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Pishnamaz M, Quack V, Herren C, Hildebrand F, Kobbe P. [Treatment strategies for pathological fractures of the spine]. Unfallchirurg 2021; 124:720-730. [PMID: 34342665 DOI: 10.1007/s00113-021-01052-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pathological fractures and instabilities of the spine are most often caused by primary tumors that hematogenously metastasize into the spine. In this context breast, prostate, kidney cell and bronchial carcinomas are the most relevant causative diseases. Furthermore, multiple myeloma is another frequent entity. Primary tumors of the spine are correspondingly rare and only make up a small proportion of all malignant processes in the spine. DECISION MAKING The main symptom of pain is prognostically unfavorable in this context and is often associated with progressive instability or pathological fractures. To objectify the treatment approach the neurological status, an oncological assessment, the biomechanical stability and (systemic) general condition (NOMS criteria) of the patient have to be considered. Another major factor is the radiation sensitivity of the tumor. The spinal instability neoplastic (SIN) score is recommended to assess stability. Regardless of whether conservative or surgical treatment is carried out, interdisciplinary cooperation between the specialist departments must be guaranteed in order to achieve adequate treatment for the patient. TREATMENT If a curative approach is followed an individualized and interdisciplinary surgical strategy must be performed to achieve an R0 resection, usually as a spondylectomy. In the case of palliative treatment, the goal of surgical treatment must be pain reduction, stability and avoidance or restoration of neurological deficits. This requires stabilization in a percutaneous or open technique, possibly in combination with decompression and local tumor debulking.
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Affiliation(s)
- M Pishnamaz
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - V Quack
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - C Herren
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - F Hildebrand
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - P Kobbe
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
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Kaczmarek C, Andruszkow H, Herren C, Pishnamaz M, Hildebrand F, Röhl A, Lichte P. [Medical ID and emergency apps: A useful tool in emergency situations or a waste of time?]. Med Klin Intensivmed Notfmed 2020; 116:339-344. [PMID: 32270256 PMCID: PMC8102457 DOI: 10.1007/s00063-020-00675-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/23/2019] [Accepted: 12/22/2019] [Indexed: 11/26/2022]
Abstract
Hintergrund Um in Notfallsituationen eine effektive Versorgung des Patienten zu gewährleisten, sind Informationen über Vorerkrankungen und bisherige Medikamenteneinnahme essenziell. Daher haben Smartphonehersteller entsprechende Anwendungssoftware (App) entwickelt, auf die im Notfall zugegriffen werden kann, um jene Informationen zu erhalten. Ziel der Studie war es herauszufinden, ob Notfall-Apps von Smartphoneinhabern aktiv genutzt werden und ob diese in Notfallsituationen von den behandelnden Notärzten eingesehen werden. Methode Zur Datenerhebung wurde eine anonymisierte Umfrage über das Nutzungsverhalten der Notfall-Apps bei verunfallten Patienten der unfallchirurgischen Ambulanz eines universitären Maximalversorgers über einen Zeitraum von 3 Monaten durchgeführt. Parallel fand eine Befragung von Notärzten verschiedener Standorte zu ihren beruflichen Erfahrungen mit den Apps statt. Ergebnisse Insgesamt wurden 192 Patienten und 103 Notärzte befragt. Die Notfall-Apps waren 45 % (n = 79) der Befragten nicht bekannt; nur bei 10 % (n = 19) der Befragten war die App mit Daten hinterlegt. Weiterhin zeigte sich, dass insgesamt 21 % (n = 41) der Personen einen Notizzettel mit Vorerkrankungen und Medikamenten bei sich trugen. Von den Befragten Ärzten gaben 42 % (n = 44) an, schon einmal von der App gehört zu haben; nur 6 % (n = 5) durchsuchten jedoch routinemäßig bei nichtansprechbaren Patienten das Smartphone. Erfolgreich genutzt wurde die App bisher nur von 14 % der Ärzte (n = 14). Schlussfolgerung Aufgrund der geringen Bekanntheit erscheint es in zeitkritischen Situationen nicht empfehlenswert, das Smartphone der Patienten nach Notfall-Apps zu durchsuchen. Bei Patienten über 55 ist es zurzeit erfolgsversprechender, die Brieftasche nach Informationen zu Vorerkrankungen zu kontrollieren.
