| 1. |
- Weber, U, et al.
(författare)
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[Rare pathological alterations of the upper cervical spine requiring surgical treatment]. : Seltene krankhafte Veränderungen der oberen Halswirbelsäule mit operativer Behandlungsindikation.
- 2006
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Ingår i: Der Orthopade. - : Springer Science and Business Media LLC. - 0085-4530 .- 1433-0431. ; 35:3, s. 296-305
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Tidskriftsartikel (refereegranskat)abstract
- Because of its unique anatomy, specific diseases and lesions arise in the upper cervical spine, which differ widely from the rest of the spine. During the last two decades standardised diagnostic and therapeutic algorithms have been defined for most of the craniocervical pathologies often occurring in combination with an underlying disease requiring surgical intervention as well. On the other hand there are some very rare phathological alterations: about 20% of the patients suffering from neurofibromatosis type I develop spinal deformities. These are mostly found in the thoracic and lumbar spine (dystrophic/non-dystrophic type). In rare cases the dystrophic neurofibromatosis type I involves the upper cervical spine leading to bizarre deformities endangering the spinal cord. An aggressive, timely and combined operative therapy is necessary. Patients with Down syndrome should be investigated regularly for affections of the upper cervical spine. Though only in about 1% of all patients with Down syndrome do instabilities require surgical intervention, the upper cervical spine should be screened on a regular basis, since neurological changes due to the pathognomy of the underlying disease often remain undetected for a long time. The operative therapy of the instable os odontoideum in Down syndrome follows the general principles of this pathoanatomical variation. Even though the Klippel-Feil syndrome is generally not linked with neuropathological findings, rare associated deformities of the upper cervical spine should be excluded by proper diagnostic procedures.
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| 2. |
- Carlsson, Åke
(författare)
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Einfach- und doppeltbeschichtete STAR-Sprunggelenkprothesen
- 2006
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Ingår i: Orthopade. - : Springer Science and Business Media LLC. - 1433-0431. ; 35:Apr 21, s. 527-532
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Tidskriftsartikel (refereegranskat)abstract
- An up to 12-year follow-up of 51 single-coated STAR revealed that 15 ankles had undergone fusion. The mean time from primary surgery to the first revision was median 51 months. In a series of 58 double-coated STAR ankles followed up to 5 years only one ankle had to be revised for component loosening. In this series the clinical survival rate was 98% and the radiographic survival rate 94% at 5 years. The radiographic survival rate, with component loosening as endpoint, was significantly better for the last 31 cases in the series of the single-coated prostheses. However, the loosening rate did not differ when these latter 31 cases were compared with the cases operated on with a double-coated prosthesis. One may conclude that improvement of the anchoring surfaces has had a limited influence on the radiographic survival of the STAR ankle. However, from the clinical survivorship figures it is obvious that the learning process continues as the difference in revision rate between the 31 last implanted single-coated and the later on implanted double-coated prostheses approached significance.
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| 3. |
- Heyde, C E, et al.
(författare)
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[Fatal complex fracture of the cervical spine in a patient with ankylosing spondylitis after a fall from a racing bicycle]. : Fatale komplexe HWS-Verletzung bei M. Bechterew nach Sturz mit dem Rennrad.
- 2007
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Ingår i: Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin. - : Georg Thieme Verlag KG. - 0932-0555. ; 21:3, s. 148-51
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Forskningsöversikt (refereegranskat)abstract
- Patients with ankylosing spondylitis are endangered suffering from cervical spine fractures following falls caused by kyphosis, stiffness and osteoporotic bone quality of the spine. Risk sustaining neurological deficits is higher than average. We present a patient with ankylosing spondylitis, who was admitted to our hospital with a complex fracture pattern of the cervical spine after a fall from a racing cycle. In spite of early operative treatment the patient died in the follow up because of severe hypoxic brain damage. We discuss the area of conflict between the recommendation for sport activities in patients with ankylosing spondylitis and the resulting risks for the diseased spine.
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| 4. |
- Heyde, C E, et al.
(författare)
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[Treatment options for problematic thoracic and lumbar osteoporotic fractures]. : Behandlungsmöglichkeiten bei thorakalen und lumbalen osteoporotischen Problemfrakturen.
- 2008
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Ingår i: Der Orthopade. - : Springer Science and Business Media LLC. - 0085-4530 .- 1433-0431. ; 37:4, s. 307-20
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Forskningsöversikt (refereegranskat)abstract
- Most osteoporotic sintering fractures are treated conservatively. However, persistent pain and consecutive spinal deformity may require certain cement-augmenting interventions. These procedures have proven their intermediate-term efficacy in pain reduction, prevention of progressive sintering and improvement of the overall quality of life in the majority of patients. In fractures with relevant spinal stenosis, persisting instability, gross deformity and trauma-associated osteoporotic fractures with or without neurological deficits, the therapeutic options may call for more extensive surgical procedures. In this regard, poor bone quality, age and respective comorbidities of the individual patient must be considered during preoperative planning and management. This article provides an overview of the diverse problem-solving strategies discussed in today's literature. It is generally acknowledged that any decision to perform surgery on an osteoporotic fracture is strongly case-dependent. Treating physicians must therefore master the complete therapeutic spectrum in order to meet this complex orthopedic challenge appropriately.
