22 results on '"Krappel F"'
Search Results
2. Establishing the Injury Severity of Subaxial Cervical Spine Trauma: Validating the Hierarchical Nature of the AO Spine Subaxial Cervical Spine Injury Classification System
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Schroeder, G. D., Canseco, J. A., Patel, P. D., Divi, S. N., Karamian, B. A., Kandziora, F., Vialle, E. N., Oner, F. C., Schnake, K. J., Dvorak, M. F., Chapman, J. R., Benneker, L. M., Rajasekaran, S., Kepler, C. K., Vaccaro, A. R., Abdelgawaad, A. S., Abdul, W., Abdulsalam, A., Abeid, M., Ackshota, N., Acosta, O., Akman, Y., Aldahamsheh, O., Alhammoud, A., Aleixo, H., Alexander, H., Alkharsawi, M., Alsammak, W., Amadou, H., Amin, M., Arbatin, J., Atan, A., Athanasiou, A., Bas, P., Bazan, P., Benzakour, T., Benzarti, S., Bernucci, C., Bosco, A., Butler, J., Castillo, A., Cawley, D., Chek, W., Chen, J., Cheng, C., Cheung, J., Chong, C., Corluka, S., Corredor, J., Costa, B., Curri, C., Dawoud, A., Delgado-Fernandez, J., Demiroz, S., Desai, A., Diez-Ulloa, M., Dimas, N., Diniz, S., Direito-Santos, B., Duerinck, J., El-Hewala, T., El-Shamly, M., El-Sharkawi, M., Espinosa, G., Estefan, M., Fang, T., Fernandes, M., Fernandez, N., Ferreira, M., Figueiredo, A., Fiorenza, V., Francis, J., Franz, S., Freedman, B., Fu, L., Fuego, S., Gahlot, N., Ganau, M., Garcia-Pallero, M., Garg, B., Gidvani, S., Giera, B., Godinho, A., Goni, M., Gonzalez, M., Gonzalez, R., Gopalakrishnan, D., Grin, A., Grozman, S., Gruenberg, M., Grundshtein, A., Guasque, J., Guerra, O., Guiroy, A., Hackla, S., Harris, C., Harrop, J., Hassan, W., Henine, A., Hickman, Z., Igualada, C., James, A., Jetjumnong, C., Kaen, A., Karmacharya, B., Kilincer, C., Klezl, Z., Koerner, J., Konrads, C., Krappel, F., Kruyt, M., Krywinski, F., Kundangar, R., Landriel, F., Lindtner, R., Linhares, D., Llombart-Blanco, R., Lopez, W., Lotan, R., Lourido, J., Luna, L., Magashi, T., Majer, C., Mandizvidza, V., Manilha, R., Mannara, F., Margetis, K., Medina, F., Milano, J., Miyakoshi, N., Moisa, H., Montemurro, N., Montoya, J., Morais, J., Morande, S., Msuya, S., Mubarak, M., Mulbah, R., Murugan, Y., Nacer, M., Neves, N., Nicassio, N., Niemeier, T., Olorunsogo, M., Orosco, D., Ozdener, K., Paez, R., Panchal, R., Paterakis, K., Pemovska, E., Pereira, P., Perovic, D., Perozo, J., Pershin, A., Phedy, P., Picazo, D., Pitti, F., Platz, U., Pluderi, M., Ponnusamy, G., Popescu, E., Ramakrishnan, S., Ramieri, A., Rebholz, B., Ricciardi, G., Ricciardi, D., Robinson, Y., Rodriguez, L., Rodrigues-Pinto, R., Romero, I., Rosas, R., Russo, S., Rutges, J., Sartor, F., Shariati, B., Sharma, J., Shoaib, M., Smith, S., Sorimachi, Y., Sribastav, S., Steiner, C., Subbiah, J., Subramanian, P., Suri, T., Tannoury, C., Tokala, D., Toluse, A., Ungurean, V., Vahl, J., Valacco, M., Valdez, C., Vernengo-Lezica, A., Veroni, A., Vieira, R., Viswanadha, A., Wagner, S., Wamae, D., Weening, A., Weidert, S., W. -T., Wu, M. -H., Wu, Yuan, H., Yuh, S. -J., Yurac, R., Zarate-Kalfopulos, B., Ziabrov, A., Zubairi, A., Surgical clinical sciences, Neuroprotection & Neuromodulation, and Neurosurgery
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Adult ,Male ,Facet (geometry) ,medicine.medical_specialty ,Cross-sectional study ,Clinical Neurology ,610 Medicine & health ,Cervical spine injury ,cervical spine ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Injury Severity Score ,Surveys and Questionnaires ,Severity of illness ,Validation ,medicine ,Humans ,Orthopedics and Sports Medicine ,Spinal cord injury ,Spinal Cord Injuries ,030222 orthopedics ,business.industry ,Reproducibility of Results ,AO spine subaxial cervical spine injury ,Cervical spine ,Classification system ,Injury severity score ,Trauma ,Cervical Vertebrae ,Cross-Sectional Studies ,Female ,medicine.disease ,medicine.anatomical_structure ,trauma ,Neurology (clinical) ,Radiology ,business ,030217 neurology & neurosurgery ,Cervical vertebrae - Abstract