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Affiliation(s)
- C Kaczmarek
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland.
- St. Elisabeth-Krankenhaus Geilenkirchen, Geilenkirchen, Deutschland.
| | - H Andruszkow
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - C Herren
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - M Pishnamaz
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - F Hildebrand
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
| | - A Röhl
- Klinik für Anästhesiologie, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - P Lichte
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland
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Herren C, Dienstknecht T, Siewe J, Kobbe P, Pape HC, Hildebrand F. [Chronic instability of the pubic symphysis : Etiology, diagnostics and treatment management]. Unfallchirurg 2016; 119:433-46. [PMID: 27146805 DOI: 10.1007/s00113-016-0166-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The most frequent causes of chronic instability of the pubic symphysis are sports-related continual overload and traumatic symphyseal injuries. Acute injury of the pubic symphysis may be the result of external forces acting on the anterior pelvic ring or the result of internal forces, such as those arising during parturition. The postpartum form of instability following a complication-free birth is reversible and usually returns to normal within a few months through strengthening of the pelvic floor muscles. Residual instability of the pubis symphysis is on the whole a rare complication. Although established therapy options for acute symphyseal separation can be found in the literature, there are only a few case reports on chronic symphyseal instability. There are no guidelines on standardized therapy options. This review article examines the etiology, clinical findings, diagnostic techniques and management options for patients suffering from chronic symphyseal instability.
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Affiliation(s)
- C Herren
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
| | - T Dienstknecht
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - J Siewe
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - P Kobbe
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - H C Pape
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - F Hildebrand
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
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Herren C, Pishnamaz M, Lichte P, Hildebrand F, Sellei R, Pape HC, Kobbe P. Die ventrale „Triple-/Quadruple“-Schraubenosteosynthese für die traumatische C1–C2-Kombinationsverletzung des geriatrischen Patienten: erste operative Erfahrungen mit 16 Patienten. Z Orthop Unfall 2015; 153:533-9. [DOI: 10.1055/s-0035-1546133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- C. Herren
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen
| | - M. Pishnamaz
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen
| | - P. Lichte
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen
| | - F. Hildebrand
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen
| | - R. Sellei
- Unfallchirurgie und Orthopädische Chirurgie, Sana Klinikum Offenbach
| | - H.-C. Pape
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen
| | - P. Kobbe
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen
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Herren C, Sobottke R, Ringe MJ, Visel D, Graf M, Müller D, Siewe J. Ultrasound-guided diagnosis of fractures of the distal forearm in children. Orthop Traumatol Surg Res 2015; 101:501-5. [PMID: 25910703 DOI: 10.1016/j.otsr.2015.02.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 01/31/2015] [Accepted: 02/27/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE Distal radius and forearm fractures are injuries that are frequently seen in trauma surgery outpatient clinics. Usually, the wrist is X-rayed in 2 planes as standard diagnostic procedure. In contrast, we evaluate in our study the accuracy of ultrasonography (US) in diagnosing these fractures. METHODS This prospective study includes the patients who presented at two trauma surgery clinics with a presumptive diagnosis of distal radius or forearm fracture between January and December 2012. After a clinical examination, US imaging of the distal forearm was first carried out on 6 standardized planes followed by radiographs of the wrist made in two planes. The age limit was set at the end of 11 years. RESULTS In total, 201 patients between 4 and 11 years of age were recruited with an average age of 9.5 years at the time of the trauma. There were 104 (51.7%) fractures distributed as follows: 89 (85.9%) injuries of the distal radius, 9 (8.7%) injuries of the distal ulna, and 6 (5.8%) combined injuries (radius and ulna). Sixty-five greenstick fractures were detected. Surgery was necessary in 34 cases. Specificity and sensitivity of ultrasound diagnosis were 99.5%. CONCLUSION Ultrasound imaging is suitable to demonstrate fractures of the distal forearm. It is a highly sensitive procedure in detecting distal forearm fractures. In our opinion, a negative result in ultrasound may reduce the need for further radiographs in children with distal forearm lesions. But in any doubtful situation the need for conventional radiographs remains.
