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Biomedical subjects

W Puhl

Publications and source records attributed to W Puhl.

At least 19 recordsLinked to original sources
PubMed1992

Ultrasonographic evaluation of Legg-Calve-Perthes disease based on sonoanatomic criteria and the application of new measuring techniques.

This study attempts an ultrasonographic classification of Legg-Calve-Perthes disease according to sonoanatomic and sonometric criteria. Four stages, similar to standard radiological staging, could reproducibly be found in 29 patients with unilateral disease. The stages could be significantly differentiated according to descriptive sonoanatomic criteria and partially newly introduced sonographic measurements, including epiphysis-metaphysis-index and acetabulum-epiphysis-distance. Sonographic evaluation of Perthes hips is a simple and standardised procedure, which can serve to stage and monitor the course of the disease and hence reduce the amount of X-ray exposure and treatment costs.

Child↗
PubMed1992

[Supinator tunnel syndrome--a differential diagnosis of so-called tennis elbow].

The increasing activity in sport lead especially in untrained persons to overstress of the elbow joint. Often one tends to diagnose a epicondlylits humeri radialis i.E. tennis elbow. In 1873, Runge (16) first described what we now call epicondylitis humeri radialis, i.e. what Morris (10) 1882 called "Tennis elbow." Its etiology is still under discussion, and the diagnosis of tennis elbow necessitates exact and detailed differential diagnostic efforts. In the work presented, we describe one major differential diagnosis, the posterior interosseous nerve syndrome or supinator entrapment syndrome. With sketches and anatomical preparations we describe the course of the radial nerve around the elbow joint and of its ramus profundus within the supinator muscle pouch. Listing representative causes of this syndrome, we also comment on clinical aspects and our surgical method of choice. We have interviewed and reexamined 6 of our patients suffering from a so called therapy-resistant epicondylitis humeri radialis. Due to their clinical picture all six had been operated for posterior interosseous nerve syndrome/supinator muscle entrapment syndrome. We present our results including neurophysiological evaluations. In relapsing, therapy resistant and diagnostically untypical humeral radial epicondylitis, a posterior interosseous nerve syndrome should be considered. After clinical and electromyographic examination a revision of the supinator channel is justified in selected cases.

Adult↗
PubMed1991

Pustular osteoarthropathy and its differential diagnosis.

A combination of costo-sterno-clavicular hyperostosis and palmo-plantar pustulosis, sometimes with hyperostotic spondylosis and spondylarthritis, is called pustular osteoarthropathy. In the Western hemisphere 40 cases have been reported and in the Far East the condition occurs more commonly. Five cases are described. Diagnosis is difficult because the skin lesions can occur before the costo-sterno-clavicular hyperostoses. The clinical condition is discussed together with the differential diagnosis. Pustular osteoarthropathy seems to be an enthesopathy and the palmoplantar pustulosis is interpreted as a form of psoriasis.

Adult↗
PubMed1990

[Congenital or acquired cleft of the tibial and fibular sesamoid bone of the phalanges of the hallux in a young athlete?].

Splitting of the medial sesamoid bone of the first metatarsophalangeae is relatively frequent, whereas splitting of the tibial and fibular sesamoid bone occurs rarely (6). Differential diagnosis must consider (in respect of pathogenesis) both a fracture if there is an adequate trauma, and a stress fracture. Diagnosis is discussed on the basis of an available case report and compared with the reports published in the literature.

Adult↗
PubMed1989

[Figure skating in high performance sports].

A top performance figure skater is compleled to expose his postural and locomotor system to maximum stress. To achieve the high level of performance that is expected from him, his training schedule must be most exacting. Parallel to this there is an enhanced risk of a sports accident and of damage to health conditioned by sports activities. We report on the results of a study conducted with 67 active and former top performance figure skaters in respect of joint mobility of the lower extremities, sports injuries and damage caused by sports. The type and rate of incidence of sports injuries and sports damage are described and compared with epidemiological data of the average population, the hobby figure skater, and related types of sports.

Adolescent↗
PubMed1978

[The early radiological findings of idiopathic necrosis of the femoral head in adults (author's transl)].

Idiopathic necrosis of the femoral head in adults occurs in about 2 to 3% of all cases of degenerative hip disease. Advanced necrosis with collapse of the head offers a difficult therapeutic problem in younger patients. Early radiological diagnosis is therefore important. The typical, early radiological findings were studied in a hundred patients with idiopathic necrosis of the femoral head. They consist of an area of sclerosis at the junction of the head and neck, with a periosteal response on the inferior margin of the neck. The relationship of these changes with mechanical stress and defective blood supply is discussed. Signs of more advanced necrosis are band-like sclerosis at the point of demarkation and sub-chondral decalcification of the femoral head. Recognition of the early radiological features improves the chances of successful treatment, particularly in the lower age group.

Adult↗
PubMed1978

[The omovertebral bone--new possibility of preoperative examination by computed axial tomography (author's transl)].

After a brief review of literature a case of congenital high scapula with omovertebral bone is presented by conventional X-ray films (plain X-ray and a. p. tomography). The additional computed axial tomography is of great diagnostic value, giving the surgeon a good deal of preoperative information on the anatomy of the bony connection between cervical vertebrae and scapula. The possible pitfalls of this new diagnostic technique are discussed as well as its limitation.

Cervical Vertebrae↗
PubMed1978

[Metabolic diseases and idiopathic ischemic necrosis of the femoral head in adults (author's transl)].

100 patients suffering from osteonecroses (including 95 with necroses of the head of the femur) were subjected to comprehensive clinical, roentgenologic and chemical laboratory examination. A triangle was established from the range of factors considered as pathogenetically important by various authors. These three outstanding factors were: disturbance of lipid metabolism, found in 41% of the patients, deviation of the liver function data, and, finally, abuse of alcohol as discovered on the basis of the case history. The statistically significant correlation of these factors makes it probable that there is actually a pathogenetic chain abuse of alcohol--hyperlipoproteinemia--arteriosclerosis--osteonecrosis. No specific importance of the uric acid and glucose metabolism could be established, since the metabolic disturbances associated with these processes are mostly linked with the observed hyperlipoproteinemia. Deliberations regarding the genesis of necrosis of the head of the femur must also take into account, over and above the relation between metabolic disturbances and stenosing vascular processes, the presence of a locally predisposing factor, such as mechanical strain or the state of enzymatic supply of the osseous tissue.

Adolescent↗
PubMed1978

[Long-term follow-ups in adult idiopathic necrosis of head of femur (author's transl)].

28 patients were subjected to follow-up examination after having suffered for more than 10 years from idiopathic necrosis of head of femur. The high incidence of the bilateral affection of the hip joint as well as the occurrence of multiple osteonecroses are correlated with distrubances of lipid metabolism. Under conservative treatment the disease takes a progressive course, which, however, can remain subclinical for a long time. Good postoperative results can only be expected from intertrochanteric corrective osteotomy which often leads to a regeneration of the head of femur. Caution is recommended before confirming the indication for athrodesis or total endoprothesis because of the risk of disturbances of consolidation or loosening of the implant.

Arthrodesis↗