STUDY DESIGN Global cross-sectional survey. OBJECTIVE To validate the AO Spine Subaxial Cervical Spine Injury Classification by examining the perceived injury severity by surgeon across AO geographical regions and practice experience. SUMMARY OF BACKGROUND DATA Previous subaxial cervical spine injury classifications have been limited by subpar interobserver reliability and clinical applicability. In an attempt to create a universally validated scheme with prognostic value, AO Spine established a subaxial cervical spine injury classification involving four elements: (1) injury morphology, (2) facet injury involvement, (3) neurologic status, and (4) case-specific modifiers. METHODS A survey was sent to 272 AO Spine members across all geographic regions and with a variety of practice experience. Respondents graded the severity of each variable of the classification system on a scale from zero (low severity) to 100 (high severity). Primary outcome was to assess differences in perceived injury severity for each injury type over geographic regions and level of practice experience. RESULTS A total of 189 responses were received. Overall, the classification system exhibited a hierarchical progression in subtype injury severity scores. Only three subtypes showed a significant difference in injury severity score among geographic regions: F3 (floating lateral mass fracture, p:0.04), N3 (incomplete spinal cord injury, p:0.03), and M2 (critical disk herniation, p:0.04). When stratified by surgeon experience, pairwise comparison showed only 2 morphological subtypes, B1 (bony posterior tension band injury, p:0.02) and F2 (unstable facet fracture, p:0.03), and one neurologic subtype (N3, p:0.02) exhibited a significant difference in injury severity score. CONCLUSIONS The AO Spine Subaxial Cervical Spine Injury Classification System has shown to be reliable and suitable for proper patient management. The study shows this classification is substantially generalizable by geographic region and surgeon experience; and provides a consistent method of communication among physicians while covering the majority of subaxial cervical spine traumatic injuries.Level of Evidence: 4.
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- 2021
3. Der Stellenwert von Sonographie, Computertomographie und Kernspintomographie bei der Epiphyseolysis capitis femoris
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Harland, U. and Krappel, F. A.
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- 2002
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4. Periprothetische Frakturen
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Oestern, H. J., primary, Balz, F., additional, Kelsch, G., additional, Nothwang, J., additional, Ulrich, Chr., additional, Spitaler, R., additional, Janousek, A., additional, Hertz, H., additional, Huber-Lang, M. S., additional, Pokar, S., additional, Kinzl, L., additional, Hehl, G., additional, Hertel, V., additional, Gonschorek, O., additional, Schütz, L., additional, Josten, C., additional, Wick, M., additional, Müller, E. J., additional, Muhr, G., additional, Nothofer, W., additional, Dannheuser, J., additional, Neugebauer, R., additional, Kapella, M., additional, Kreusch-Brinker, R., additional, Krappel, F. A., additional, Hippchen, M., additional, and Harland, U., additional
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- 2001
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5. Failure of osteosynthesis and prosthetic joint infection due to Mycobacterium tuberculosis following a subtrochanteric fracture: a case report and review of the literature
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Krappel, F. A. and Harland, U.
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- 2000
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6. Der heutige Stellenwert der Sonographie in der Orthopädie*
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Krappel, F., primary and Harland, U., additional
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- 2008
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7. Die Sonographische Diagnostik der vorderen Syndesmosenruptur*
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Krappel, F., primary, Schmitz, R., additional, and Harland, U., additional
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- 2008
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8. Kann die Time-of-Flight-Angiographie in der MRT die präoperative Duplex- und Doppler-Untersuchung der Arteria carotis ersetzen? - Ergebnisse eines prospektiven Vergleichs mit Literaturübersicht
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Krappel, F., primary, Bauer, E., additional, and Harland, U., additional
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- 2002
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9. Die Effizienz der MRT - Wirbelsäulenganzaufnahme in der Diagnostik von Wirbelmetastasen - Ergebnisse einer prospektiven Untersuchung
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Krappel, F., primary, Bauer, E., additional, and Harland, U., additional
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- 2001
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10. Are bone bruises a possible cause of osteochondritis dissecans of the capitellum? a case report and review of the literature.
