M Maghsudi

Universität Regensburg, Ratisbon, Bavaria, Germany

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Publications (21)20.1 Total impact

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    ABSTRACT: The biomechanical stability of a newly developed humerus nail (Sirustrade mark) for the treatment of fractures of the proximal humerus was analyzed in comparison to established systems. In total, three randomized groups were formed (n = 4 pairs) from 12 matched pairs of human cadaver humeri. All intact bones were mechanically characterized by five subsequent load cycles under bending and torsional loading. The bending moment at the osteotomy was 7.5 N m the torsional moment was 8.3 N m over the hole specimen length. Loading was consistently initiated at the distal epiphysis and the deformation at the distal epiphysis was continuously recorded. Prior to implant reinforcement, a defect of 5 mm was created to simulate an unstable subcapital humerus fracture. For paired comparison, one humerus of each pair was stabilized with the Sirus proximal humerus nail while the counterpart was stabilized by a reference implant. In detail, the following groups were created: Sirus versus Proximal humerus nail (PHN) with spiral blade (group I); Sirus versus PHILOS plate (group II); Sirus versus 4.5 mm AO T-plate (group III). The Sirus nail demonstrated significantly higher stiffness values compared to the reference implants for both bending and torsional loading. The following distal epiphyseal displacements were recorded for a bending moment of 7.5 N m at the osteotomy: Sirus I: 8.8 mm, II: 8.4 mm, III: 7.7 mm (range 6.9-10.9), PHN 21.1 mm (range 15.7-25.2) (P = 0.005), PHILOS plate 27.5 mm (range 21.6-35.8) (P < 0.001), 4.5 AO T-plate 26.3 mm (range 24.3-33.9) (P = 0.01). The rotations corresponding to 8.3 N m torsional moment were: Sirus I: 9.1 degrees , II: 9.3 degrees , III: 10.6 degrees (range 7.5-12.2), PHN 13.5 degrees (range 10.3-15.6) (P = 0.158), PHILOS plate 15.6 degrees (range 13.7-20.8) (P = 0.007), 4.5 AO T-Platte 14.1 degrees (range 11.5-19.7) (P = 0.158). The intramedullary load carriers were biomechanically superior when compared to the plating systems in the fracture model presented here. Supplementary, the Sirus Nail showed higher stiffness values than the PHN. However, the latter are gaining in importance due to the possibility of minimal invasive implantation. Whether this will be associated with functional advantages requires further clinical investigation.
    Archives of Orthopaedic and Trauma Surgery 08/2007; 127(6):441-7. · 1.36 Impact Factor
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    ABSTRACT: A new proximal humerus nail (Sirus) for the treatment of proximal humerus fractures has become available. This paper presents the clinical and radiological outcome of the first collective study of 36 patients. Evaluation was performed prospectively. An antero-acromial approach was used for all patients. Three fixed-angle screws were inserted in a locking technique. Thirty-six fractures were fixed with the Sirus nail. These were dislocated 2- and 3-part fractures as described by Neer (J Bone Joint Surg 52:1077-1089). Outcomes were evaluated using the Constant score. Of the 36 patients evaluated 23 had sustained a 2-part fracture and 13 a 3-part fracture. The average age at surgery was 71.2 years (range, 30-93). In 75% of the cases, good to very good outcomes were achieved. Outcomes were satisfactory in 13.8% of the cases. Twenty-five fractures were treated in a closed technique. Average operating time was 41 minutes (range, 19-106) with a fluoroscopy time of 0.6 minutes (range, 0.4-2.6). Secondary fragment dislocation occurred in two cases. After 12.1 months the average Constant score was 79.2 (range, 46-100). Initial clinical experience with the Sirus nail indicates that the procedure is straightforward and has a low complication rate. Functional outcomes are predominantly good to very good. Large fragments of the greater tuberosity and 4-part fractures are beyond the scope of this application.