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Affiliation(s)
- C Herren
- University Clinic RWTH Aachen, Department for Trauma and Reconstructive Surgery, Pauwelsstraße 30, 52074 Aachen, Germany.
| | - R Sobottke
- Medizinisches Zentrum StädteRegion Aachen GmbH, Centre for Orthopaedic and Trauma Surgery, Mauerfeldchen 25, 52146 Würselen, Germany
| | - M J Ringe
- Medizinisches Zentrum StädteRegion Aachen GmbH, Centre for Orthopaedic and Trauma Surgery, Mauerfeldchen 25, 52146 Würselen, Germany
| | - D Visel
- Städtisches Krankenhaus Heinsberg, Department for Surgery and Trauma Surgery, Auf dem Brand 1, 52525 Heinsberg, Germany
| | - M Graf
- Medizinisches Zentrum StädteRegion Aachen GmbH, Centre for Orthopaedic and Trauma Surgery, Mauerfeldchen 25, 52146 Würselen, Germany
| | - D Müller
- University of Cologne, Department for Radiology, Kerpener Street 62, 50937 Cologne, Germany
| | - J Siewe
- University of Cologne, Department for Orthopaedic and Trauma Surgery, Kerpener Street 62, 50937 Cologne, Germany
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Herren C, Sobottke R, Dadgar A, Ringe MJ, Graf M, Keller K, Eysel P, Mallmann P, Siewe J. Peripartum pubic symphysis separation--Current strategies in diagnosis and therapy and presentation of two cases. Injury 2015; 46:1074-80. [PMID: 25816704 DOI: 10.1016/j.injury.2015.02.030] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 01/26/2015] [Accepted: 02/28/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND During spontaneous vaginal delivery, pubic symphyseal widening is normal. Common changes are reversible after complication-free birth. However, cases of peripartum symphysis separation are rare. There is no consensus in the literature on how to treat pregnancy-related pubic symphysis separation. METHODS This review used a literature-based search (PubMed, 1900-2013) and analysis of 2 own case reports. Studies with conclusions regarding management were particularly considered. RESULTS Characteristic symptoms, suprapubic pain and tenderness radiating to the posterior pelvic girdle or lower back, may be noted 48 h after delivery. Pain on movement, especially walking or climbing stairs, is often present. Conservative treatments, such as a pelvic brace with physiotherapy and local interventions such as infiltration, are successful in most cases. Symptom reduction within 6 weeks is the most common outcome, but can take up to 6 months in some cases. Surgical intervention is needed in cases of persistent separation. Anterior plate fixation is offered as a well-known and safe procedure. Minimally invasive SI joint screw fixation is required in cases of combined posterior pelvic girdle lesions. SUMMARY Postpartum symphyseal rupture can be indicated with the rare occurrence of pelvic pain post-delivery, with sciatica or lumbago and decreased mobility. The diagnosis is made on clinical findings, as well as radiographs of the pelvic girdle. Conservative treatment with a pelvic brace is the gold standard in pre- and postpartum cases of symphysis dysfunction.
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Affiliation(s)
- C Herren
- University Clinic RWTH Aachen, Department of Trauma and Reconstructive Surgery, Pauwelsstraße 30, 52074 Aachen, Germany.
| | - R Sobottke
- Medical Center of the City/Region Aachen GmbH, Center for Orthopedic and Trauma Surgery, Mauerfeldchen 25, 52146 Würselen, Germany
| | - A Dadgar
- University of Oklahoma-Tulsa, Department of Orthopedics, 2424 E 21st Street Suite 320, Tulsa, 74113 OK, United States
| | - M J Ringe
- Medical Center of the City/Region Aachen GmbH, Center for Orthopedic and Trauma Surgery, Mauerfeldchen 25, 52146 Würselen, Germany
| | - M Graf
- Medical Center of the City/Region Aachen GmbH, Center for Orthopedic and Trauma Surgery, Mauerfeldchen 25, 52146 Würselen, Germany
| | - K Keller
- University Hospital Cologne, Clinic and Polyclinic for Orthopedic and Trauma Surgery, Kerpener Str. 62, 50937 Köln, Germany
| | - P Eysel
- University Hospital Cologne, Clinic and Polyclinic for Orthopedic and Trauma Surgery, Kerpener Str. 62, 50937 Köln, Germany
| | - P Mallmann
- University Hospital Cologne, Clinic and Polyclinic for Obstetrics and Gynecology, Kerpener Str. 62, 50937 Köln, Germany
| | - J Siewe