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Krappel, F. A., Bauer, E., and Harland, U.
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BONE injuries , *BLUNT trauma , *MEDICAL imaging systems , *PHYSICAL therapy , *BRUISES , *PAIN - Abstract
A 17-year old soccer-player sustained a fracture and dislocation of the ulnar epicondyle combined with a bone bruises at the radial head and the capitellum. An open reduction and internal fixation was performed using two K-wires. Initial recovery was uneventful. After the operation he was discharged home and reviewed on a regular basis. When bony union had occurred the two K-wires were removed. However, on follow up he continued to complain of pain on the radial aspect of the joint and did not regain his normal range of movement. A further MRI was performed. Now a grade II osteochondritis dissecans not visible on the previous MRI taken 12 weeks earlier was clearly visualised. Treatment was continued conservatively with physiotherapy but avoiding aggressive mobilisation. On final review 6 months later he was able to move painfree with residual limitation of movement (ROM 0–5–130°). Another MRI taken now was assessed as normal. [ABSTRACT FROM AUTHOR]
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- 2005
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11. Die Sonographische Diagnostik der vorderen Syndesmosenruptur*.
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Krappel, F., Schmitz, R., and Harland, U.
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- 1997
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12. Der heutige Stellenwert der Sonographie in der Orthop�die*.
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Krappel, F. and Harland, U.
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- 1997
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13. Regional and experiential differences in surgeon preference for the treatment of cervical facet injuries: a case study survey with the AO Spine Cervical Classification Validation Group
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Canseco, Jose A, Schroeder, Gregory D, Patel, Parthik D, Grasso, Giovanni, Chang, Michael, Kandziora, Frank, Vialle, Emiliano N, Oner, F Cumhur, Schnake, Klaus J, Dvorak, Marcel F, Chapman, Jens R, Benneker, Lorin M, Rajasekaran, Shanmuganathan, Kepler, Christopher K, Vaccaro, Alexander R, Abdelgawaad, Ahmed, Abdul, Waheed, Abdulsalam, Asmatullah, Abeid, Mbarak, Ackshota, Nissim, Acosta, Olga, Akman, Yunus, Aldahamsheh, Osama, Alhammoud, Abduljabbar, Aleixo, Hugo, Alexander, Hamish, Alkharsawi, Mahmoud, Alsammak, Wael, Amadou, Hassame, Amin, Mohamad, Arbatin, Jose, Atan, Ahmad, Athanasiou, Alkinoos, Bas, Paloma, Bazan, Pedro, Benzakour, Thami, Benzarti, Sofien, Bernucci, Claudiio, Bosco, Aju, Butler, Joseph, Castillo, Alejandro, Cawley, Derek, Chek, Wong, Chen, John, Cheng, Christina, Cheung, Jason, Chong, Chun, Corluka, Stipe, Corredor, Jose, Costa, Bruno, Curri, Cloe, Dawoud, Ahmed, Delgado- Fernandez, Juan, Demiroz, Serdar, Desai, Ankit, Diez-Ulloa, Maximo, Dimas, Noe, Diniz, Sara, Direito-Santos, Bruno, Duerinck, Johnny, El- Hewala, Tarek, El-Shamly, Mahmoud, El-Sharkawi, Mohammed, Espinosa, Guillermo, Estefan, Martin, Fang, Taolin, Fernandes, Mauro, Fernandez, Norbert, Ferreira, Marcus, Figueiredo, Alfredo, Fiorenza, Vito, Francis, Jibin, Franz, Seibert, Freedman, Brett, Fu, Lingjie, Fuego, Segundo, Gahlot, Nitesh, Ganau, Mario, Garcia-Pallero, Maria, Garg, Bhavuk, Gidvani, Sandeep, Giera, Bjoern, Godinho, Amauri, Goni, Morshed, Gonzalez, Maria, Gopalakrishnan, Dilip, Grin, Andrey, Grozman, Samuel, Gruenberg, Marcel, Grundshtein, Alon, Guasque, Joana, Guerra, Oscar, Guiroy, Alfredo, Hackla, Shafiq, Harris, Colin, Harrop, James, Hassan, Waqar, Henine, Amin, Hickman, Zachary, Igualada, Cristina, James, Andrew, Jetjumnong, Chumpon, Kaen, Ariel, Karmacharya, Balgopal, Kilincer, Cumur, Klezl, Zdenek, Koerner, John, Konrads, Christian, Krappel, Ferdinand, Kruyt, Moyo, Krywinski, Fernando, Kundangar, Raghuraj, Landriel, Federico, Lindtner, Richard, Linhares, Daniela, Llombart-Blanco, Rafael, Lopez, William, Lotan, Raphael, Lourido, Juan, Luna, Luis, Magashi, Tijjani, Majer, Catalin, Mandizvidza, Valentine, Manilha, Rui, Mannara, Francisco, Margetis, Konstantinos, Medina, Fabrico, Milano, Jeronimo, Miyakoshi, Naohisa, Moisa, Horatiu, Montemurro, Nicola, Montoya, Juan, Morais, Joao, Morande, Sebastian, Msuya, Salim, Mubarak, Mohamed, Mulbah, Robert, Murugan, Yuvaraja, Nacer, Mansouri, Neves, Nuno, Nicassio, Nicola, Niemeier, Thomas, Olorunsogo, Mejabi, Oner, F. C., Orosco, David, Ozdener, Kubilay, Paez, Rodolfo, Panchal, Ripul, Paterakis, Konstantinos, Pemovska, Emilija, Pereira, Paulo, Perovic, Darko, Perozo, Jose, Pershin, Andrey, Phedy, Phedy, Picazo, David, Pitti, Fernando, Platz, Uwe, Pluderi, Mauro, Ponnusamy, Gunasaeelan, Popescu, Eugen, Ramakrishnan, Selvaraj, Ramieri, Alessandro, Rebholz, Brandon, Ricciadri, Guillermo, Ricciardi, Daniel, Robinson, Yohan, Rodriguez, Luis, Rogrigues-Pinto, Ricardo, Romero, Itati, Rosas, Ronald, Russo, Salvatore, Rutges, Joost, Sartor, Federico, Schroeder, Gregory, Shariati, Babak, Sharma, Jeevan, Shoaib, Mahmoud, Smith, Sean, Sorimachi, Yasunori, Sribastav, Shilanant, Steiner, Craig, Subbiah, Jayakumar, Suramanian, Panchu, Suri, Tarun, Tannoury, Chadi, Tokala, Devi, Toluse, Adetunji, Ungurean, Victor, Vaccaro, Alexander, Vahl, Joachim, Valacco, Marcelo, Valdez, Cristian, Vernengo-Lezica, Alejo, Veroni, Andrea, Vieira, Rian, Viswanadha, Arun, Wagner, Scott, Wamae, David, Weening, Alexander, Weidert, Simon, Wu, Wen-Tien, Wu, Meng-Huang, Yuan, Haifeng, Yuh, Sung-Joo, Yurac, Ratko, Zarate- Kalfopulos, Baron, Ziabrov, Alesksei, Zubairi, Akbar, AO Spine Cervical Classification Validation Group, Canseco, Jose A, Schroeder, Gregory D, Patel, Parthik D, Grasso, Giovanni, Chang, Michael, Kandziora, Frank, Vialle, Emiliano N, Oner, F Cumhur, Schnake, Klaus J, Dvorak, Marcel F, Chapman, Jens R, Benneker, Lorin M, Rajasekaran, Shanmuganathan, Kepler, Christopher K, Vaccaro, Alexander R, Canseco J.A., Schroeder G.D., Patel P.D., Grasso G., Chang M., Kandziora F., Vialle E.N., Oner F.C., Schnake K.J., Dvorak M.F., Chapman J.R., Benneker L.M., Rajasekaran S., Kepler C.K., Vaccaro A.R., Abdelgawaad A., Abdul W., Abdulsalam A., Abeid M., Ackshota N., Acosta O., Akman Y., Aldahamsheh O., Alhammoud A., Aleixo H., Alexander H., Alkharsawi M., Alsammak W., Amadou H., Amin M., Arbatin J., Atan A., Athanasiou A., Bas P., Bazan P., Benzakour T., Benzarti S., Bernucci C., Bosco A., Butler J., Castillo A., Cawley D., Chek W., Chen J., Cheng C., Cheung J., Chong C., Corluka S., Corredor J., Costa B., Curri C., Dawoud A., Delgado-Fernandez J., Demiroz S., Desai A., Diez-Ulloa M., Dimas N., Diniz S., Direito-Santos B., Duerinck J., El-Hewala T., El-Shamly M., El-Sharkawi M., Espinosa G., Estefan M., Fang T., Fernandes M., Fernandez N., Ferreira M., Figueiredo A., Fiorenza V., Francis J., Franz S., Freedman B., Fu L., Fuego S., Gahlot N., Ganau M., Garcia-Pallero M., Garg B., Gidvani S., Giera B., Godinho A., Goni M., Gonzalez M., Gopalakrishnan D., Grin A., Grozman S., Gruenberg M., Grundshtein A., Guasque J., Guerra O., Guiroy A., Hackla S., Harris C., Harrop J., Hassan W., Henine A., Hickman Z., Igualada C., James A., Jetjumnong C., Kaen