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Königshausen M, Schliemann B, Schildhauer TA, Seybold D. Evaluation of immobilization in external rotation after primary traumatic anterior shoulder dislocation: 5-year results. Musculoskelet Surg 2013; 98:143-51. [PMID: 23737143 DOI: 10.1007/s12306-013-0276-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 05/22/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND It is still not clear which method is the most efficient for treating primary traumatic anterior shoulder dislocation. Immobilization in external rotation has become increasingly discussed within the last 10 years. The aim of this study was to evaluate the rate of recurrence and clinical outcome of the immobilization in external rotation after primary traumatic anterior dislocation within a midterm period of 5 years. Additionally, a summary of literature is given according to the present knowledge of this issue. METHODS From May 2004 to May 2006, 28 patients with primary traumatic anterior shoulder dislocations were included in a prospective MRI-controlled study. After a follow-up of 5 years, the recurrence rate and clinical outcomes of the patients were evaluated using clinical scores (Constant and Murley score, Western Ontario Shoulder Instability Index, Rowe score). RESULTS After 5 years, 26 patients (93 %; males, n = 25; female, n = 1; mean age, 29.3 years) were interviewed concerning re-dislocations. In the meantime, four patients (15 %) experienced a re-dislocation (ø 12.2 months) after the end of the immobilization. Overall, 21 patients (75 %) were included in a clinical follow-up (CM score: ø 92.8 points; Western Ontario Shoulder Instability Index: ø 87 %; Rowe score (in 17 patients): ø 94.2 points). Upon clinical examination, unidirectional anterior instability was found in one patient, which corresponds to an overall instability rate of 19 % within the examined patient population including the re-dislocations. CONCLUSIONS Immobilization in external rotation shows satisfactory results after 5 years in regard to recurrence and instability rates and clinical outcomes. The data show that with immobilization in external rotation, re-dislocations occur within the first 2 years.
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kali M, Kuruvilla J, Lucas D, Broce M, Seybold D, Reyes B. Abstract 33: Incidence Of Urinary Tract Infection Among Patients With Acute Cerebrovascular Accidents: A Possible Trigger For Stroke. Circ Cardiovasc Qual Outcomes 2013. [DOI: 10.1161/circoutcomes.6.suppl_1.a33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Acute infections and other inflammatory stimuli have emerged as important triggers of vascular events. Previous studies have reported 25 to 35% antecedent infection rates among patients with acute cerebrovascular accidents (CVA). The mechanisms involved in acute infection include immunological mediated activation of platelets and endothelial dysfunction. The incidence of antecedent UTI has not been reported and could establish an important relationship between UTI and CVA.
Objective:
The aim of the current study was to determine and compare the incidence of antecedent UTI among CVA patients to reported UTI rates among the general population.
Methods:
This was a retrospective review of 1295 medical records for CVA from the emergency department in a high volume tertiary care center. Our cohort included CVA patients that also had urinalysis within 72 hours prior to or less than 24 hours after admission. Patients with bacteriuria without any of the additional findings were excluded. The incidence of UTI was compared to the infection rate calculated for a hypothetical equal size comparison group based on previously reported literature (i.e., historical controls).
Results:
Thirty-seven percent (476/1295) of the patients met inclusion criteria of simultaneous CVA and urinalysis. The overall crude incidence of UTI was 39.3% (187/476). Ischemic strokes accounted for a larger percentage of abnormal urinalysis (74.9%), when compared to hemorrhagic strokes (25.1%). Nonetheless, patients suffering hemorrhagic strokes had similar rates of UTI (40.2%) versus Ischemic Stroke Patients (38.7%). The incidence of UTI was significantly higher than reported infection rates of general population controls (187/476=39.3% versus 52/424=10.9%, p<0.001).
