty-seven fractures of the tibial shaft with concomitant soft tissue injury were managed at the "Bergmannsheil" Bochum, University Clinic between May 1, 1991 and March 31, 1993. 33 fractures underwent unreamed nailing whereas 34 fractures were stabilized with external skeletal fixation. There were 20 closed fractures with soft tissue compromise (13 types GII and 7 types GIII (Oestern/Tscherne classification)) and 25 compound fractures (8 grade I, 12 grade II and 27 grade III (Gustilo-Anderson classification)). The grade III open fractures were subdivided by the Gustilo-Mendoza-Williams classification (13 types IIIA, 10 types IIIB and 4 types IIIC). Sixty-five fractures have healed (1 amputation type IIIC, 1 patient died). The mean time to union was 28 weeks in the fixator group and 23.5 weeks in the unreamed nail group (statistically not significant, p < 0.095). Also the infection rate (1 case in each group), the fasciotomies due to compartment syndrome, the number of bone grafts, the number of device change and mesh grafts was not statistically significant in both groups. Only the number of performed flaps for wound coverage was statistically significant higher in the fixator group (p < 0.05). In the unreamed nailing population, breakage of the locking bolts occurred in 4 cases. In 3 cases secondary reamed nailing was necessary (2 delayed unions, 1 avulsion of distal bolts). Two fractures underwent dynamization by removal of the distal locking bolts 6 weeks post initial static nailing. The unreamed nail is a versatile implant for tibial shaft fractures with closed and open soft tissue compromise.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

[Negative effects of local tibial muscle flap repair on foot function].

Although local muscle flaps of the lower leg are often used, the functional problems that arise after these reconstructive procedures have not yet been adequately studied. Twenty patients who had undergone a local muscle flap of the lower leg 3 years earlier were studied using a isokinetic muscle test. The isokinetic muscle strength profile during flexion of the foot was reduced by up to 21 +/- 16% after transfer of the m. gastrocnemius and by up to 31 +/- 20% after transfer of the m. soleus at a angular velocity of 120 degrees. The isokinetic muscle strength profile during pronation and supination of the foot at an angular velocity of 120 degrees was reduced by up to 89 +/- 32% after transfer of the m. soleus. Statistically, compound tibia fractures without a local flap for soft tissue therapy showed significantly better results. In view of this functional loss, the use of local muscle flaps, particularly the transfer of the m. soleus, should be restricted in younger patients, and alternative techniques (free flaps) should be used.

Adult↗
PubMed1993

[Conservative or surgical treatment of metacarpal fractures].

A total of 146 patients with 150 closed metacarpal fractures were treated between 1980 and 1981, and 109 patients with 113 metacarpal fractures (75%) were followed up (follow up 7.3 years). After conservative treatment, the functional results were good to excellent in 92.7%, while 5.8% had satisfactory and 1.5% poor functional results. After operative treatment 81.5% had good or excellent functional results, 14.8% satisfactory results and 3.7%, poor functional results. The radiological result did not correspond with the functional result. Angulation of the Ist-IVth metacarpal bones by up to 20 degrees of the Vth metacarpal bone by up to 50 degrees, and even shortening by up to 8 mm had no detrimental influence on the functional results. Axial rotational deviation of the Vth metacarpal bone by up to 15 degrees was tolerated. Joint fractures with a 1 mm step could also be treated by conservatively means.

Adult↗
PubMed1993

[Post-primary functional soft tissue coverage after extensive muscle-/soft tissue loss of the upper extremity].

Two cases of severe contusion/avulsion injuries of the upper extremity with involvement of the neuro-vascular structures and extensive muscle necrosis after post-ischemic syndrome (PIS) are demonstrated. The concept of early post-primary soft tissue coverage and the opportunity of a simultaneous "functional" soft-tissue replacement with pedicled neuro-vascular myocutaneous island flaps is elucidated.

Adult↗
PubMed1993

[Arterial vascular injuries in fractures or dislocations of the lower extremity. Therapeutic concept and results].

Combinations of fractures or dislocations with vascular damage of the leg have a high incidence of amputation or severe functional deficit. With this type of lesion 22 patients were treated at "Bergmannsheil" from 1986 to 1991. Using a pre-, intra- and postoperative protocol, the amputation rate decreased to 18%. More than 80% of the patients had a good function of their leg with only minor joint restrictions.

Anastomosis, Surgical↗
PubMed1992

[Arthroscopy of the wrist and elbow joint].

Arthroscopy of the wrist and elbow is a helpful diagnostic procedure in patients with chronic disability not demonstrated by clinical and radiological examinations. At the wrist, especially triangular fibrocartilage, chondral or ligamentous defects can often not be demonstrated by other tests. Arthroscopy of the wrist allows examination of more than a dozen separate articular surfaces and the function of eight discrete joints. The geometry of the elbow joint limits intra-articular inspection and the use of instruments. The risk of neurovascular injuries is great and depends on exact puncture sites and portals. Its efficiacy is not yet proven.

Adult↗
PubMed1992

[Complications after surgical management of scaphoid pseudarthroses].

The Matti-Russe technique yields a 95% success rate in treating scaphoid non-unions diagnosed in the first years after trauma and without osteoarthrosis of the radiocarpal joint. Between October 1981 and December 1989, 215 patients were treated by Matti-Russe procedure at the University Hospital of "Bergmannsheil" Bochum. In ten cases, this operation did not lead to osseous consolidation. The results are presented and discussed.

Bone Transplantation↗
PubMed1991

[Primacy of soft tissue reconstruction in complicated tibial fracture--a new concept].

A total of 158 tibial shaft fractures with soft tissue injuries were treated from 1986 to 1990. In cases with type III open fractures, early reconstructive procedures with local or free flaps were carried out after radical debridement. After 12 months 95% of these fractures had healed. Postoperative infection occurred only in 4 (2.5%) of these 158 tibial shaft fractures with soft tissue damage. Before 1986, without these principles, the infection rate of type III open fractures was 17%.

Fracture Fixation↗
PubMed1989

["Prognostic" analysis of late results of trochanteric femoral osteotomy following post-traumatic malalignment].

Post-traumatic axial malalignment of the lower limbs causes osteoarthrosis of the adjacent joints. Whether or not correction osteotomy is indicated depends upon the degree and the location of the deformity. Malalignment of the proximal femur should be corrected if the axis of the leg does not pass through the knee joint. If the axis is outside the central half of the tibial head, the indication for correction osteotomy is a relative one: varus deformities are more difficult to compensate and it is more urgent that these be corrected. Of 103 patients who underwent osteotomies of the proximal femur during the period 1973-1981, there were 73 in whom it was possible to follow up an average of 7 years after the realignment procedure. In nearly two-thirds of these patients the clinical symptoms noted before surgery had improved. In 10 cases of pseudarthrosis of the femoral neck, necrosis of the femoral head could not be avoided in spite of the surgical correction; nonetheless, the prognosis is better if the correction is done within the first 3 months after the trauma.

Adult↗