Continuous passive motion in the prevention of deep-vein thrombosis: a randomised comparison in trauma patients.

There is a high risk of venous thromboembolism when patients are immobilised following trauma. The combination of low-molecular-weight heparin (LMWH) with graduated compression stockings is frequently used in orthopaedic surgery to try and prevent this, but a relatively high incidence of thromboembolic events remains. Mechanical devices which perform continuous passive motion imitate contractions and increase the volume and velocity of venous flow.

Quality of life 20 years after arthrodesis of the ankle. A study of adjacent joints.

biotalar fusion is considered to be the standard treatment for end-stage post-traumatic arthritis of the ankle. We report a retrospective, objective long-term study of the quality of life of 17 patients with 18 arthrodeses of the ankle, over a period of more than 20 years. We looked particularly for correlation between clinical and radiological signs of osteoarthritis in adjoining joints.

[Is there a correlation between clinical results or quality of life and radiological findings after implantation of a total knee prosthesis?].

Aim Of The Study: To establish whether there is a clinical correlation between clinical outcome or quality of life and radiographic findings.

Material And Methods: 17 patients (mean age 68.2 years) with total knee arthroplasty were examined after an average follow-up of 24.

Sonographic evaluation of ACL rupture signs compared to arthroscopic findings in acutely injured knees.

Evaluation of ultrasound (US) examination for the diagnosis of an acute anterior cruciate ligament (ACL) rupture. We performed a prospective examination of 193 patients to analyze the three indirect criteria of ACL rupture: echo-poor space at the femoral insertion of the ACL, S-shaped course and thickening of the posterior cruciate ligament (PCL) and protrusion of the posterior fibrous capsule. The assumption that the echo-poor space at the femoral insertion has a great significance was confirmed in this study.

[Oxidation of ultra high molecular weight polyethylene as a result of sterilization].

Purpose Of The Study: To improve (UHMWPE) Ultra High Molecular Weight Polyethylene quality for use in arthroplastic components, sterilization related oxidative changes were investigated in raw and manufactured material.

Material: To evaluate sterilization related effects, 15 x 15 mm samples of UHMWPE were taken from a defined area of raw manufactured UHMWPE plates. The raw manufactured plates were produced using the compression molding method.

Do functional deficits result from radial head resection?

The treatment of comminuted fractures of the radial head with primary or secondary head resection is controversial. To assess the outcome of patients after radial head resection, a retrospective study with clinical and radiologic follow-up including isokinetic testing was performed. Between 1981 and 1992, 151 patients underwent radial head resection for comminuted fractures.

Incidence and symptoms of clinically manifest rotator cuff lesions.

A clinical study of 200 unselected elderly subjects with an average age of 78 years living in retirement homes was performed to determine the prevalence of clinically manifest rotator cuff tears and the relevance of the tear for daily life. A comprehensive questionnaire was performed and the examination included the UCLA- and Constant-shoulder assessment scales and a multitude of special tests. The criteria for clinical diagnosis of a rotator cuff tear were a positive Jobe-test, diminished external rotation, a positive zero-degree-abduction test, the drop arm sign, pseudoparalysis and atrophy.

[New methods for effective prevention of thromboembolism in surgical medicine exemplified by trauma surgery].

Under conventional prevention (pharmacological and physical) of thromboembolism 30-40% of surgical patients develop deep vein thrombosis (DVT). Mechanical methods significantly increase the efficacy of prophylaxis for thromboembolism: these include intermittent pneumatic compression, A-V impulse systems and ankle motion devices. For all trauma patients it is advisable that conventional prophylaxis of thromboembolism be supplemented with elements of mechanical prophylaxis in order to reduce the continuing high thrombosis rate significantly.

[Ultrasound diagnosis of acute rupture of the anterior cruciate ligament. An experimental and clinical study].

In an experimental study on 20 cadaver knee joints we found examined the ventral translation of the tibial head, which is otherwise shown by the Lachmann test, by dorsal sonography. These examinations were performed in knees in which arthroscopical examination had confirmed intact ACL. After endoscopical partial and complete rupture of the ACL the examinations were repeated.

[Physical prevention of thrombosis with the ankle joint with the motorized ankle joint movement device. Initial results of a clinical study].

Between 1993 and 1994 the value of the "Artroflow" device in deep venous thrombosis was tested in 95 trauma surgical high risk patients. Parallel to the application of Heparin and physical methods, the "Artroflow" device was employed. The test and compare group showed an equal amount of risk parameters and comparable injuries.

[Ultrasound criteria of fresh rupture of the anterior cruciate ligament].

In a prospective, controlled, monocentric clinical study 193 recently traumatized knee joints, suspicious of a ruptured anterior cruciate ligament, were examined sonographically. Three indirect signs of rupture were analyzed and compared to the results of the clinical tests of stability (Lachmann). Arthroscopy and arthrotomy were regarded as approved methods of reference.