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Biomedical subjects

W Linhart

Publications and source records attributed to W Linhart.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Cervical spine trauma in patients with trisomy 21].

Atlantoaxial subluxation is predominantly found in trisomy 21. While neurological symptoms occur less frequently, fatal atlantoaxial instability with spinal cord compression has been described in trisomy 21 after minor trauma of the cervical spine. Presenting a special case we could demonstrate that atlantoaxial instability has to be ruled out in patients with trisomy 21 suffering from acute cervical spine trauma. We further recommend primary posterior fusion if the biomechanical stability of the atlantoaxial complex remains unclear after clinical and radiological exploration.

Atlanto-Axial Joint↗
PubMed2001

Hip locomotion mechanisms in cerebral palsy crouch gait.

The purpose of this study was to evaluate three defined locomotion patterns in cerebral palsy gait using computerised gait analysis. Ambulant diplegic children who had no previous surgery were included in the study and were divided into two groups: one group consisted of children having a crouch gait, and the other group did not have the crouch pattern of gait. An age-matched group of normal children served as the control group. Locomotion patterns studied were the hip hike, propulsive function of the hip extensors, and pseudo-adduction. A statistical analysis was performed between the groups, using defined parameters. The mechanism of hip hike was not utilised by any of the groups. Both groups of diplegic children showed power generation at the hip beginning in the first double support phase of the gait cycle and continuing in the first half of single limb support, while in the normals this was only in the first half of single limb support. Both the groups of diplegic children showed significantly more internal rotation in the first half of stance as compared to the group of normal children; the degree of hip adduction was the same in all the groups. Thus diplegic children had pseudo-adduction.

Biomechanical Phenomena↗
PubMed2001

Conservative management of dynamic equinus in diplegic children treated by gait improvement surgery.

Multilevel surgery for gait improvement was performed on twelve ambulatory children with diplegic type of cerebral palsy and dynamic equinus deformity. Dynamic equinus deformities were defined as those who had an equinus at initial contact during preoperative gait analysis, and where the equinus deformity was correctable passively during physical examination. Ankle function was evaluated by clinical examination and gait analysis before surgery, and at least 3 years after surgery. The ankle showed an increase in dorsal flexion at initial contact, at single stance and in swing. There was an increase in dorsal flexion at the beginning of push-off, without a decrease in the range of motion of the ankle during push-off. Ankle moments demonstrated significant improvement in the maximum flexor moment in the second half of single stance. There was a change from abnormal generation of the energy in mid-stance to the normal pattern of energy absorption. Positive work during push-off was significantly increased. Conservative management of dynamic equinus deformities combined with multilevel surgery to correct other deformities of the locomotion system resulted in significant improvements in ankle function during gait.

Adolescent↗
PubMed2000

The Baumann procedure for fixed contracture of the gastrosoleus in cerebral palsy. Evaluation of function of the ankle after multilevel surgery.

We treated 22 children (28 limbs) with diplegic cerebral palsy who were able to walk by the Baumann procedure for correction of fixed contracture of the gastrosoleus as part of multilevel single-stage surgery to improve gait. The function of the ankle was assessed by clinical examination and gait analysis before and at two years (2.1 to 4.0) after operation. At follow-up the ankle showed an increase in dorsiflexion at initial contact, in single stance and in the swing phase. There was an increase in dorsiflexion at initial push-off without a decrease in the range of movement of the ankle, and a significant improvement in the maximum flexor moment in the ankle in the second half of single stance. There was also a change from abnormal generation of energy in mid-stance to the normal pattern of energy absorption. Positive work during push-off was significantly increased. Lengthening of the gastrocnemius fascia by the Baumann procedure improved the function of the ankle significantly, and did not result in weakening of the triceps surae. We discuss the anatomical and mechanical merits of the procedure.

Adolescent↗
PubMed2000

Assessment of hip rotation after gait improvement surgery in cerebral palsy.

Sixteen children with diplegic type of cerebral palsy and spastic internal rotation gait were evaluated using gait analysis before and an average of 3 years after multiple soft tissue surgery. Significant correction of the internal rotation gait was observed after multi-level soft tissue surgery which included medial hamstring lengthening in all cases. Our results suggest that for children with spastic internal rotation gait, multi-level soft tissue surgery effectively corrects the dynamic internal rotation gait in the absence of fixed bony rotational deformities.

Adolescent↗
PubMed1998

[Biologic reactions to calcium phosphate ceramic implantations. Results of animal experiments].

Calciumphosphate-ceramics have been intensively investigated as bone replacement materials for more than twenty years. In consequence to numerous experimental as well as clinical implantations Tricalciumphosphate-ceramic and Hydroxyapatite-ceramic proved to be the most suitable substances. Nevertheless, due to several shortcomings, these synthetic bone replacement materials can up to now in no way replace autogenous bone, the 'golden standard', for all indications of the clinical setting. The reason for this is that despite our ever increasing knowledge of materials' and host bed properties we still are unable to securely predict the outcome after the implantation of such synthetic substitutes. The article reviews the most important biological reactions in mammals and explains the underlying causes.

Animals↗
PubMed1998

[The so-called Spigelian hernia--a rare lateral hernia of the abdominal wall].