Conclusion:
Our findings provide some evidence that the incidence of UTI is significantly higher for patients with CVA than is found in the general population
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Godry H, Citak M, Königshausen M, Schildhauer TA, Seybold D. [A new reduction technique for posterior locked shoulder dislocation. Case report and technique description]. Unfallchirurg 2013; 115:754-8. [PMID: 22159504 DOI: 10.1007/s00113-011-2115-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The case of a 61-year-old male with posterior dislocation of the right shoulder joint is presented and a new technique for closed reduction of posterior locked shoulder dislocation is described. The technique involves four steps: in step 1 a constant traction is applied on the injured arm, in step 2 the arm is internally rotated and in steps 3 and 4 the second arm of the physician is used as a lever arm to lateralize and ventralize the shoulder. Lateralization and ventralization of the humeral head are essential to engage the humeral head and to pass it around the glenoid during reduction. Steps 3 and 4 are performed simultaneously. In the presented case the patient suffered a traumatic shoulder dislocation with a rim fracture of the glenoid. After reduction the shoulder was stable and conservative treatment was performed. A 2 year follow-up examination revealed a pain-free and stable shoulder with free range of motion and an Oxford instability score of 48 points. The described reduction technique for posterior locked shoulder dislocation is a simple and gentle technique, which can be performed easily by one person.Presentation of a reduction technique for locked posterior shoulder dislocation. Constant traction and internal rotation is performed for engaging the locked humeral head. After disengaging the humeral head the reduction is performed by using the arm of the physician as a lever arm.
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Turner S, Seybold D, Celestine C, Williams D. Incidence of Anemia Among Obstetric Patients in an Appalachian Teaching Clinic. Mil Med 2012; 177:1212-6. [DOI: 10.7205/milmed-d-11-00445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Königshausen M, Kübler L, Godry H, Citak M, Schildhauer TA, Seybold D. Clinical outcome and complications using a polyaxial locking plate in the treatment of displaced proximal humerus fractures. A reliable system? Injury 2012; 43:223-31. [PMID: 22001506 DOI: 10.1016/j.injury.2011.09.024] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 09/19/2011] [Accepted: 09/23/2011] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The surgical treatment of displaced proximal humeral fractures (ORIF) is a perpetual challenge to the surgeon. For this reason, the principle of polyaxiality was developed to provide an improved primary stability of the fracture through better anchorage of the screws, especially in osteoporotic bone. The aim of this study was to present clinical results with the polyaxial locking plate in the operative treatment of proximal humerus fractures in order to determine whether the technique of polyaxiality leads to better functional outcome and lower complication rates in comparison to monoaxial plates in the literature. PATIENTS AND METHODS Seventy-three patients with displaced proximal humeral fractures were treated surgically with the polyaxial locking Suture Plate™ (Arthrex(®)) between 03/2007 and 06/2009. Fifty-two of the patients (mean age, 69.9 ± 12.1) were included in a radiographical and clinical examination using the Constant score (CS) and the Disabilities of the Arm, Shoulder and Hand score (DASH). RESULTS The follow-up examinations were on average 13.9 ± 4.5 months (10-27 months) after surgical treatment. The mean CS of the patients was 66.0 ± 13.7 points, the age- and gender-related CS was 90.9% ± 20.0% and the mean DASH score was 23.8 ± 19.8 points for the injured side. The patients with a nearly anatomical reduction of their fracture (n = 13) reached a significantly higher CS (75.1 ± 8.5; p = 0.004) and DASH-score (13.6 ± 11.6; p = 0.043) and none of these patients had a complication. The complications were identified in 12 (23.1%) cases, 5 of which involved loss of reduction. All of these 5 cases were lacking of initial medial column support and 4 of which were type C2.3 AO-Classification. CONCLUSION The data show that the combination of angular stability with the possibility of variable polyaxial screw direction is a good concept for reduction and fixation of displaced proximal humeral fractures, but anatomical reduction and medial support remain important preconditions for a good outcome. However, a significantly lower rate of complications or better clinical outcome than that reported in the literature could not be found.
