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Your search keyword '"Bühren, Volker"' showing total 42 results
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42 results on '"Bühren, Volker"'

41. [End-of-stem pain in hip and knee arthroplasty].

Author

Ettinger M, Savov P, Windhagen H, Bühren V, and Hungerer S

Subjects
Humans, Pain, Prosthesis Design, Reoperation, Arthroplasty, Replacement, Hip adverse effects, Arthroplasty, Replacement, Knee adverse effects, Bone Cements, Hip Prosthesis, Prosthesis Failure
Abstract

End-of-stem pain after knee and hip arthroplasty with diaphyseal supportive stems is a frequently overlooked and potentially underestimated complication. A commonly recurring clinical phenome is the symptom-free interval after surgery of weeks to months, with new onset of symptoms under stress only later. The patient is often again reliant on walking sticks. End-of-stem pain is a diagnosis of exclusion. Pain is projected into the tip of the stem, and if differential diagnoses such as loosening are excluded, then the patient might be treated with a "bending-plate". Since bone cement has a similar elastic modulus to human cortical bone, a change of method to a cemented implant can also be expedient. In the primary situation, in addition to cemented stems, the use of "split-stems" could be useful. After revision surgery of any kind, a timely cessation of pain confirms the diagnosis.

Published
2021
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42. Increased intrathecal pressure after traumatic spinal cord injury: an illustrative case presentation and a review of the literature.

Author

Grassner L, Winkler PA, Strowitzki M, Bühren V, Maier D, and Bierschneider M

Subjects
Accidental Falls, Fracture Dislocation diagnostic imaging, Humans, Male, Middle Aged, Spinal Cord Injuries diagnostic imaging, Thoracic Vertebrae diagnostic imaging, Thoracic Vertebrae injuries, Zygapophyseal Joint diagnostic imaging, Zygapophyseal Joint injuries, Cerebrospinal Fluid Pressure physiology, Fracture Dislocation etiology, Spinal Cord Injuries physiopathology, Thoracic Vertebrae physiopathology, Zygapophyseal Joint physiopathology
Abstract

Purpose: Early surgical management after traumatic spinal cord injury (SCI) is nowadays recommended. Since posttraumatic ischemia is an important sequel after SCI, maintenance of an adequate mean arterial pressure (MAP) within the first week remains crucial in order to warrant sufficient spinal cord perfusion. However, the contribution of raised intraparenchymal and consecutively increased intrathecal pressure has not been implemented in treatment strategies., Methods: Case report and review of the literature., Results: Here we report a case of a 54-year old man who experienced a thoracic spinal cord injury after a fall. CT-examination revealed complex fractures of the thoracic spine. The patient underwent prompt surgical intervention. Intraoperatively, fractured parts of the ascending Th5 facet joint were displaced into the spinal cord itself. Upon removal, excessive protruding of medullary tissue was observed over several minutes. This demonstrates the clinical relevance of increased intrathecal pressure in some patients., Conclusion: Monitoring and counteracting raised intrathecal pressure should guide clinical decision-making in the future in order to ensure optimal spinal cord perfusion pressure for every affected individual.

Published
2017
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