    International Orthopaedics 07/2007; 32(6):759-65. · 2.32 Impact Factor
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    ABSTRACT: The Trans Iliacal Internal Fixator (TIFI) is a minimally invasive technique for the stabilization of sacro-iliac joint ruptures and fractures lateral to the sacral ala or through the sacral foramen. In this study, 7.0 mm pedicle screws of the Universal-Spine-System (USS, Synthes) were inserted 1-2 cm on the cranial side of the posterior superior iliac spine and parallel to the superior gluteal line. The connecting bar was inserted subfascially and fixed with the locking head pedicle screws to form an fixed-angle construction. In a prospective study 31 patients with vertical shear injuries of the pelvis were treated with the TIFI. There were two wound infections and one loosening of a pedicle screw. None of the screws were incorrectly positioned and no neuro-vascular lesions were caused by the implant. 2 years postoperatively we found 50% good and excellent results for type C pelvic ring injuries. Early findings show that the TIFI is well suited to stabilization of sacro-iliac joint ruptures and fractures of the lateral sacrum. Closed reduction and minimally invasive insertion technique are possible. The implant leads to sufficient biomechanical stability but there is a very low intraoperative risk of neuro-vascular lesion.
    Der Unfallchirurg 01/2005; 107(12):1142-51. · 0.64 Impact Factor
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    ABSTRACT: We report about a case of a pregnant women in the 23rd gestation week who sustained an isolated acetabular fracture in a car accident. The fracture was treated surgically by open reduction and internal fixation 6 days after trauma. The outcome for the mother and the baby was excellent; both could be followed up for 1.5 years. The baby did not suffer from any disease related to the diagnostic or surgical procedures. We conclude from this case and from reviewing the literature that the operative fixation of an acetabular fracture during pregnancy is the appropriate treatment with minimal risk for the unborn child and best outcome for the mother.
    Der Unfallchirurg 06/2003; 106(5):419-23. · 0.64 Impact Factor
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    ABSTRACT: Wir berichten über eine Patientin, die sich, in der 23.Woche schwanger, im Rahmen eines Verkehrsunfalls eine Acetabulumfraktur zuzog, die 6 Tage nach Trauma operativ versorgt wurde; 1 1/2 Jahre nach dem Unfall ist die Mutter klinisch beschwerdefrei, das Kind entwickelte sich unauffällig und es besteht keinerlei Anhalt für eine Schädigung.Aufgrund dieses Falls sowie der entsprechenden Literatur sehen wir die operative Versorgung einer Acetabulumfraktur in der Schwangerschaft bei bestehender Indikation als die Methode der Wahl an, da sie für die Mutter zweifellos die beste Behandlung darstellt und gleichzeitig für Mutter und Kind mit nur minimalem Risiko einhergeht. We report about a case of a pregnant women in the 23rd gestation week who sustained an isolated acetabular fracture in a car accident. The fracture was treated surgically by open reduction and internal fixation 6 days after trauma.The outcome for the mother and the baby was excellent; both could be followed up for 1.5 years.The baby did not suffer from any disease related to the diagnostic or surgical procedures.We conclude from this case and from reviewing the literature that the operative fixation of an acetabular fracture during pregnancy is the appropriate treatment with minimal risk for the unborn child and best outcome for the mother.
    Der Unfallchirurg 05/2003; 106(5):419-423. · 0.64 Impact Factor
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    ABSTRACT: In a retrospective study, 51 patients with femoral neck fractures received open reduction and internal fixation. They were divided into two groups. Group A included all patients treated with anatomical reduction. In Group V, the bone fragments were positioned in > or = 5 degrees valgus. The median age of the patients was 37.4 years (range 13-58). 51 patients were available for follow-up assessment at 10.1 (+/- 4.3) years. There were 33 patients in Group A and 18 in Group V. All patients were examined with regard to early and long-term complications. In the first five years, avascular necrosis was seen in 18% in Group A and not at all in Group V. Nonunion occurred in 9% of Group A and 5.5% of Group V. On average at 10 years after the operation, coxarthritis (Kellgren 2) was evident in 21.2% of Group A and 55.6% of Group V (p = 0.04). According to the Hip-Score of Merle d'Aubigné, the patients treated with anatomical reduction had a better functional outcome after 10 years. With respect to the results we recommend in younger patients (< 60 years) anatomical reduction in Pauwels I and Garden-II-fractures. Valgusreduction should be performed as well in Pauwels II and III as Garden-III-and-IV-fractures.
