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1.
Volkmar Heppert Ulrich Glatzel Thomas Schmickal Andreas Wentzensen 《Trauma und Berufskrankheit》2002,4(4):431-439
External fixation is an apparently simple and therefore highly fascinating method for the stabilization of fractures.Minimally invasive incisions guarantee that regional soft tissue perfusion is conserved after trauma,which makes it the best procedure for stabilization of fractures combined with severe soft tissue damage.However, modern trauma surgery is subject to cyclical trends in the same way as fashion is; noninternal devices are currently barely tolerated.The literature suggests that specialists are virtually competing to see who can stabilize fractures with the most severe soft tissue damage by internal procedures – with the best results, of course. It seems, then, that times are hard for external fixation, but we still believe that for fractures with severe soft tissue damage external fixation still brings a lot of benefit to the patient. 相似文献
2.
Paul Hochstein Ulrich Glatzel Thomas Schmickal Andreas Wentzensen 《Trauma und Berufskrankheit》2002,4(2):s110-s114
The treatment of deep cartilage defects in load-bearing joints is a problem that still has no satisfactory solution. Full-thickness defects of the articular cartilage rarely heal spontaneously, usually leaving damage that can lead to early arthrosis. Techniques currently available for the treatment of chondral defects include abrasion, drilling, micro-fracturing, transplantation of tissue autografts and allografts, and cell transplantation. Osteochondral autograft transplantation is currently the only surgical cartilage repair technique known to lead to the formation of genuine hyaline articular cartilage and its retention at least in the medium term. The Draenert method, in which a water-cooled diamond bone-cutting system is used, is an effective procedure for resurfacing the joints affected by localised cartilaginous defects, even when there is also severe bone loss. Donor-side morbidity can be kept to a minimum by filling the defect caused by harvesting with a press-fit cylinder of cancellous bone covered with periosteum for protection. 相似文献
3.
Trauma und Berufskrankheit - Die Berufsgenossenschaft der chemischen Industrie hat eine Fall-Kontroll-Studie durchgeführt, um Effekte einer Interventionsstrategie des Sachbearbeiters zusammen... 相似文献
4.
To determine the specifications of a hinged fixator for the upper ankle joint, biomechanical investigations were performed on 20 human cadaver specimens and the talocrural axis was recorded by X-ray cinematography in all levels of the space.The results showed a medium variation of the axis in zero position (mean: 5.8 degrees ) from 3 degrees to 10 degrees in the anterior-posterior view. The span of the axis migration around zero position amounted to a minimum of 3 degrees and a maximum value of 10 degrees (mean: 7.2 degrees ). It could be ascertained that the axis kinetics does not move linearly in all cases. The talus rotation (the axle deviation from the sagittal plane) amounted to a minimum value of 2 degrees and a maximum value of 12 degrees (mean: 5.3 degrees ). In the transverse level, the axis kinetics was tracked by separate X-ray markings of the lateral and medial cortical of the talus in the zero point of the talocrural axis.The results were typical migration curves of the X-ray markings, demonstrating a ventral convex curve at the medial and lateral cortex. This migration of the cortex crossing point of the axis was geometrically entered in a coordinate system. The variance of the axis cortex crossing point at the medial cortical was X(M)=4.2 mm (min: 2 mm, max: 7 mm) and Y(M)=4.7 mm (2-7 mm), at the lateral cortical X(L)=3.7 mm (1-9 mm) and Y(L) =4.1 mm (1-8 mm). Regarding the clinical relevance for the development of a hinged fixator for the upper ankle joint, the results indicate that an external axis guidance of these axoids is not possible, but that an adjusted axis is necessary taking into consideration the values measured using ligamentotaxis. 相似文献
5.
Possible indications for the use of biodegradable implants are presented and the chemical compounds in question are briefly described. The results of a laboratory investigation to determine mechanical stability, tensile strength and molecular weight are reported, in order to characterize the polymers and co-polymers of the lactide under study. 相似文献
6.