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| 5. |
- Brorson, Håkan
(författare)
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Fettabsaugung des Lymphödems am Arm
- 2003
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Ingår i: Handchirurgie, Mikrochirurgie, Plastische Chirurgie. - 0722-1819. ; 35:4, s. 32-225
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Tidskriftsartikel (refereegranskat)
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| 6. |
- Eklof, Bo G., et al.
(författare)
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Revised CEAP classification for chronic verrous disorders
- 2005
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Ingår i: Phlebologie. - 0939-978X. ; 34:4, s. 220-225
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Tidskriftsartikel (refereegranskat)abstract
- The CEAP classification for chronic venous disorders (CVD) was developed in 1994 by an international ad hoc committee of the American Venous Forum, endorsed by the Society for Vascular Surgery, and incorporated into "Reporting Standards in Venous Disease" in 1995. Today most published clinical papers use all or portions of CEAP. Rather than have it stand as a static classification system, an ad hoc committee of the American Venous Forum, working with an international liaison committee, has recommended a number of practical changes, detailed in this consensus report. These include refinement of several definitions used in describing CVD; refinement of the C classes of CEAP, addition of the descriptor n (no venous abnormality identified); elaboration of the date of classification and level of investigation; and as a simpler alternative to the full (advanced) CEAP classification, introduction of a basic CEAP version. It is important to stress that CEAP is a descriptive classification, whereas venous severity scoring and quality of life scores are instruments for longitudinal research to assess outcomes.
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| 7. |
- Giesecke, T., et al.
(författare)
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Zentrale Schmerzverarbeitung bei chronischem Rückenschmerz : Hinweise auf verminderte Schmerzinhibition : Central pain processing in chronic low back pain : Evidence for reduced pain inhibition
- 2006
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Ingår i: Schmerz. - : Springer Science and Business Media LLC. - 0932-433X. ; 20:5, s. 411-417
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: A study of patients with low back pain (LBP) had revealed altered central pain processing. At an equal pain level LBP patients had considerably more neuronal activation in the somatosensory cortices than controls. In a new analysis of this dataset, we further investigated the differences in central pain processing between LBP patients and controls, looking for possible pathogenic mechanisms.METHODS: Central pain processing was studied by functional magnetic resonance imaging (fMRI), using equally painful pressure stimuli in a block paradigm. In this study, we reanalyzed the fMRI data to statistically compare pain-elicited neuronal activation of both groups.RESULTS: Equally painful pressure stimulation resulted in a significantly lower increase of regional cerebral blood flow (rCBF) in the periaqueductal gray (PAG) of the LBP patients. The analysis further revealed a significantly higher increase of rCBF in LBP than in HC in the primary and secondary somatosensory cortex and the lateral orbitofrontal cortex (LOFK), elicited by these same stimuli.CONCLUSIONS: These findings support a dysfunction of the inhibitory systems controlled by the PAG as a possible pathogenic mechanism in chronic low back pain.
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| 8. |
- Gohritz, A, et al.
(författare)
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Ersatzoperationen bei Ausfall motorisher Funktionen an der Hand : Tendon transposition to restore muscle function in the hand
- 2007
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Ingår i: Der Unfallchirurg. - : Springer Science and Business Media LLC. - 0177-5537 .- 1433-044X. ; 110:9, s. 759-76
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Tidskriftsartikel (refereegranskat)abstract
- Nerve injuries in the upper extremity can result in severe disability. In the last three decades, progress in microsurgical techniques has improved the outcome for nerve injuries and if the prognosis is reasonably good, nerve repair should usually be performed prior to tendon transfer procedures. However, above all proximal lesions of peripheral nerves such as high radial nerve palsy still often yield unsatisfactory results, despite a technically well-executed nerve repair. Prognosis further depends on the time interval since the injury and also on the age of the patient, as the regenerative process is delayed in older patients. The indication for tendon transfers strongly depends on the personal and professional profiles of the individual patient. Tendon transfer procedures alleviate the suffering from functional hand impairment providing a superior alternative to permanent external splints. Tendon transfers are usually secondary procedures for replacing function after evaluation of the functional motor loss. Numerous transfer procedures have been described for every nerve trunk of the upper extremity, their prognosis depending mainly on the extent and pattern of nerve loss, local effects of the trauma (e.g. involvement of soft tissues, joints), and the physiological characteristics of the transferred muscle. Even if the results of the tendon transfers may finally be less satisfactory in cases of complex nerve damage than in isolated motor nerve lesions, they offer a valuable functional benefit, often being the only possibility to restore hand function. Although regrettably underused, tendon transfer improve upper extremity function in more than 70% of patients with cervical spinal cord injury. Reconstruction of key elements such as wrist extension, key grip between the thumb and the index finger, or digital flexion and extension leads to highly improved use of the tetraplegic hand and thus provides new mobility and independence from the help of others. This article presents an overview of the most common procedures to restore hand function in peripheral nerve injuries and tetraplegia in order to provide a systematic approach for decision making.
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