Beitrage zur Orthopadie und Traumatologie最新文献

The clinical use of SB endoprosthesis and new international models and research results have increased the importance of functional intervertebral disc prosthetics as an alternative method to certain fusion operations. An analysis of the development of intervertebral disc prostheses and special problems regarding this development will be discussed.

56 patients with fractures of the tibial plateau were treated at the surgical department of the Wilhelm-Pieck-University Rostock between 1980 and 1987. 18 of these underwent on operative treatment, 38 patients were treated nonoperatively. Using a clinical and radiological follow-up on 35 of these patients the results after operative and functional-conservative treatment are shown and the indications for the different methods are concluded.

By means of a consultation with patients is reported about satisfaction and quotes of success at 195 hallux valgus deformity-operations. As a most used method has proved the 2/3 resection according Brandes, which has a high quotes of success. It is reported and discussed about alternative operations, which more respect different variations and claims of feet.

During a 6-year period from 1983 to 1989 we performed lumbal discography in 403 disc levels on 144 patients. We used the discography to determine the therapeutic way in patients with chronic back pain. In the greater half it was possible to define the symptomatic level exactly. About 90% the discography was very helpful to get a diagnosis or to plan the therapy. The reproduction of pain with discography is helpful in the assessment of abnormal disc levels. Even today in view of CT and MRI.

There is reported about 63 cases of ruptures of the Achilles-tendon from 1969 to 1988. A comparison was made between a modificated tendon suture by Kirchmayr and its combination with the tendon plastic by Silfverskjöld. This resulted into the conclusion that the anatomical reconstruction of the Achilles-tendon is sufficient for good functional results if this operation takes place primary.

Based on a disproportion between individual exercise tolerance and actual physical strain a multicausal tender swelling of achilles tendon with concomitant impaired function due to oedematous swelling, cellular proliferation and degeneration in tendon and paratenon is developing especially in motion engaged professionals like dancers artists and sportsmen. Consistent prevention of paratenonitis exist in selection of favourable bottom or mal conditions, maintenance of muscular balances, correction of ligamentous laxities and foot deformities, fitting chuck absorbing footwear and every time dosed increase of physical strain. While in acute stage after elimination of causative factors the conservative treatment is indicated, the treatment resistant chronic achillodynia with anamnesis of 4 month and more is an indication for operative treatment.

In varus deformity of the knee describes the lateral tilt of the shank the disturbed weight bearing situation more completely than the well known femorotibial angle. The results of a retrospective study concerning 66 high tibial osteotomies showed at the follow up-status a bigger influence of the tibial tilt in comparison to a smaller one of the femorotibial angle. The postoperative lateral tibial tilt should range from 4 to 6 degrees. It seems useful to consider the tilt of the shank to indicate high tibial osteotomy.

The paper analysis the therapeutic effects of isometric training and electromechanic therapy (EMT) of the quadriceps muscles on subjects. The effects of the training practised with the knee joint bent was to be compared with previous results of training with the knee joint stretched. 36 subjects were trained and the increase in strength was measured with the help of a strain gauge dynamometer. Again a marked superiority of the EMT over sole isometric training could be demonstrated. More over, the results showed that the increase of the isometric maximal strength following an EMT is not influenced by the position of the angle of the joint.

The rare syndrome of Lér's melorheostosis is described on the basis of a case encountered in one of our own patients, a 29 year old male patient. Particular attention is given to the symptoms, the specific results of clinical examination, and the differential diagnosis.

We discuss in 118 hip endoprostheses on the basis of Protrusio acetabuli in rheumatoid arthritis the possibilities of the fixation of the artificial acetabular component. The efficiency of autologous cancellous bone grafts avoids a further progression and additional alloplastic implants were not necessary.