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Biomedical subjects

W Seggl

Publications and source records attributed to W Seggl.

14 recordsLinked to original sources

Scope and limitations of ultrasonography in the documentation of fractures--an experimental study.

Sonographic studies were performed on cadaveric bones placed in a water bath, using 7.5-MHz linear-array transducers and 3.5-MHz sector transducers. Depending on its size, the defect was revealed as an interruption of the cortical reflection of echo or a dorsal band of echoes confined to the region of the fracture. It was interesting to note that fractures and bony defects are not visualized when the transducer is placed parallel to the fracture line or the zone of bony impaction. A further remarkable aspect was the numerous artefacts adjacent to each other at several fracture margins. It may be concluded that in an experimental setting and under standardized conditions, high-resolution transducers permit the examiner to detect cortical discontinuities of 1 mm or more.

Bone and Bones↗

[Value of ultrasound imaging of the Achilles tendon in traumatology].

METHOD: In an experimental study on ten isolated human cadaver tendons, the ultrasound anatomy and the reproducibility of artefacts was determined using 10- and 13-MHz probes. With these in vitro data, the form and diameter of a non-injured tendon were documented in a series of 30 patients between 3 and 60 years old. In a second series of 32 patients with acute, traumatic ruptures of the Achilles tendon and 40 patients with chronic disorders, we distinguished the pathological anatomy. RESULTS: Injuries to a tendon with chronic disorders, reruptures and complications in the postoperative period after tendon repair can be made more difficult by calcification, scars, oedema, haematoma and suture materials. It is necessary to check the changing ultrasound patterns owing to an haematoma or oedema with tendon carpulence, the missing linear signals in a fresh rupture and the different signals after operative or nonoperative treatment. CONCLUSION: Using high-frequency probes with 10 or more MHz, it is possible to examine even the insertion area of the tendon or the pathology of a subachilleal bursa by tilting the probe. The dynamic examination and the comparison with the contralateral side in two planes should be included in a standardized examination procedure and are of great importance in some cases of fresh tendon ruptures. Knowledge of the physical principles and the possibility of misleading artefacts is crucial.

Achilles Tendon↗

Quantitative assessment of fracture healing. The value of computerised sonometry in a correlative animal experiment in sheep.

Usually follow-up of the healing process of bone fractures is by subjective assessment of standard X-rays, based on the clinician's personal experience. It is therefore impossible to completely avoid misjudgements in the evaluation of the mechanical stability. Other authors have reported that the mechanical response of bony structures to a knock impulse allows a definitive statement about the stiffness of a fracture. The practicability of computerised sonometry in computer-aided evaluation of the mechanical vibration reaction and the acoustic transmission of sound through osseous structures for assessing stability has been proved in experimental and clinical studies. We designed an animal study that would allow a systematic correlation between the diagnostic investigations in general use. As a main goal, this study tries to correlate sonography with other quantitative techniques, even if they are not used under everyday clinical conditions. Our results show that methods based on direct assessment of the mechanical stability between fracture fragments allow a more exact evaluation of fracture healing. This study helps to classify the results of computerised sonometry together with other diagnostic procedures used for the evaluation of fracture healing, and furthermore provides a basis for clinical interpretation of the findings of a new, non-invasive technique for precise quantitative assessment of fracture healing.

Animals↗

Early detection of delayed union in lower leg fractures using a computerised analysis of mechanical vibration reactions of bone for assessing the state of fracture healing.

Standard X-ray techniques are used to follow up the healing process of bone fractures. However, these methods allow only indirect conclusions about the stability of the healing bone, depending on the experience of the clinician. In addition, by radiologic means, delayed union or non-union can only be diagnosed on the basis of the absence of specific changes such as callus formation. Therefore, efforts have been made to develop alternative methods for monitoring the healing process. The measuring principle of a non-invasive method is based on evaluation of changes in mechanical vibration reactions. The measuring system is composed of two sound transducers, an amplifier module and an AD converter attached to a PC. The assessment of 150 healthy individuals as well as an initial measuring series after treatment of tibial fractures with an external fixator system revealed highly significant differences between intact and fractured tibias. Thus, computerised sonometry is capable of supplying quantitatively recordable information about the stability of a fractured bone at any time in the healing process. Furthermore, this non-invasive technique allows early diagnosis of disorders in the repair process by the absence of change in the parameters.

Biomechanical Phenomena↗

Proximal humeral fractures. Management techniques and expected results.