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Seybold D, Königshausen M, Geßmann J, Schildhauer TA. Glenoidrekonstruktionen in der Revisionsendoprothetik der Schulter. Zentralbl Chir 2011. [DOI: 10.1055/s-0031-1288999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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32
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Königshausen M, Nicolas V, Schildhauer T, Seybold D. Die konservative Therapie anteroinferiorer Pfannenrandfrakturen der Schulter. Zentralbl Chir 2011. [DOI: 10.1055/s-0031-1289000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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33
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Seybold D, Schliemann B, Geßmann J, Schildhauer TA. Die Duokopfprothese zur Therapie der Schenkelhalsfraktur – Einfluss von OP-Dauer, Tageszeit und Erfahrung des Operateurs auf die Komplikationsrate. Zentralbl Chir 2011. [DOI: 10.1055/s-0031-1288965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Geßmann J, Jung S, Schildhauer TA, Seybold D. Die Pirogoff-Amputation mittels Ilizarov-Osteosynthese bei Infekt-Defektsituationen des Fußes. Zentralbl Chir 2011. [DOI: 10.1055/s-0031-1288982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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35
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Heyer CM, Seybold D, Ozokyay L, Lemburg S. [Unilateral pseudo-Madelung deformity as initial manifestation of Ollier disease in a 9-year-old girl]. ROFO-FORTSCHR RONTG 2011; 183:977-9. [PMID: 21863539 DOI: 10.1055/s-0031-1281613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Gessmann J, Ozokyay L, Fehmer T, Muhr G, Seybold D. [Arthrodesis of the infected ankle joint: results with the Ilizarov external fixator]. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2010; 149:212-8. [PMID: 20941692 DOI: 10.1055/s-0030-1250360] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The treatment of severe bacterial infections of the ankle joint is difficult and complex. In the case of a chronic infection with destruction of the ankle joint, a tibiotalar arthrodesis with external fixation is the treatment of choice. In this study the results of ankle arthrodesis due to bacterial infection using the Ilizarov external fixator are presented. PATIENTS AND METHODS Between 2001 and 2004 37 patients (10 female, 27 male, mean age 58 years) were treated with a tibiotalar arthrodesis using the Ilizarov fixator. All patients had a confirmed infection in the course of their disease. Active infection was present in 20 patients at the time of the operation. Most secondary ankle arthritides (81 %) were caused post-traumatically after various internal fixation procedures. Previous ankle arthrodeses were tried in 14 cases (12 cases with internal fixation, two cases with external monolateral fixation). Patients were treated with a four-ring Ilizarov frame (in two cases with a five-ring frame) and stainless steel wires. All patients could be included at a mean follow-up of 46 (12-49) months. A modified AOFAS score was used for the functional outcome. RESULTS The operation took 141 minutes at an average ranging from 90 to 252 minutes. The inpatient treatment lasted between 10 and 63 days (mean 26 days). The time spent in the fixator was 116.7 (69-245) days. All patients were mobilised under full weight bearing with the external fixator. Surgical revision was necessary in 13 patients: four patients needed wound revisions due to ongoing infection, six patients needed wire exchange due to deep infection in three cases and wire breakage in three cases, one patient needed additional wires because of an initially instable frame configuration and two patients needed secondary skin grafting. Bony consolidation was achieved in 32 patients (86.5 %). With a re-arthrodesis performed in four patients using the Ilizarov fixator, the overall fusion rate was 94.6 %. Infection was persistent in two cases with one solid ankle fusion and one ankle pseudarthrosis. At the time of follow-up 35 patients were able to walk under full weight loading with orthopaedic shoe modifications, four patients needed support of a cane and three patients wore an ankle-foot orthesis. The two patients with persistent pseudarthrosis were mobilised in a lower-leg orthesis after declining another surgical revision. The positioning of the hindfoot showed in seven cases an equinus of 10°, in one case a varus of 10° and in two cases a valgus positioning of 10°. A plantigrade foot positioning or with minimal degrees of deviation could be achieved in all other cases. The modified AOFAS score at the time of the follow-up examination ranged from 19 to 86 with an average score of 67.9 points. All patients except three were satisfied or rather satisfied with the treatment procedure and its results. CONCLUSION The Ilizarov external fixator is a safe method for ankle fusion in cases of infection. The advances are a possible application at acute infection and immediate mobilisation at full weight bearing. However, it remains a time-consuming and stressful procedure for the patient.