A., Karmacharya B., Kilincer C., Klezl Z., Koerner J., Konrads C., Krappel F., Kruyt M., Krywinski F., Kundangar R., Landriel F., Lindtner R., Linhares D., Llombart-Blanco R., Lopez W., Lotan R., Lourido J., Luna L., Magashi T., Majer C., Mandizvidza V., Manilha R., Mannara F., Margetis K., Medina F., Milano J., Miyakoshi N., Moisa H., Montemurro N., Montoya J., Morais J., Morande S., Msuya S., Mubarak M., Mulbah R., Murugan Y., Nacer M., Neves N., Nicassio N., Niemeier T., Olorunsogo M., Orosco D., Ozdener K., Paez R., Panchal R., Paterakis K., Pemovska E., Pereira P., Perovic D., Perozo J., Pershin A., Phedy P., Picazo D., Pitti F., Platz U., Pluderi M., Ponnusamy G., Popescu E., Ramakrishnan S., Ramieri A., Rebholz B., Ricciadri G., Ricciardi D., Robinson Y., Rodriguez L., Rogrigues-Pinto R., Romero I., Rosas R., Russo S., Rutges J., Sartor F., Schroeder G., Shariati B., Sharma J., Shoaib M., Smith S., Sorimachi Y., Sribastav S., Steiner C., Subbiah J., Suramanian P., Suri T., Tannoury C., Tokala D., Toluse A., Ungurean V., Vaccaro A., Vahl J., Valacco M., Valdez C., Vernengo-Lezica A., Veroni A., Vieira R., Viswanadha A., Wagner S., Wamae D., Weening A., Weidert S., Wu W.-T., Wu M.-H., Yuan H., Yuh S.-J., Yurac R., Zarate-Kalfopulos B., Ziabrov A., Zubairi A., Surgical clinical sciences, Neuroprotection & Neuromodulation, and Neurosurgery
- Subjects
Cervical spine ,Joint dislocations ,Neck injuries ,Spinal diseases ,Spinal injuries ,Trauma ,medicine.medical_specialty ,Facet (geometry) ,Neck injurie ,Neuroscience(all) ,610 Medicine & health ,Experiential learning ,Joint dislocation ,03 medical and health sciences ,0302 clinical medicine ,Spinal disease ,medicine ,Humans ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Surgeons ,Validation group ,Spinal injurie ,business.industry ,Spine.cervical ,medicine.disease ,Preference ,Spinal Fusion ,Cervical Vertebrae ,Physical therapy ,Surgery ,Neurosurgery ,Anterior approach ,business ,030217 neurology & neurosurgery - Abstract
Purpose The management of cervical facet dislocation injuries remains controversial. The main purpose of this investigation was to identify whether a surgeon’s geographic location or years in practice influences their preferred management of traumatic cervical facet dislocation injuries. Methods A survey was sent to 272 AO Spine members across all geographic regions and with a variety of practice experience. The survey included clinical case scenarios of cervical facet dislocation injuries and asked responders to select preferences among various diagnostic and management options. Results A total of 189 complete responses were received. Over 50% of responding surgeons in each region elected to initiate management of cervical facet dislocation injuries with an MRI, with 6 case exceptions. Overall, there was considerable agreement between American and European responders regarding management of these injuries, with only 3 cases exhibiting a significant difference. Additionally, results also exhibited considerable management agreement between those with ≤ 10 and > 10 years of practice experience, with only 2 case exceptions noted. Conclusion More than half of responders, regardless of geographical location or practice experience, identified MRI as a screening imaging modality when managing cervical facet dislocation injuries, regardless of the status of the spinal cord and prior to any additional intervention. Additionally, a majority of surgeons would elect an anterior approach for the surgical management of these injuries. The study found overall agreement in management preferences of cervical facet dislocation injuries around the globe.