Thomas Schmickal und Andreas Wentzensen 《European Journal of Trauma》1999,25(2):64-70
Zusammenfassung Zur Bestimmung der Voraussetzungen für einen Bewegungsfixateur des Ellbogengelenks wurden acht menschliche Kadavergelenke anatomisch und biomechanisch untersucht. Als Ergebnis konnte beobachtet werden, daß die Achsenschwankungen des Ellbogens mit maximal 3° wesentlich geringer anzusehen sind als bisher angenommen. Die Untersuchungen ergaben, daß die Extensions-Flexions-Bewegung nicht allein von dem Winkel zwischen Humerusschaft und Ulnaschaft abhängt. Zusätzlich beeinflussen die Winkeländerungen des Incisura-trochlearis-Verlaufs und die Winkelabweichungen des Humerus- und Ulnaschaftes von der Gelenkebene sowie der Abwinklung der Incisura ulnae vom Ulnaschaft und die unterschiedlichen Ventralabwinklungen der radialen und ulnaren Rolle die Ellbogengelenkbewegung.Als Konsequenz aus den Untersuchungen wurden ein Scharniergelenk für ein externes Fixationssystem entwickelt und die Gelenkfuhrung röntgenkinematographisch untersucht. Als Resultat wurde festgestellt, daß sich in allen acht Fällen nach vollständiger Banddurchtrennung eine korrekte Gelenkführung ohne Abweichung vom physiologischen Gelenkverlauf ergab. Das Scharniergelenk erfüllt nach dieser Untersuchung die Funktion einer externen Gelenkführung des Ellbogens im Sinne einer Näherungslbsung. 相似文献
7.
The discussion about the therapy of the posterior cruciate ligament persists. Conservative treatment, augmented repair, and
reconstruction with autografts are discussed. From 1993 to 1997, 49 patients with posterior cruciate ligament rupture had
repair Trevira ligament augmentation of 3 mm. There were 21 isolated and 28 combined ruptures. In 5 cases bony avulsions were
refixed by screw or additional hook plate. Investigation of 36 patients, in 15 cases with isolated ligamentous ruptures was
made. Osseous avulsion had good results in all cases. Isolated posterior cruciate ligament rupture showed good stability in
7 of 15 cases and instability of 2 + in 8 cases. The medial range Lysholm score was 76.8 (+/− 21.6), the OAK score showed
2 very good and 5 good results, 3 fair and 5 bad results. Using the IKDC score led to 3 very good and 4 good results, 2 fair
and 6 bad results. Using subjective criteria, 10 patients described results as very good or good, 2 fair and 3 bad. Posterior
cruciate ligament rupture with additional knee injury or fracture of the leg showed bad results in 60 % of cases, and good
or fair results in only 40 %. We think augmented repair of fresh injury of the posterior cruciate ligament can be used as
an alternative therapy to reconstruction with autograft. 相似文献
8.
Dr. T. Schmickal A. Zwick B. Schinke K. Lederle A. Wentzensen 《Trauma und Berufskrankheit》2007,9(2):103-108
Fracture healing in tibia fracture, treated with an external fixator, can be followed by stiffness measurement at the fixator rod. For additional information a permanent data recording system with strain gauges integrated into the fixator rod and additional acceleration sensor was built and used for aftercare in the treatment of tibia fracture with an external fixator. The system was used in a clinical trial with six patients and provided additional information about stability of regular fracture healing and complications (delayed healing, Schanz screw failure). As a result permanent stiffness measurement in external fixator treatment of a distal leg fracture can furnish additional information about fracture healing. 相似文献
9.
Hochstein Paul Glatzel Ulrich Schmickal Thomas Wentzensen Andreas 《Trauma und Berufskrankheit》2014,4(2):s110-s114
Trauma und Berufskrankheit - Die Behandlung tiefer Knorpeldefekte in belasteten Gelenken stellt nach wie vor ein erhebliches Problem dar. Gröbere und tiefe Defekte heilen nur selten spontan... 相似文献
10.