- University Hospital Cologne, Clinic and Polyclinic for Orthopedic and Trauma Surgery, Kerpener Str. 62, 50937 Köln, Germany
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Siewe J, Rudat J, Zarghooni K, Sobottke R, Eysel P, Herren C, Knöll P, Illgner U, Michael J. Injuries in competitive boxing. A prospective study. Int J Sports Med 2014; 36:249-53. [PMID: 25376728 DOI: 10.1055/s-0034-1387764] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Boxing remains a subject of controversy and is often classified as dangerous. But the discussion is based mostly on retrospective studies. This survey was conducted as a prospective study. From October 2012 to September 2013, 44 competitive boxers were asked to report their injuries once a month. The questionnaire collected general information (training, competition) and recorded the number of bouts fought, injuries and resulting lost days. A total of 192 injuries were recorded, 133 of which resulted in interruption of training or competition. Each boxer sustained 3 injuries per year on average. The injury rate was 12.8 injuries per 1 000 h of training. Boxers fighting more than 3 bouts per year sustain more injuries (p=0.0075). The injury rate does is not a function of age (age≤19 vs. > 19a, p=0.53). Injuries to the head and the upper limbs occur most frequently. The most common injuries are soft tissue lacerations and contusions. Head injuries with neurological symptoms rarely occur (4.2%). Boxing has a high injury rate that is comparable with other contact sports, but most injuries are minor. Injury frequency is not a function of whether the boxer competes in the junior or adult category. Athletes fighting many bouts per year have a greater risk of injury.
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Affiliation(s)
- J Siewe
- Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
| | - J Rudat
- Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
| | - K Zarghooni
- Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
| | - R Sobottke
- Centre of Orthopedic and Trauma Surgery, Medical Centre Aachen, Würselen, Germany
| | - P Eysel
- Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
| | - C Herren
- Centre of Orthopedic and Trauma Surgery, Medical Centre Aachen, Würselen, Germany
| | - P Knöll
- Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
| | - U Illgner
- Department of Orthopeadic and Trauma Surgery, St. Josef-Stift, Sendenhorst, Germany
| | - J Michael
- Department of Orthopedic, Trauma and Spine Surgery, Marienhaus Hospital, Bendorf-Neuwied-Waldbreitbach, Germany
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Siewe J, Marx G, Knöll P, Eysel P, Zarghooni K, Graf M, Herren C, Sobottke R, Michael J. Injuries and overuse syndromes in competitive and elite bodybuilding. Int J Sports Med 2014; 35:943-8. [PMID: 24886919 DOI: 10.1055/s-0034-1367049] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Competitive bodybuilding is a weightlifting sport similar to powerlifting, strongman competition and Olympic weightlifting, which aims to increase muscle mass, symmetry, and body definition. Although data regarding rates of injury, overuse syndromes and pain during routine training is available for these other disciplines, it is rare for competitive bodybuilding. The aim of this study was to investigate rates of injury, pain during workouts and/or overuse syndromes, as well as the influence of particular intrinsic and external factors. Data was collected using questionnaires from 71 competitive and elite bodybuilders. The information included training routines and prior injuries. Participants were recruited from bodybuilding clubs in Germany. 45.1% of athletes reported symptoms while training. The overall injury rate was computed to be 0.12 injuries per bodybuilder per year (0.24 injuries per 1 000 h of bodybuilding). Athletes over 40 exhibited higher rates of injury (p=0.029). Other investigated parameters showed no effects. Most injuries occurred in the shoulder, elbow, lumbar spine and knee regions. A large proportion of bodybuilders complained of pain not resulting in interruptions of training/competition. The injury rate is low compared to other weightlifting disciplines such as powerlifting, Olympic weightlifting or strongman competition. In comparison to team or contact sports the injury rate is minimal.