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- 2020
14. Herniectomy versus herniectomy with the DIAM spinal stabilization system in patients with sciatica and concomitant low back pain: results of a prospective randomized controlled multicenter trial.
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Krappel F, Brayda-Bruno M, Alessi G, Remacle JM, Lopez LA, Fernández JJ, Maestretti G, and Pfirrmann CWA
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- Adult, Back Pain etiology, Female, Humans, Intervertebral Disc Displacement complications, Low Back Pain etiology, Male, Middle Aged, Orthopedic Procedures instrumentation, Pain Measurement, Prospective Studies, Quality of Life, Sciatica etiology, Treatment Outcome, Diskectomy methods, Intervertebral Disc Displacement surgery, Lumbar Vertebrae surgery, Orthopedic Procedures methods
- Abstract
Purpose: To investigate the short and medium term efficacy and patient outcomes of DIAM spinal stabilization system on back pain, disability, leg pain and quality of life., Methods: 165 patients were enrolled; 146 patients with a single level disc herniation (L2 to L5) were randomized: 75 investigational (herniectomy and DIAM) and 71 control (herniectomy alone) treated and followed up for 24 months., Results: Significant improvements overtime (P < 0.001) in both groups but not significantly different between groups for visual analog scale (VAS) back pain at 6 months (investigational -3.97 ± 2.55 vs control-3.37 ± 3.15, P = 0.228) and Oswestry Disability Index (ODI) at 12 months (-38.55 ± 20.10 vs -37.19 ± 22.61, P = 0.719). For both outcomes, there was no statistically significant difference between the groups, at all postoperative time points. Although the enrolment ended before the intended sample size (308 patients) was reached, the number of patients reaching the VAS back pain minimally clinically important difference (MCID) of ≥2.2 at 6 months was higher in the investigational (79.4 % vs control 57.1 %, P = 0.008). These results were sustained throughout 24 months (82.8 vs 64.4 %, P < 0.05). In average, surgical duration (P < 0.001), blood loss (P = 0.029) and skin incision (P < 0.001) in the investigational were 10 min longer, 22.5 ml greater and 2.0 cm wider than control group (median values). Improved tertiary outcomes from BL to 24 mo in both groups (investigational vs control): VAS leg pain (mean decrease -6.41 ± 2.57 to -6.41 vs -5.61 ± to -3.30); improved quality of life (SF-36: 20.68 ± 9.44 vs 16.90 ± 10.74); pain medication reduction: 56.7 vs 47.9 %; return to work: 45.7 vs 38.0 %. Adverse event rates: 68.5 % investigational and 66.2 % control., Conclusions: This is the first randomized controlled trial to report equivalent efficacy and safety of herniectomy with or without DIAM spinal stabilizing device. Leg pain, back pain and the level of disability were not significantly different between groups; however, number of patients reaching the MCID for back pain was significantly higher in the investigational group at 6 through 24 months.
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- 2017
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15. [Long-term results, status of studies and differential indication regarding the DIAM implant].
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Krappel FA
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- Decompression, Surgical instrumentation, Equipment Failure Analysis, Humans, Longitudinal Studies, Prosthesis Design, Spinal Stenosis diagnosis, Treatment Outcome, Decompression, Surgical methods, Intervertebral Disc Displacement etiology, Intervertebral Disc Displacement surgery, Joint Prosthesis, Spinal Stenosis etiology, Spinal Stenosis surgery
- Abstract
The DIAM (Device for Interspinous Assisted Motion) interspinous device offers the possibility of a viscoelastic supplementation of the lumbar motion segment with a small, reversible operation. It is intended as a restabilisation procedure after a discectomy to avoid facet joint overload and as a topping of procedure for the segment adjacent to a fusion. The device has been on the German market since 2004. There are several biomechanical studies available showing an effect mainly in extension and flexion, but hardly any in rotation and lateral inclination. Despite frequent clinical use, there have only been a few, mainly retrospective clinical studies indicating the success of the implant; however, sound scientific data are missing. Several prospective, randomised, controlled studies are now underway to fill that gap. Only then will it be possible to assess whether this implant is of true value to improve clinical results and to slow down the degenerative cascade or not.
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- 2010
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16. [Value of ultrasound, CT, and MRI in the diagnosis of slipped capital femoral epiphysis (SCFE)].