During a ten-year period (1978-1988), 143 of 1386 patients with proximal humeral fractures were treated with internal osteosynthesis. Ninety-seven proximal humeral osteosynthesis cases had adequate documentation, and 77 (80%) were available for clinical review. The 97 fractures were graded by the AO/ASIF classification and included 44 Group A, 32 Group B, and 21 Group C fractures. Exercise-stable osteosynthesis using T-plate, cloverleaf plate, or small condylar plate was performed in 70% of patients. In the remaining patients, a less rigid fixation, with Kirschner wires or screws and cerclage wires, was used. Fifty-two percent of the patients had excellent and good results, 15% had fair results, and 33% had poor results. Most poor results occurred in patients with four-part fractures (61% of poor results). Of the cases involving four-part fractures, however, 22% had an excellent result after internal fixation. Displaced four-part fractures or fracture-dislocations should be treated by reconstruction of the proximal humerus, especially in young patients. The use of minimal fixation rather than rigid fixation is considered after careful assessment of the condition of the soft tissue and blood supply of the humeral head fragments. Primary treatment with endoprostheses is required when internal fixation is impractical in AO/ASIF fracture Types C 2/3 and C3 fractures. Improved clinical results may be achieved, particularly in the more severe fracture types, with increased experience in techniques of internal fixation of proximal humeral fractures.

Female↗

[Arthroscopic technique for replacing the anterior cruciate ligament using a free patellar tendon transplant].

The replacement of the anterior cruciate ligament (ACL) by a free patellar tendon graft is a well-known procedure. The disadvantage is that the necessary arthrotomy destroys the nerve supply of the joint capsule. Therefore, we developed a procedure of ACL replacement that can be done by arthroscopy without opening the joint except for a small incision needed for the arthroscopy and working canal. The surgical technique is described.

Anterior Cruciate Ligament↗

[Conservative and semiconservative treatment of calcaneus fractures].

The functional closed and percutaneous techniques for the treatment of fractures of the os calcis are described. We compare the different classifications, reduction techniques, advantages and disadvantages, as well as the results, after open reduction and internal fixation in an attempt to determine the special indications.

Adult↗

Fractures of the humerus.

Early active mobilization of sporting injuries is usually necessary for good functional results. Stable fixation, especially in severe joint fractures, should therefore be achieved. Indications according to the different fracture types using the AO-Classification and the fixation techniques, are described for proximal, shaft and distal humeral fractures.

Athletic Injuries↗

[Post-traumatic hemarthrosis of the knee joint--an indication for arthroscopy].

Diagnostic arthroscopy including the use of a probe should be performed if the cause for a haemarthrosis of the knee cannot be established by radiological means. The clinical examination of the recently injured knee must be considered to be unreliable due to pain. In approximately one-third of knee injuries an incorrect or incomplete diagnosis is made. Even if ligamentous injuries can be established, arthroscopy is mandatory, because this is the only sure way in which acute and degenerative meniscal or cartilaginous lesions can be diagnosed. Arthroscopy should be performed under general or spinal anaesthesia to allow the use of a tourniquet and the immediate repair of ligaments if deemed necessary. The experienced arthroscopist needs only a few minutes to obtain information that could influence the approach to the injury and its longterm prognosis. In a series of 1238 arthroscopies 252 (20.3%) were done for haemarthrosis of unknown origin. In 68% of these cases diagnosis could only have been established by arthroscopy. In this series of 252 cases 23% had an isolated complete anterior cruciate ligament (ACL) injury, 28% had anterior-medical instability, 8% had partial ACL lesions, 5% posterior cruciate ligament injuries, 15% medial collateral ligament injuries, 11% had only synovial tears or contusions. 5% of cases had chronic ACL instability, 4% had osteochondral fragments which could not be diagnosed radiologically. A recent traumatic patellar dislocation with a tear of the retinaculum was found in 1.6% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthroscopes↗

Eighty-five talus fractures treated by ORIF with five to eight years of follow-up study of 69 patients.

Four types of talus fractures can be distinguished and the prognosis predicted on the basis of vascular patterns before and after injury. Early decompression of the soft tissues or anatomic reduction by closed or (if not possible) open methods is indicated. Stable fixation by lag screws and functional aftertreatment help to improve the prognosis. The late results with reference to necrosis, posttraumatic arthrosis, secondary arthrodesis, and functional outcome show that open reduction and internal fixation, applied early, can produce better functions than was heretofore thought possible. Special emphasis is placed on careful indications, operative techniques, and postoperative treatment--particularly the time of partial weight-bearing with a caliper brace.

Arthritis↗

Results of AO plate fixation of forearm shaft fractures in adults.

A series of 111 forearm fractures in 108 individuals involving 177 individual bones, and treated by AO plating is reported. There were 18 different surgeons. Open fractures occurred in 24 per cent of limbs. Reviews at a mean of 3 years after the accident showed 97 per cent of bones to be solidly united, and satisfactory function to be achieved in 80 per cent of limbs. Deep infection occurred 6 times, and non-union in 7 bones. Cross-union developed in 6 patients, all of whom had sustained head injuries. Seven patients sustained operative nerve injuries. It is felt that the implant of choice at the moment is the small fragment Dynamic Compression Plate (DCP).

Adolescent↗