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Gessmann J, Baecker H, Graf M, Ozokyay L, Muhr G, Seybold D. [Operative treatment of pediatric open fractures of the lower limb using the Taylor spatial frame fixator]. Unfallchirurg 2010; 113:413-7. [PMID: 20174917 DOI: 10.1007/s00113-009-1720-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The operative management of open fractures of the lower limb requires a consistent treatment to avoid soft tissue complications. Acute angular shortening of the fracture enabling primary soft tissue closure is still an uncommon operative technique because of difficulties in correcting the secondary deformity. The case of a pediatric open fracture of the lower limb (Gustilo type IIIa) is described, which was treated with acute angular shortening followed by gradual correction using the Taylor spatial frame (TSF).
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Citak M, Backhaus M, Seybold D, Muhr G, Roetman B. [Arm wrestling injuries--report on 11 cases with different injuries]. SPORTVERLETZUNG-SPORTSCHADEN 2010; 24:107-10. [PMID: 20517803 DOI: 10.1055/s-0029-1245358] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Arm wrestling may cause severe injuries. Various injuries after arm wrestling have been reported in the literature, whereas the most common injury is the humeral shaft fracture. In this context we report on eleven cases with different injuries during arm wrestling. MATERIAL AND METHODS All patients were analyzed using a standardized questionnaire. The effect of drugs, pre-existing conditions and injuries as well as sport activities were examined. Furthermore we report about a 24 year old patient who sustained a radial shaft fracture which has not been reported in the literature yet. RESULTS 8 patients suffered from a fracture. The humerus was the most affected bone in 7 cases. 3 patients had a muscle strain, whereas in all 3 cases the patients were regularly sportive active and warmed-up be for the injury. Ten patients were reintegrated into the previous job after an average time period of 6 weeks. One patient was out of work. CONCLUSIONS Regular sport activity and the muscle strength are important factors for the injury intensity. Further studies are necessary to confirm this theory.
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Goetz MB, Seybold D, Gossé F, Muhr G, Roetman B. [The risk of nerve lesions in hip alloarthroplasty]. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2010; 148:163-7. [PMID: 20376758 DOI: 10.1055/s-0029-1240961] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM Repeated luxations, periprosthetic fractures, infections, and nerve palsies are the most frequent complications of hip alloarthroplasty. Paresis acquired during elective implantation entails considerable restrictions in the quality of life. The risk of sustaining a nerve injury depends upon the initial clinical situation, cases of planned leg lengthening in patients with hip dysplasia and high luxations being particularly at risk. METHOD A Medline search was conducted using the query "nerve palsies during hip prosthesis implantation", yielding 126 publications, of which 18 were used to predict the risk of nerve palsies in cases with simultaneous leg lengthening during total hip arthroplasties according to different preconditions. RESULTS The risk for an acquired nerve lesion during hip alloarthroplasty in arthritis was 0.5 %. In cases of hip dysplasia (with no or moderate leg lengthening during the procedure), the risk was increased to 2.3 %. An even higher risk of 3.5 % was found in cases of revision surgery. According to the literature, the risk of nerve palsies in cases of continuous leg lengthening before THA is raised to 5.9 % with a linear correlation between the amount of leg lengthening and rate of nerve palsies. CONCLUSION Neural lesions during single-stage leg lengthening of less than 3 cm in hip alloarthroplasty are uncommon. More extensive lengthening can be achieved with continuous procedures, which should be conducted under clinical monitoring of the peripheral nerves to avert possible nerve injury.