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Harland U and Krappel FA
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- Child, Female, Femur Neck pathology, Humans, Joint Instability diagnosis, Male, Reference Values, Sensitivity and Specificity, Epiphyses, Slipped diagnosis, Femur Head pathology, Magnetic Resonance Imaging, Tomography, X-Ray Computed, Ultrasonography
- Abstract
Traditionally, radiographic assessment of the hip with anteroposterior and lateral views is the gold standard of diagnosis in SCFE. This paper evaluates the possible contributions of other methods of modern imaging to the early diagnosis and treatment. There is scientific evidence that ultrasound can diagnose the disease earlier than conventional radiography and also has the possibility to differentiate the classification between stable and unstable. MRI depicts marrow changes earlier than any other imaging method available and has a role in cases where the diagnosis is difficult to make as well as in assessing the risk of chondrolysis and avascular necrosis. To show the anatomic deformity, anteroposterior and lateral radiographs remain the mainstay of preoperative planning.
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- 2002
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17. [Can TOF MRA replace duplex and Doppler sonography in preoperative assessment of the carotid arteries? A prospective comparison and review of the literature].
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Krappel FA, Bauer E, and Harland U
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- Aged, Carotid Arteries surgery, Cervical Vertebrae pathology, Female, Humans, Intervertebral Disc Displacement diagnosis, Male, Middle Aged, Sensitivity and Specificity, Spinal Cord Compression diagnosis, Spinal Stenosis diagnosis, Carotid Arteries pathology, Carotid Stenosis diagnosis, Cervical Vertebrae surgery, Intervertebral Disc Displacement surgery, Preoperative Care, Spinal Cord Compression surgery, Spinal Fusion, Spinal Stenosis surgery, Ultrasonography, Doppler, Duplex
- Abstract
Aim: To examine the quality and usefulness of time-of-flight MR-angiography and duplex-doppler sonography, respectively, in assessment of the extracranial arteries before cervical spine operations., Methods: Patients scheduled for operations of the cervical spine had an MRI plus TOF as well as a duplex and Doppler scan. At the time of the examination the radiologist and the neurologist in charge were blinded for the study. Endpoints were not only the accuracy of the procedures but more so which method improved the preoperative process most., Results: Twenty patients were examined so far. Only in one case did the result differ when a complete occlusion diagnosed sonographically was judged as a severe stenosis on MRA. One patient did not tolerate the MRA for the extra 5 minutes necessary, therefore a contrast-enhanced MRA was performed. MRA eased the preoperative process as imaging of the pathology and the carotids were realised in one step. The costs were slightly higher for MRA than for duplex-doppler sonography., Conclusion: TOF-MRA can replace the duplex-doppler examination in the preoperative assessment of the carotids and has the potential to streamline the preoperative time schedule. Similar to duplex and doppler, in order to be accurate enough the method requires a high degree of expertise from the radiologist.
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- 2002
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18. [MRI diagnosis of intervertebral disk disease].
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Krappel FA and Harland U
- Subjects
- Adolescent, Age Factors, Back Pain etiology, Diagnosis, Differential, Discitis diagnosis, Female, Follow-Up Studies, Humans, Intervertebral Disc Displacement, Male, Middle Aged, Myelography methods, Osteochondritis diagnosis, Prospective Studies, Randomized Controlled Trials as Topic, Sciatica etiology, Spinal Diseases diagnostic imaging, Spinal Diseases surgery, Time Factors, Tomography, X-Ray Computed, Intervertebral Disc pathology, Magnetic Resonance Imaging methods, Spinal Diseases diagnosis
- Abstract
Magnetic resonance imaging (MRI) is the leading diagnostic procedure for disk pathology and has overtaken other imaging modalities in frequency of use. However, one must be cautious not to overinterpret small abnormalities that are also frequent in asymptomatic subjects. There is conflicting evidence about the correlation of high-intensity zones with clinical symptoms. Bulging disks and protrusions are a common finding in asymptomatic individuals, whilst extrusions are almost always accompanied by back pain and sciatica. In patients with back pain or sciatica, MRI is indicated after failure of conservative management or neurological deterioration. Contrast-enhanced MRI is well suited to differentiate a recurrent disk extrusion from epidural fibrosis. In all cases suspicious of tumor or infection, MRI is indicated as a first-line investigation. The indications and pitfalls of the state of the art of MRI are delineated in this article.
- Published
- 2001
- Full Text
- View/download PDF
19. [Efficacy of MRI--whole spine image in diagnosis of vertebral metastases--results of a prospective study].