    Der Unfallchirurg 11/2001; 104(11):1055-60. · 0.64 Impact Factor
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    ABSTRACT: In einer retrospektiven Studie wurden 51 Patienten mit osteosynthetisch versorgter medialer Schenkelhalsfraktur nach 10,1 (±4,3) Jahren klinisch und radiologisch nachuntersucht. Das durchschnittliche Alter betrug 37,4 Jahre (13–58 Jahre). Das Kollektiv wurde in 2 Gruppen eingeteilt Gruppe A (n=33), deren Fraktur anatomisch reponiert wurde und Gruppe V (n=18), deren Fraktur in Valgusstellung reponiert wurde. In den ersten 5 postoperativen Jahren traten folgende Frühkomplikationen auf: Kopfnekrose Gruppe A: 18,2%, V: 0%; Pseudarthrose A: 9,1%, V: 5,5%; Implantatbruch A: 3%, V: 5,5%; revisionspflichtige Implantatlockerung A: 3%, V: 0%. Im 5.–15. postoperativen Jahr entwickelten 21,2% der Patienten aus Gruppe A und 55,6% aus Gruppe V eine Koxarthrose im Stadium Kellgren ≥2 (p=0,04). Nach dem Hüftgelenks-Score von Merle d'Aubigné fanden sich bessere Langzeitergebnisse im anatomisch reponierten Kollektiv. Vor diesem Hintergrund empfehlen wir bei jüngeren Patienten (<60 Jahre) eine anatomische Reposition bei nicht dislozierten Frakturen mit kleinem Pauwelswinkel (Pauwels I, Garden II). Dislozierte Frakturen mit steilem Bruchlinienverlauf (Pauwels II und III, Garden III und IV) sollten in Valgusposition reponiert werden. In a retrospective study, 51 patients with femoral neck fractures received open reduction and internal fixation. They were divided into two groups. Group A included all patients treated with anatomical reduction. In Group V, the bone fragments were positioned in ≥5° valgus. The median age of the patients was 37.4 years (range 13–58). 51 patients were available for follow-up assessment at 10.1 (±4.3) years. There were 33 patients in Group A and 18 in Group V. All patients were examined with regard to early and long-term complications. In the first five years, avascular necrosis was seen in 18% in Group A and not at all in Group V. Nonunion occurred in 9% of Group A and 5.5% of Group V. On average at 10 years after the operation, coxarthritis (Kellgren 2) was evident in 21.2% of Group A and 55.6% of Group V (p=0.04). According to the Hip-Score of Merle d'Aubigné, the patients treated with anatomical reduction had a better functional outcome after 10 years. With respect to the results we recommend in younger patients (<60 years) anatomical reduction in Pauwels I and Garden-II-fractures. Valgusreduction should be performed as well in Pauwels II and III as Garden-III- and -IV-fractures.
    Der Unfallchirurg 01/2001; 104(11):1055-1060. · 0.64 Impact Factor
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    ABSTRACT: Experiencing communication problems in our emergency services, we developed an innovative communication network and system the NOAH-system (NOAH, which stands for Notfall -, Organisations - und Arbeitshilfe or Emergency-Organisation Active Aide System). In contrast with the currently established emergency services communication in Germany by radio wave, data is transferred from the scene in the form of an electronic record on a mobile computer by means of the wireless data communication network Modacom (Mobile Data Communication), which is provided by German Telekom. It is received at the dispatch-centre in mentioned format and transferred to the admitting hospital without any loss of data. - In a prospective study, the technical and conceptual suitability of this system was investigated. It was shown that an admitting hospital was informed more than 20 minutes in advance about the admittance of a patient. To assure the quality of transferred data, information was ranked by different criteria. This further demonstrated that much more precise information about a patient's condition was already available upon admittance in the hospital.