A patient with Spigelian hernia is presented and the main pathological and clinical features are discussed. Its true incidence is probably greater than the small number of patients reported in the literature due to failure to recognize the clinical picture. A hernia through a defect in the Spigelian fascia (aponeurosis of the transverse muscle of the abdomen) is called Spigelian hernia. The semilunar (Spigelian) line is defined as the line forming the transition from muscle to aponeurosis in the transverse muscle of the abdominal wall. It is a lateral convey line between the costal arch and the pubic tubercle. The part of the aponeurosis that lies between this semilunar line and the lateral edge of the rectus muscle is called the "Spigelian fascia" (correct: Spigelian aponeurosis). The hernia is located intramurally because the hernia is covered by the aponeurosis of the external oblique aponeurosis, so that both, the hernial sac and the orifice, can often not be detected by palpation. Clinical symptoms are not characteristic but most patients have a distinct tender point above the hernial orifice.

Abdominal Muscles↗
PubMed1994

[Forearm fractures in children].

A total of 285 children out of an 8 year period with fractures of the forearm were studied. Of these 175 (62.2%) had a fracture of the distal radius and 51 (18.2%) had a fracture of the distal forearm and there were 42 (14.7%) fractures in the middle or proximal third in this region. Three children with injuries of the distal radial epiphysis had to be treated by percutaneous wire fixation. Except for 2 cases who needed surgery all severe dislocated forearm fractures could be treated by closed reduction. In all cases the children were immobilized with a long upper arm cast for 3 to 4 weeks. Follow-up examinations up to 6 years after injury showed excellent results in distal forearm and distal radial fractures whereas results were only satisfactory in midshaft forearm fractures.

Adolescent↗
PubMed1994

[Radiologic diagnosis of Perthes disease].

In Legg-Calvé-Perthes disease (LCPD), magnetic resonance imaging (MRI) and conventional radiography in two planes are considered the most important methods of investigation for early diagnosis and for assessment of the course of the disease. MRI can reveal the early marrow oedema, thus allowing early differential diagnosis against diseases that are similar in clinical appearance (coxitis fugax, epiphyseal dysplasia). The extent of the necrotic area within the epiphysis, the most important indicator of the prognosis of the disease and thus for the therapeutic management, can be assessed earlier and more reliably with MRI than with other techniques. The loss of containment can be visualized by MRI, because depiction of the cartilaginous structures is possible earlier than with conventional radiography. Staging of LCPD is also possible with MRI, especially in stages I and II. Radiography shows the reossification and the osseous remodelling of the epiphysis better. A disadvantage of MRI seems to be the occasional need for sedation or anaesthesia of the child to avoid motion artefacts.

Diagnosis, Differential↗
PubMed1993

[Valgisation osteotomy of unstable pertrochanteric femoral fracture. Results of 92 patients over 7.75 years].

We report on 92 patients (average age: 76.9 years) with unstable trochanteric fractures (Type A2 and subtypes according to the AO/ASIF-Classification) that were treated by valgisation/medial displacement osteotomy and 130 degrees-angled blade plate fixation during a time period of 7.75 years at the Department of Traumatology of the University Clinics of Frankfurt. Average time in the OR was 106 min, average amount of blood necessary was three units. The rate of complications due to the implant was 14.1% taking into account: "cut out" of blade (four patients), loosening of plate (three patients), failure of implant-breakage (two patients)--and development of delayed union (2 patients). There were 4.3% hematomas and 3.3% infections that required revisional surgery. 16 (17.4%) out of 92 patients died during their hospital stay. 77.2% of surviving patients regained walking ability during their hospitalization and only 12% had to be dismissed to a nursing home. "Pros and cons" of our method of treatment for these fracture types against DHS and gamma-nailing are discussed.

Aged↗
PubMed1990

[Histochemical and histomorphometric studies on growth fractions in human breast carcinoma].

Nucleolar organizer regions (NOR) can easily be recognized on paraffin sections of bioptic material with an argyrophilic stain. NORs are meant to to correlate with mitotic activity of proliferating cells. This study examine wether NOR-activity corresponds with the proliferations marker KI-67. 10 fibroadenomas and 40 invasive ductal breast carcinomas were studied. For objective tumor grading the size of the nuclei was determined morphometrically. NORs, KI-67 and nuclei sizes correlate closely in fibroadenomas. In carcinomas, however, a correlation between NORs, KI-67, and the size of the nuclei could not be found. NORs and KI-67 evidently mark different cell activities. For prognostic evaluation of malignant tumors they should therefore not be used alternatively but complementarily.

Breast Neoplasms↗
PubMed1989

Magnetic resonance imaging in children with acute hip pain.

45 children presenting with acute hip pain were prospectively evaluated with conventional radiography, radioisotope bone scan, and magnetic resonance imaging (MRI). The final diagnoses were transient synovitis (n = 17), septic arthritis (n = 2), Legg-Calve-Perthes disease (LCPD, n = 13), epiphyseal dysplasia (n = 2), other conditions (n = 4), and normal findings (n = 7). In the work-up MRI provided more morphologic information than other techniques and enlarged the diagnostic possibilities. It was the only imaging technique able to give an early indication of bone marrow involvement in systemic diseases. For the early diagnosis of LCPD, MRI was as sensitive as isotope bone scan and more precise than conventional radiography. In the follow-up of LCPD patients MRI was not able to indicate the start of revascularisation of the necrotic area, which bone scans showed reliably in six patients: but MRI provided excellent evaluation of the position, form and size of the femoral head and the surrounding soft tissues.

Acute Disease↗
PubMed1982

[Results of proximal tibia osteotomy in varus deformity].

54 patients (mean age 63.5 years), mostly women, suffering from degenerative arthritis of the knee joint underwent high osteotomy of the condylus of the tibia. Fixation together with compression was achieved by external fixation. The patients were not followed up until one year after completion of treatment. In a percentage of 90 the patients were freed from pain, in 10% the results obtained did not satisfy the patients.

Arthritis↗