- Author
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Krappel FA, Bauer E, and Harland U
- Subjects
- Aged, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Prospective Studies, Sensitivity and Specificity, Spinal Neoplasms diagnosis, Magnetic Resonance Imaging, Spinal Neoplasms secondary, Spine pathology
- Abstract
Aim: To prospectively investigate the outcome efficacy of whole spine MRI for diagnosis and treatment in patients with suspected metastases of the spine., Methods: All patients older than 50 years with newly diagnosed back pain and/or newly diagnosed spine-related neurological symptoms without a diagnosis by other imaging modalities were accepted in this study. A whole spine MRI and a detailed MRI per spine region with suspicious lesions were performed using a Siemens Magnetom Expert 1.0 Tesla machine. Outcome efficacy was determined by assessing further therapy and result for the patient., Results: In all 15 patients of the year 1999 whole spine MRI allowed us to determine the definite diagnosis and treatment. Plain X-ray and 99mTc bone scanning gave a diagnostic suspicion but no definite diagnosis or therapeutic consequence., Conclusions: MRI of the spine including whole spine images allows clear cut decision making in diagnosis and treatment of cases suspicious for metastatic disease of the spine. Careful history taking and clinical examination provide enough information to opt for whole spine MRI as the first choice investigation. This will provide maximum benefit to the patient and avoid examination cascades.
- Published
- 2001
- Full Text
- View/download PDF
20. [Current role of ultrasonography in orthopedics. Results of a nationwide survey].
- Author
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Krappel F and Harland U
- Subjects
- Adult, Child, Curriculum, Education, Medical, Graduate, Germany, Hip Dislocation, Congenital diagnostic imaging, Humans, Infant, Orthopedics education, Ultrasonography, Joint Diseases diagnostic imaging, Orthopedics methods
- Abstract
The purpose of this study was to determine the current position of diagnostic ultrasound imaging in the day to day orthopaedic practice. A questionnaire was sent to all the 387 conservative and operative orthopaedic hospitals and orthopaedic university departments in Germany. 167 of these hospitals completed the forms and provided the basis for this evaluation (response rate 43.2%). Screening of the fetal hip for CDH was by far the most common indication, the shoulder was ranking second, the knee and the hip joint in children and adults rank third and fourth. Other frequent indications were injuries of the achilles tendon, the menisci of the knee, the knee in rheumatoid arthritis and muscle injuries. Ultrasound imaging is clearly established as a diagnostic tool at least in the named areas. It is therefore of importance to include ultrasound examination techniques in the curriculum of the orthopaedic training scheme.
- Published
- 1997
- Full Text
- View/download PDF
21. [Sonographic diagnosis of anterior syndesmosis rupture].
- Author
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Krappel F, Schmitz R, and Harland U
- Subjects
- Arthrography, Humans, Ligaments diagnostic imaging, Ligaments injuries, Predictive Value of Tests, Prospective Studies, Rupture, Sensitivity and Specificity, Ultrasonography, Ankle Injuries diagnostic imaging
- Abstract
In a prospective trial we evaluated the diagnostic value of ultrasound imaging in the diagnosis of injuries to the anterior syndesmosis of the ankle joint. In an initial series of 20 patients using a basic standard ultrasound machine (Siemens Sonoline SL 1 with a 7.5 MHz piece) and a simple dynamic testing protocol as described in this article we found a significant difference between the ultrasound result for the ruptured syndesmosis versus non rupture and a specificity similar to that of arthrography. We conclude that ultrasound imaging is a useful tool in the diagnosis of syndesmotic rupture. Given the statistical significance of these results we feel confident that-despite the small amount of patients of this series and after an individual learning curve-ultrasound will eventually replace arthrography as the standard of investigation for this type of injury.
- Published
- 1997
- Full Text
- View/download PDF
22. Arthroscopic excision of symptomatic medial plica. A study of 118 knees with 1-4 year follow-up.
- Author
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Flanagan JP, Trakru S, Meyer M, Mullaji AB, and Krappel F
- Subjects
- Adolescent, Adult, Arthroscopy, Child, Female, Humans, Male, Middle Aged, Retrospective Studies, Knee Joint surgery, Synovectomy
- Abstract
We retrospectively reviewed 93 patients (118 knees) treated by arthroscopic excision of painful medial plica. A scoring scale 0-100 was used to evaluate the symptoms. After an average of 2 (1-4) years, 109 of 118 knees had little, if any, pain and the average improvement in the score was 41 points. Thus arthroscopic excision of a painful medial plica can provide lasting and satisfactory relief of symptoms.
- Published
- 1994
- Full Text
- View/download PDF
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