    European journal of medical research 02/2000; 5(1):13-8. · 1.10 Impact Factor
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    ABSTRACT: Eighty-six surgical interventions in 76 consecutive patients with symptomatic spinal metastases were reviewed retrospectively. To evaluate the postoperative outcome and quality of life of patients surgically treated for symptomatic spinal metastases. The standard surgical treatment for patients with symptomatic spinal metastases is anterior spinal cord decompression with stabilization. However, because therapy is only palliative, satisfactory quality of life and high patient acceptance are essential. The medical records of all patients were reviewed retrospectively. Furthermore, all surviving patients or the next of kin of deceased patients were interviewed by telephone, and the family doctors or the care-providing physicians of external institutions were contacted. First-choice surgical treatment was anterior spinal cord decompression with stabilization. Postoperative mean survival was 13.1 months, and mean time at home after spinal surgery was 11.1 months. Neurologic improvement with regard to Frankel classification was observed in 58% of the patients, and 93% were able to walk postoperatively. Pain relief was noted in 89%. Overall, 67% of the patients achieved moderate or good general health as shown by the Karnofsky Index, and 80% were satisfied or very satisfied with the surgical intervention. Moreover, 19% of the surgical interventions were associated with complications, local tumor recurrence developed in 22% of the patients, and paraplegia ultimately developed in 18% of patients. Surgical management of symptomatic spinal metastases, in particular anterior decompression, is of benefit in most metastatic lesions in terms of satisfactory postoperative outcome and quality of life. However, in patients with melanoma or lung carcinoma, the authors advocate spinal surgery only in very exceptional cases.
    Spine 12/1999; 24(21):2240-6. · 2.16 Impact Factor
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    ABSTRACT: We have developed a communication system in which data are transferred from the scene of an emergency in the form of an electronic record on a notepad computer by means of a satellite link (MODACOM). The data are received at the dispatch centre and transferred to the admitting hospital automatically. In a prospective study of 53 emergencies the technical suitability of the system was investigated. First-sight information could be fed into the computer in 15 s and transmitted within 3 min of arrival on the scene. For 16 patients with life-threatening conditions, the admitting hospital was notified on average after 13.6 min (SD 6.0), whereas by conventional VHF radio it took 35.5 min (SD 8.9). In addition, more precise information about the patient's condition was received at the hospital.
    Journal of Telemedicine and Telecare 02/1999; 5(4):249-52. · 1.47 Impact Factor
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    ABSTRACT: It is generally accepted that when a fracture is treated with external fixation, dynamization of the fixation accelerates formation of the bony callus by transferring part of the functional loads. The aim of the research presented here was to validate this principle using in vivo measurements of callus stiffness. We created a transverse fracture in the mid third of the tibial shaft in 12 sheep and maintained a 3 mm gap between the fragments for 3 weeks. Two types of unilateral external fixators were applied. Axial loading was permitted (dynamization) from the fourth week onwards in 6 animals. In the other 6 animals, fixation remained static for both types of fixation. Weekly measurements of callus stiffness were obtained using a goniometer and load cell to assess bending stiffness. Two slightly different fixators were used. Callus formed in all 12 animals. Callus stiffness increased exponentially to reach the degree of stiffness measured on the contralateral side. There was no clear difference in healing between the two types of fixations nor between dynamic and static fixation. If a unilateral fixator was applied which did not maintain absolutely rigid fixation, the fracture generally healed well even without contact between the fragment ends. If the process of callus formation had begun normally, dynamic fixation offered no further benefit. Measuring the stiffness of the callus with an adequate measurement apparatus in vivo indicated that the fixator could be removed earlier than would have been authorized on the basis of radiological evidence alone.