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Affiliation(s)
- J Siewe
- Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
| | - G Marx
- Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
| | - P Knöll
- Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
| | - P Eysel
- Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
| | - K Zarghooni
- Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
| | - M Graf
- Centre of Orthopedic and Trauma Surgery, Medical Centre Aachen, Würselen, Germany
| | - C Herren
- Centre of Orthopedic and Trauma Surgery, Medical Centre Aachen, Würselen, Germany
| | - R Sobottke
- Centre of Orthopedic and Trauma Surgery, Medical Centre Aachen, Würselen, Germany
| | - J Michael
- Department of Orthopedic, Trauma and Spine Surgery, Marienhaus Hospital, Bendorf-Neuwied-Waldbreitbach, Germany
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Siewe J, Zarghooni K, Röllinghoff M, Herren C, Koy T, Eysel P, Sobottke R. [Complication analysis of spinal interventions in adult central movement disorders and scoliosis]. Z Orthop Unfall 2013; 151:454-62. [PMID: 23817804 DOI: 10.1055/s-0032-1328664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Adult central movement disorders, malpostures, and scolioses can have their cause in various neurological underlying diseases such as Morbus Parkinson, Pisa syndrome, or segmental dystonia. Important clinical characteristics are marked postural distortions such as camptocormia (bent spine) or laterocollis. In cases of these adult scolioses, surgical spine treatment puts high demands on the surgeon. Surgery in Parkinson's disease, for example, is associated with serious surgery-specific as well as general complications. The more rarely occurring Pisa syndrome is an entity primarily requiring medical therapy. PATIENTS AND METHODS A series of ten case reports of patients with Morbus Parkinson and Pisa syndrome who underwent spinal surgery is presented and discussed. From these reports, treatment recommendations have been derived and complemented by references from the literature. An extensive MEDLINE search was performed for this purpose. RESULTS AND CONCLUSION In patients suffering from Parkinson's disease, even minor surgical interventions can lead to instability of whole spine segments or even the entire spine. Implant loosening, adjacent segment instability, general perioperative complications, and progressive malposture due to disease progress can bring forth disastrous treatment courses. Spinal fixation should be performed long-segmented in combination with ventral stabilisation. Due to osteoporosis, pedicle screw cement augmentation is recommended in this collective. If the diagnosis of Pisa syndrome is established, an optimised preoperative preparation should be initiated in close cooperation with neurologists. In many cases medical therapy is sufficient and surgical interventions can be avoided.
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Affiliation(s)
- J Siewe
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universität Köln
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Herren C, Lühmann M, Graf M. Vergleich zweier minimal-invasiver Versorgungstechniken zur Behandlung von proximalen Humerusfrakturen bei 30 Patienten: Marknagelung vs. eingeschobene winkelstabile Platte (Philos®). Zentralbl Chir 2011. [DOI: 10.1055/s-0031-1289001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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von Walter M, Herren C, Gensior TJ, Steffens GCM, Hermanns-Sachweh B, Jahnen-Dechent W, Rüger M, Erli HJ. Biomimetic modification of the TiO(2)/glass composite Ecopore with heparinized collagen and the osteoinductive factor BMP-2. Acta Biomater 2008; 4:997-1004. [PMID: 18346949 DOI: 10.1016/j.actbio.2008.01.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2007] [Revised: 11/28/2007] [Accepted: 01/23/2008] [Indexed: 11/17/2022]
Abstract
The porous TiO(2)/glass composite Ecopore has potential applications in hard tissue replacement. We describe the modification of Ecopore with the growth factor bone morphogenetic protein-2 (BMP-2) to add osteoinductive properties. Ecopore covalently coated with BMP-2 caused a weak induction of alkaline phosphatase in murine embryonal fibroblasts. In a rabbit bone defect model, BMP-2-coated Ecopore had moderately higher bone apposition rates and ingrown bone quantities at 6 weeks after implantation. To overcome loss of function due to chemical surface coupling, we filled the pore system of Ecopore with heparinized collagen sponge and loaded this secondary matrix with BMP-2. Heparinization of collagen filling increased the BMP-2 loading capacity of the matrix approximately 1.28-fold. Within 96 h, 17.0+/-0.1 and 10.1+/-0.2% of the used BMP-2 was released from non-modified and heparinized Ecopore/collagen, respectively, indicating that the heparin modification retarded BMP-2 release. Revealed by energy-dispersive X-ray spectroscopy analysis of implant cross-sectional areas, BMP-2-loaded Ecopore/collagen had significantly higher bony ingrowth quantities in rabbits, with the heparinized modification yielding the highest value (16.09+/-3.51%, p<0.005) compared with the non-heparinized matrix (10.72+/-4.07%, p<0.05) and the BMP-2-free controls (5.60+/-1.47%). This suggested a beneficial effect of the biomimetic modification of Ecopore with heparinized collagen for bone healing and integration.
