Publications by authors named "Robert Schmidhammer"

Background: Obstetric brachial plexus injuries (OBPIs) not only lead to severe and life changing sequelae regarding motor impairment but can also be responsible for multi-characteristic pain. In everyday routine, questions regarding pain of the developing child with an OBPI are often overseen and neglected. We aimed to elucidate this specific question and analyzed all patients with OBPI treated in our center to unmask initially non-observed pain and ultimately put pain in correlation to the surgical reconstructive treatment performed.

View Article and Find Full Text PDF

(1) Background: Although most brachial plexus birth palsies show some spontaneous recovery, secondary operations are likely to follow. Accordingly, due to the loss of muscle innervation, the growth of the affected limb and the shoulder girdle is reduced. This is associated with pathological scapula positioning and rotation.

View Article and Find Full Text PDF

Background: Full-thickness burn injuries (FTBI) not only lead to a significant burden in multiple ways, including social life and self-esteem, but have also a tremendous impact on environmental interaction by reducing sensibility in manifold ways. On these grounds, possible ways and solutions to recover sensibility in burn wounds are essentials and should not be overlooked.

Methods: A review of experimental, clinical studies and the related literature was performed with the aim to highlight post-burn nerve regeneration and discover ways for sensory re-integration to complement the therapeutic concept.

View Article and Find Full Text PDF

Introduction/aims: High-resolution ultrasound (HRUS) is the imaging method of choice to visualize peripheral nerve size, structure, and biomechanical performance. The purpose of this study was to show and quantify the effects of active and passive wrist alignment on median nerve (MN) cross-sectional area (CSA) along the forearm in a healthy population.

Methods: Sixteen healthy volunteers underwent HRUS of their dominant forearm (n = 16, 10 males, 6 females, 18-55 y of age).

View Article and Find Full Text PDF

Recently, plastic surgery lost one of its most prominent surgeons-Dr. Hanno Millesi. His contributions to the field continue to impact the practice of medicine and surgery.

View Article and Find Full Text PDF

Homuncular organization, i.e., the neuronal representation of the human body within the primary motor cortex, is one of the most fundamental principles of the human brain.

View Article and Find Full Text PDF

To improve the outcome after autologous nerve grafting in the clinic, it is important to understand the limiting variables such as distinct phenotypes of motor and sensory Schwann cells. This study investigated the properties of phenotypically different autografts in a 6 mm femoral nerve defect model in the rat, where the respective femoral branches distally of the inguinal bifurcation served as homotopic, or heterotopic autografts. Axonal regeneration and target reinnervation was analyzed by gait analysis, electrophysiology, and wet muscle mass analysis.

View Article and Find Full Text PDF

Cortical reorganization in response to peripheral nervous system damage is only poorly understood. In patients with complete brachial plexus avulsion and subsequent reconnection of the end of the musculocutaneous nerve to the side of a phrenic nerve, reorganization leads to a doubled arm representation in the primary motor cortex. Despite, homuncular organization being one of the most fundamental principles of the human brain, movements of the affected arm now activate 2 loci: the completely denervated arm representation and the diaphragm representation.

View Article and Find Full Text PDF

Treatment of peripheral nerve injuries has evolved over the past several decades to include the use of sophisticated new materials endowed with trophic and topographical cues that are essential for in vivo nerve fibre regeneration. In this research, we explored the use of an advanced design strategy for peripheral nerve repair, using biological and semi-synthetic hydrogels that enable controlled environmental stimuli to regenerate neurons and glial cells in a rat sciatic nerve resection model. The provisional nerve growth conduits were composed of either natural fibrin or adducts of synthetic polyethylene glycol and fibrinogen or gelatin.

View Article and Find Full Text PDF

Background Aims: As new approaches for peripheral nerve regeneration are sought, there is an increasing demand for native Schwann cells for in vitro testing and/or reimplantation. Extracorporeal shockwave treatment (ESWT) is an emergent technology in the field of regenerative medicine that has also recently been shown to improve peripheral nerve regeneration.

Methods: In this study, we elucidate the effects of ESWT on Schwann cell isolation and culture.

View Article and Find Full Text PDF

Tissue engineering approaches in nerve regeneration search for ways to support gold standard therapy (autologous nerve grafts) and to improve results by bridging nerve defects with different kinds of conduits. In this study, we describe electrospinning of aligned fibrin-poly(lactic-co-glycolic acid) (PLGA) fibers in an attempt to create a biomimicking tissue-like material seeded with Schwann cell-like cells (SCLs) in vitro for potential use as an in vivo scaffold. Rat adipose-derived stem cells (rASCs) were differentiated into SCLs and evaluated with flow cytometry concerning their differentiation and activation status [S100b, P75, myelin-associated glycoprotein (MAG), and protein 0 (P0)].