    Injury 02/1999; 30 Suppl 1:A44-51. · 2.46 Impact Factor
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    ABSTRACT: The growing complexity of the performance processes in medicine makes it mandatory that the flow of information is faster and more consistent, especially when the sites of health care are far away from each other. The Regensburg model, a realization of lean telemedicine from a low-cost domain, using PC-based standard videoconferencing systems shows the use of modern telecommunications, especially in trauma surgery. In 203 prospectively evaluated teleconsultations between 15 participants a total of 697 images were transmitted via videoconferencing. In 95% of the trauma cases the transmitted material was judged as at least sufficient. In project-attending evaluations the efficacy of these systems and their use were clearly demonstrated. Savings in transportation costs of up to 4,400 DM per case were achieved. Through quicker flow of information quality improvements for all participants resulted; to some extent considerable costs for health care were avoided or reduced. Based on these thoughts, a new platform of communication will be established in Regensburg as a closed medical intranet for the region of eastern Bavaria.
    Der Chirurg 12/1998; 69(11):1123-8. · 0.52 Impact Factor
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    ABSTRACT: Die steigende Komplexität der Leistungsprozesse in der Medizin erfordert einen schnelleren und konsistenteren Informationsfluß, gerade zwischen entfernt gelegenen Versorgungseinrichtungen. Das Regensburger Modell, eine Realisation „schlanker“ Telemedizin aus dem „Low-cost-Bereich“ unter Verwendung PC-basierter Videokonferenzsysteme zeigt die Nutzung moderner Telekommunikation speziell im unfallchirurgischen Umfeld. Bei 203 prospektiv evaluierten Telekonsilen wurden zwischen 15 Teilnehmern insgesamt 697 Bilder per Videokonferenz verschickt. In 95 % des traumatologischen Krankengutes wurde das Befundmaterial qualitativ als mindestens ausreichend beurteilt. In einer projektbegleitenden Evaluation konnte die Effizienz dieser Systeme wie auch deren Nutzen gezeigt werden. Einsparungen an Transportkosten in einer Höhe bis zu 4.400 DM pro Fall konnten erzielt werden. Durch einen schnelleren Informationsfluß resultierten Qualitätsverbesserungen für alle Beteiligten. Auf dem Boden dieser Überlegungen entsteht in Regensburg eine weiterführende Kommunikationsplattform als abgeschlossenes medizinisches Netzwerk für die Region Ostbayern. The growing complexity of the performance processes in medicine makes it mandatory that the flow of information is faster and more consistent, especially when the sites of health care are far away from each other. The Regensburg model, a realization of lean telemedicine from a low-cost domain, using PC-based standard videoconferencing systems shows the use of modern telecommunications, especially in trauma surgery. In 203 prospectively evaluated teleconsultations between 15 participants a total of 697 images were transmitted via videoconferencing. In 95 % of the trauma cases the transmitted material was judged as at least sufficient. In project-attending evaluations the efficacy of these systems and their use were clearly demonstrated. Savings in transportation costs of up to 4,400 DM per case were achieved. Through quicker flow of information quality improvements for all participants resulted; to some extent considerable costs for health care were avoided or reduced. Based on these thoughts, a new platform of communication will be established in Regensburg as a closed medical intranet for the region of eastern Bavaria.