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Affiliation(s)
- M von Walter
- Clinic of Trauma Surgery, RWTH Aachen University, Germany.
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Abadi B, Herren C. Clinical treatment of ectodermal dysplasia: a case report. QUINTESSENCE INTERNATIONAL (BERLIN, GERMANY : 1985) 2001; 32:743-5. [PMID: 11695142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Ectodermal dysplasia is both physically and emotionally devastating to patients. With proper restorative intervention, the quality of life can be improved for patients with ectodermal dysplasia. This case report outlines a method of restoring function and esthetics for a 14-year-old boy with ectodermal dysplasia. It is important that these patients be treated at an early age to aid in their social interactions.
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Affiliation(s)
- B Abadi
- Division Chief of Removable Prosthodontics, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
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Herren C, Lindroth J. Obsessive compulsive disorder: a case report. J Contemp Dent Pract 2001; 2:41-9. [PMID: 12167926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
A general dentist often will find the most challenging aspect of dentistry is patient management. In the controlled environment of a dental school, many students are not exposed to certain patient populations. It is likely that their first experience with particular patient pools will be in private practice. One such group of patients is those suffering from Obsessive Compulsive Disorder (OCD). This article reviews the clinical signs and symptoms of this group of patients.
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Affiliation(s)
- C Herren
- Department of Oral Health Practice, University of Kentucky College of Dentistry, USA.
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Herren C, Dousse J. High-resolution measurements of the K-MM radiative Auger effect in medium-mass atoms. Phys Rev A 1996; 53:717-725. [PMID: 9912943 DOI: 10.1103/physreva.53.717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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15
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Boschung B, Carlen MW, Dousse J, Galley B, Herren C, Hoszowska J, Kern J, Rhême C, Ludziejewski T, Rymuza P, Sujkowski Z, Halabuka Z. Probabilities for L-shell ionization in intermediate-velocity collisions of medium-mass elements with 4He2+ ions. Phys Rev A 1995; 52:3889-3898. [PMID: 9912699 DOI: 10.1103/physreva.52.3889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Ludziejewski T, Rymuza P, Sujkowski Z, Boschung B, Dousse J, Galley B, Halabuka Z, Herren C, Hoszowska J, Kern J, Rhême C, Polasik M. High-resolution study of the K beta 2 x-ray spectra induced by proton and photon impact on Zr, Mo, and Pd targets. Phys Rev A 1995; 52:2791-2803. [PMID: 9912561 DOI: 10.1103/physreva.52.2791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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17
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Boschung B, Dousse J, Galley B, Herren C, Hoszowska J, Kern J, Rhême C, Halabuka Z, Ludziejewski T, Rymuza P, Sujkowski Z, Polasik M. K alpha hypersatellite lines of medium-mass atoms induced by 100-MeV 4He2+ ions. Phys Rev A 1995; 51:3650-3659. [PMID: 9912032 DOI: 10.1103/physreva.51.3650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Herren C, Bucher U. [How long will preserved blood and bone marrow films give reliable cytochemical staining?]. Klin Wochenschr 1985; 63:1055-60. [PMID: 2415749 DOI: 10.1007/bf01739673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We tested how long unstained and unfixed films of blood and aspirated bone marrow could be kept before special cytochemical staining. To exclude influences other than time on the outcome of the reactions, all the material was taken from hematologically normal persons. A simple score was used to evaluate the results. These may be summarized as follows: in most cells Naphthol-AS-acetate-esterase first shows a progressive decline in reactivity after a delay of 6 weeks, the reaction becoming very weak after 10 +/- 1 weeks. This does not hold for monocytes, megakaryocytes and platelets, which maintain reactivity (and susceptibility to NaF) for more than three months. With PAS staining, a slight decrease in reactivity after 8 +/- 2 weeks could be observed, whereas all other stainings tested (POX, Sudan black B and Naphthol-AS-D-esterase) were unaffected even by a delay of up to 16 weeks.
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Abbühl K, Baltzer Y, Borter W, Gasser P, Gertsch HR, Gossweiler N, Gürtler R, Gränicher R, Herren C, Kohli P, Leya A, Reiniger M, Wattenwyl N, Zenger F. [Experience with an antihypertensive in general practice (group study with brinerdin)]. Schweiz Rundsch Med Prax 1976; 65:551-6. [PMID: 824641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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