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Schliemann B, Seybold D, Gessmann J, Fehmer T, Schildhauer T, Muhr G. Die Duokopfprothese zur Therapie der Schenkelhalsfraktur – Einfluss von OP-Dauer, Tageszeit und Erfahrung des Operateurs auf die Komplikationsrate. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2009; 147:689-93. [DOI: 10.1055/s-0029-1186204] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gessmann J, Seybold D, Helwing M, Muhr G, Schildhauer TA. [Solitary fibrous tumor of the pelvis: a rare extrathoracic manifestation]. DER ORTHOPADE 2009; 38:626-31. [PMID: 19499211 DOI: 10.1007/s00132-009-1444-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Solitary fibrous tumors (SFT) are rare spindle cell neoplasms. To date only very few cases of pelvic SFT have been reported in the literature. SFT are characterized by unique microscopic and immunohistochemical findings. Complete local resection is the treatment of choice. Recurrence and metastasis may be related to infrequent malignant histological features, but histology is not always a reliable predictor for prognosis. Therefore long-term follow-up is necessary.We report about a male patient with a malignant pelvic SFT. After complete resection the tumor recurred after a short period of 6 months posterior to the original location in the pelvis. The differential diagnoses and the therapy options are discussed with a review of the present literature.
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Königshausen M, Seybold D, Heyer CM, Muhr G, Gekle C. [Tuberculous rice body synovitis of the shoulder joint]. DER ORTHOPADE 2009; 38:1106-12. [PMID: 19680629 DOI: 10.1007/s00132-009-1461-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The clinical presentation of synovitis with rice bodies is found in a few systemic diseases as accompanying manifestations within joints or joint-associated bursa. A 79-year old patient was examined, who had complained of pain and swelling in the left shoulder for a long time. Sonography identified multiple spindle-shaped joint bodies within the joint effusion. MRI showed a large amount of so-called rice bodies with joint effusion in the shoulder and a massive destruction of the rotator cuff of the left shoulder. The histological examination showed a tuberculosis-specific inflammatory response with giant cells and epithelioid granulomas and molecular biological detection of Mycobacterium tuberculosis. Within a few months after surgical removal of the rice bodies from the joint space and the bursa a relapse occurred with repeated synovial effusion followed by a renewed surgical removal of the joint bodies. We describe the rare case of a patient with unilateral musculoskeletal manifestation of tuberculosis presented as synovitis of the left shoulder and the adjacent bursa with rice bodies and accelerated growth trend without coexisting active tuberculosis or tuberculosis in the previous history. Furthermore, a brief summary of the literature is given.
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Gessmann J, Seybold D, Baecker H, Muhr G, Graf M. Korrektur von sprunggelenksnahen Deformitäten mit dem Taylor Spatial Frame. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2009; 147:314-20. [PMID: 19551582 DOI: 10.1055/s-0029-1185299] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schliemann B, Seybold D, Muhr G, Gekle C. Die Ruhigstellung der Schulter in Außenrotation nach traumatischer Erstluxation – Was kann man seinen Patienten zumuten? Eine retrospektive Patientenbefragung. SPORTVERLETZUNG-SPORTSCHADEN 2009; 23:100-5. [DOI: 10.1055/s-0028-1109418] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Seybold D, Gessmann J, Ozokyay L, Muhr G, Graf M. [The Taylor Spatial Frame. Correction of posttraumatic deformities of the tibia and hindfoot]. Unfallchirurg 2009; 111:985-6, 988-95. [PMID: 19037621 DOI: 10.1007/s00113-008-1488-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Posttraumatic deformities in the lower limb are mainly multidirectional, with angulation, translation, and rotatory deformities. Acute corrections with internal fixation are often not possible due to the soft tissue damage and the extent of the deformity. The Taylor Spatial Frame (TSF) allows correction in a virtual hinge with 6 axes, thus enabling the correction of multidirectional deformities simultaneously. METHODS From February 2003 until December 2006, we applied 31 TSFs to 20 patients with a posttraumatic deformity of the tibia and hindfoot. The mean patient age was 41 years (range 12-73). 9 patients had a nonunion of the tibia with deformity, 6 had a malunion of the lower tibia and ankle, 3 had an angular deformity after ankle fusion, and 2 had malaligned Ilizarov bone segment transports. The mean follow-up time was 25.3 months (range 10-82). RESULTS In all 20 patients, full correction of the deformity was achieved. The mean time for correction was 29 days (range 5-82). On average, the frame was worn (time to healing) 164.2 days (80-300) and the mean distraction rate was 1.1 mm/day (0.5-2.0). The Web-based planning was done two times per case for full deformity correction. Complications were 3 pin-site infections, 2 insufficient callus formations and 1 pinhole stress fracture. CONCLUSIONS The main advantage of the TSF compared with other external frames is the ability to perform simultaneous correction of angular, axial, translational, and rotatory deformities. This enables a reduced correction time and increased patient comfort.