    Der Chirurg 10/1998; 69(11):1123-1128. · 0.52 Impact Factor
  • M Maghsudi, M Nerlich
    Der Chirurg 04/1998; 69(3):313-22. · 0.52 Impact Factor
  • M Maghsudi, M Nerlich
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    ABSTRACT: Das Polytrauma ist definiert als Mehrfachverletzung, von der verschiedene Körperregionen betroffen sind; mindestens eine dieser Verletzungen oder die Kombination mehrerer sind vital bedrohlich. Obwohl Lebensgefahr besteht, kann oft die Ursache dafür nicht sofort erkannt werden. Dies gilt besonders für stumpfe Gewalteinwirkung auf innere Organe. Eindrucksvolle äußere Verletzungen müssen nicht unbedingt die vital gefährdenden sein. Es verlangt viel Erfahrung, dies unter den gegebenen Verhältnissen zu erkennen und weniger imponierende Befunde nicht zu verkennen, die auf eine vitale Gefährdung hinweisen. Auch Mißinterpretationen und technische Pannen, z.B. Tubusfehllage oder Verwechslung von Vene und Arterie, kommen leider immer wieder vor. Die Konsequenzen, die sich aus der Therapie von Polytrauma-Patienten ergeben haben, schlagen sich in definierten Behandlungs-Algorithmen nieder. Diese wurden unter Berücksichtigung der Literatur von den Autoren zusammengestellt und reflektieren auch deren Erfahrungen mit einem eigenen großen Krankengut.
    Der Internist 03/1998; 39(2):188-94. · 0.33 Impact Factor
  • M. Maghsudi, M. Nerlich
    Der Chirurg 02/1998; 69(3):313-322. · 0.52 Impact Factor
  • M Maghsudi, C Neumann, R Hente, M Nerlich
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    ABSTRACT: In eight patients with delayed union or nonunion after 3 degrees open fracture of the tibia, a minimally invasive technique of autologous bone grafting was performed. Bone harvesting from the iliac crest and debridement of the fracture side were done percutaneous by using a 5.5 mm acromionizer without complications. In seven of eight patients complete fracture healing could be achieved (88%). Percutaneous autologous bone grafting can be recommended on limited bone defects in patients with nonunion or delayed union of the tibia and severe soft tissue damage in the lower leg.
    Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress 02/1998; 115:1218-20.
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    ABSTRACT: Human chondrocytes were incubated under following conditions: Group 1 (control group): Incubation in 25 cm2 cell culture flasks (Costar) with RPMI-medium (6%-AB-serum, L-Glutamin, Hepes-buffer and antibiotics); Group 2: Different concentrations of IGF-I (1 ng/ml, 10 ng/ml) were added to the RPMI-medium; Group 3: Incubation (like control group) with additional coating of the cell culture flasks with different concentrations of RGD (5 mg/ml; 7.5 mg/ml; 10 mg/ml; 20 mg/ml); Group 4: Combination of coating with RGD (5 mg/ml; 10 mg/ml) and addition of IGF-I (1 ng/ml; 10 ng/ml) to the medium. The cells of the control group could be doubled within 2 weeks. The amplification rate of the groups 2 and 3 was improved in comparison to group 1 with the following maxima: Group 2 (5 mg/ml RGD) 3.1 times and group 3 (1 ng/ml IGF-I) 2.6 times of the number of the cells in the beginning. Group 4 (RGD and IGF-I) showed additive effects, for 4.1 times of the number of the cells in the beginning could be counted after 14 days. RGD and IGF-I (groups 2 to 4) made possible an earlier dedifferentiation and adhesion of the cells to the bottom of the cell culture flasks. By using both growth factors (RGD and IGF-I), the number of the cells could be enhanced more than 2 times in comparison to the control group within the same time. So less than half of the autologous patient's cartilage is necessary for cultivation of hyaline cartilagee.
    Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress 02/1998; 115(Suppl I):205-8.
  • M. Nerlich, M. Maghsudi
    Notfall 10/1997; · 0.54 Impact Factor
  • M Nerlich, M Maghsudi
    Der Unfallchirurg 09/1996; 99(8):595-606. · 0.64 Impact Factor

Publication Stats

265 Citations
20.10 Total Impact Points

Institutions

  • 1996–2005
    • Universität Regensburg
      Ratisbon, Bavaria, Germany
  • 2003
    • Sana Kliniken Ostholstein
      Eutin mit Malente, Schleswig-Holstein, Germany
  • 1999–2003
    • University Hospital Regensburg
      • Abteilung für Unfallchirurgie
      Regensburg, Bavaria, Germany