View Article and Find Full Text PDF

Intramuscular injection of the calpain inhibitor leupeptin promotes peripheral nerve regeneration in primates (Badalamente et al., 1989 [13]), and direct positive effects of leupeptin on axon outgrowth were observed in vitro (Hausott et al., 2012 [12]).

View Article and Find Full Text PDF

De-focused low energy extracorporeal shock wave therapy (ESWT) has been widely used in various clinical and experimental models for the treatment of painful conditions such as epicondylitis and plantar fascitis and also bone and wound healing. There is evidence that ESWT improves the metabolic activity of various cell types, e.g.

View Article and Find Full Text PDF

Background: In brachial plexus avulsion, a recent technique connects the ending of the disrupted musculocutaneous nerve to the side of the intact phrenic nerve to regain elbow flexion. This requires the phrenic nerve to perform a new double function: independent control of breathing and elbow flexion. Neuroplastic changes associated with acquisition of double nerve functions have not yet been investigated.

View Article and Find Full Text PDF

Final outcome after surgical repair of peripheral nerve transections varies. Here, we present the first longitudinal functional magnetic resonance imaging (fMRI) observation of cortical somatosensory reorganization patterns after surgery. A 43-year-old man presented with isolated complete transection of the right median nerve and underwent immediate epineural end-to-end coaptation.

View Article and Find Full Text PDF

Introduction: The question as to whether the patient consumed drugs prior to the trauma and which drugs were consumed, is of prime importance for the anesthesia required during surgery. However, many patients are unwilling or unable (including those with multiple trauma or impaired consciousness, or unconscious patients) to answer this question. The purpose of our prospective multicenter study was to collect data about drug consumption in Austria to determine whether drugs are identifiable in the urine of recently injured individuals and to establish the types of drugs consumed.

View Article and Find Full Text PDF

To bring some light into the ongoing controversy concerning end-to-side coaptation in brachial plexus surgery, the authors organized a symposium in 2006 titled How To Improve Peripheral Nerve Surgery. The authors sought the participation of experienced surgeons and researchers who had made personal contributions to the field. This article contains information collected at this symposium and presents the authors' clinical results and ideas illustrating the potential of nerve fiber transfer by end-to-side coaptation.

View Article and Find Full Text PDF

Background: High-resolution microcomputed tomography (microCT) is one of the most recent technical developments to visualize and quantify primarily cancellous bone. Regarding bone formation, microCT is becoming increasingly important, although its reliability has not yet been evaluated. Our study had two goals: to develop a reproducible nonunion model and to determine the efficacy of microCT for the assessment of bone healing in this model.

View Article and Find Full Text PDF

Administration of a single bolus of endotoxin is a model of sepsis response in experimental animal studies. Large animal species, such as pigs and sheep, are more sensitive to endotoxin administration due to an initial excessive pulmonary hypertensive response frequently resulting in acute right heart dysfunction. We investigated whether infusion of high-dose endotoxin in pigs but administered in an increasing dose results in inflammatory response without excessive pulmonary hypertension and right heart dysfunction.

View Article and Find Full Text PDF

Although reamed intramedullary nailing has been one of the greatest advances in modern fracture care, the concomitant increase in medullary cavity pressure leads to intravasation of bone marrow content into the blood stream, an effect that can evoke serious systemic reactions. A newly developed rinsing-suction-reamer (RSR) was able to substantially reduce the pressure and bone marrow intravasation content during experimental femoral nailing. We investigated the pathophysiological effects using the RSR, testing the hypothesis that by reducing marrow fat embolization, RSR would also reduce the activation of coagulation compared with the universal AO-Reamer (AOR) and comparable to external fixation.

View Article and Find Full Text PDF

Background: This retrospective study investigated three very similar cases of bilateral lower leg amputation. The aim was to determine which of two therapeutical procedures is associated with better long-term outcome: replantation or primary treatment of the stumps and subsequent prosthetic replacement.

Methods: Evaluation included clinical examination, gait analysis, and a workup of the psychosocial background.

View Article and Find Full Text PDF

Background: In the clinical management of combined tendon and nerve injuries, competing treatment strategies are well known. The effect of mobilization on the functional regeneration of peripheral nerves remains controversial. This study sought to determine the effect of full range of motion mobilization on nerve repair by using tubular segmental nerve splinting to block movement, and thereby variable tension, at the nerve repair site.

View Article and Find Full Text PDF