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Seybold D, Geßmann J, Özokyay L, Bäcker H, Muhr G, Graf M. Die Korrektur von posttraumatischen Fehlstellungspseudarthrosen der Tibia mit dem Taylor Spatial Frame. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2009; 147:26-31. [DOI: 10.1055/s-2008-1038978] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gessmann J, Seybold D, Baecker H, Muhr G, Graf M. [The Taylor spatial frame fixator. Soft-tissue distraction for post-traumatic varus deformities of the hindfoot]. Unfallchirurg 2009; 112:207-10. [PMID: 19165459 DOI: 10.1007/s00113-008-1532-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Despite adequate primary treatment many ankle fractures result in post-traumatic deformities and arthrosis. Revision mostly requires a multidirectional correction whereas internal fixation procedures are often not applicable due to soft tissue damage and the extent of deformity. The Taylor spatial frame enables simultaneous correction of multidirectional deformities through a virtual hinge using the same ideas of distraction osteogenesis as the Ilizarov fixator. The presented case demonstrates minimally invasive correction of a complex deformity of the ankle with the Taylor spatial frame fixator. Orthogonal alignment was achieved and a stabilizing tibiotalar arthrodesis was performed achieving a good functional and pain-free result.
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Altenbernd J, Bitu S, Lemburg S, Peters S, Seybold D, Meindl R, Nicolas V, Heyer C. Wirbelfrakturen bei Patienten mit Spondylitis ankylosans: Eine retrospektive Analyse von 66 Patienten. ROFO-FORTSCHR RONTG 2008; 181:45-53. [PMID: 19085689 DOI: 10.1055/s-2008-1027886] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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49
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Gessmann J, Seybold D, Baecker H, Muhr G, Graf M. [Operative management and fracture care of the lower leg with the Ilizarov fixator in morbidly obese patients: literature review and results]. Chirurg 2008; 80:34-44. [PMID: 18853125 DOI: 10.1007/s00104-008-1629-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Given the rising prevalence of obesity, surgeons and hospitals must become more familiar with the treatment and operative management of obese patients. Several additional pre- and postoperative considerations must be involved such as appropriate assessment of comorbidities and requirements for special equipment. There are still very few data regarding morbidly obese patients with BMIs >50 kg/m(2). After a general literature review of operative management of obese patients, we report on fracture care of the lower limb in such patients with custom-made Ilizarov ring fixators. We found them suited to bear enormous weight-loading but that associated comborbidities can limit successful fracture care.
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Brett D, Seybold D, Michalski S, Muhr G. [Acute traumatic abdominal wall hernia after blunt abdominal trauma]. Unfallchirurg 2008; 111:361-4. [PMID: 18273590 DOI: 10.1007/s00113-007-1370-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Traumatic abdominal wall hernias are rare injuries despite the high incidence of blunt abdominal traumas. The mechanism of this injury includes a sudden increase in intra-abdominal pressure and extensive shear forces applied to the abdominal wall. The typical location is found at anatomic weak areas in the lower abdomen. Often, significant intra-abdominal injuries or injuries of the pelvis and chest are associated. We describe a case of an abdominal contusion trauma leading to a traumatic abdominal wall hernia beside the rectal sheath. In this case, parts of the small bowel penetrated through the ruptured muscle of the abdominal wall up to the subcutis. After appropriate diagnosis, the defect was repaired using a sheet of synthetic mesh to stabilize the abdominal wall. Based on this case, the management of blunt abdominal wall hernias and the literature are discussed.
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