Joachim GülkeUlm University | UULM · Centre of Surgery
Joachim Gülke
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43
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Introduction
Skills and Expertise
Publications
Publications (43)
Ulnar nerve injuries can cause deficient hand movement patterns. Their assessment is important for diagnosis and rehabilitation in hand surgery cases. The purpose of this study was to quantify the changes in temporal coordination of the finger joints during different power grips with an ulnar nerve block by means of a sensor glove. In 21 healthy su...
Study design:
A within-subject research design was used in this study. The difference of the range of motion (ROM) with and without ulnar nerve block was analyzed.
Introduction:
For the clinical evaluation of the functional effects of ulnar nerve palsy at the hand the relevance of clinical tests is in discussion.
Purpose of the study:
The aim...
Zusammenfassung
Die veraltete skapholunäre Dissoziation (SLD) Stadium 2 und 3 kann bei fehlender Therapie zu posttraumatischen Folgeschäden führen. Verschiedene Therapieansätze wie Kapsulodesen, Tenodesen oder andere Verfahren wurden beschrieben. Ziel aller Verfahren ist die Palmarkippung des Kahnbeines mit nachfolgender Arthrose (SLAC-wrist) zu ve...
Background:
These days there are different types of aftercare following flexor tendon injury. Patients in this study received a dynamic Kleinert protocol and additionally two different postoperative treatments. Both treatment groups were compared to each other and results were put into perspective when compared to other treatment options.
Methods...
Objective:
Revision ACL reconstruction is becoming more frequent because of a 10% rate of re-ruptures and insufficiencies. Currently, computed tomography (CT) represents the gold standard in detecting and measuring the tunnels of the initial ACL reconstruction. The purpose of this study was to compare measurement results of CT and thin-sliced MRI...
Introduction:
In the assessment of hand and upper limb function, grip strength is of the major importance. The measurement by dynamometers has been established.
Purpose of the study:
In this study, the effect of a simulated ulnar nerve lesion on different grip force measurements was evaluated.
Methods:
In 25 healthy volunteers, grip force meas...
Study design:
Prospective cohort randomized controlled trial.
Purpose of the study:
Is either a home exercise (HE) program or traditional physical therapy (PT) more effective in the postoperative management of metacarpal fractures?
Methods:
Sixty patients suffering from nonthumb metacarpal fractures who received mobilization-stable open reduct...
Background:
Peripheral lesions of the median nerve cause characteristic changes of the grip function of the hand. For evaluating grip force changes, measurement by dynamometers (JAMAR dynamometer and pinch dynamometer) is of high relevance. In this study the ability of grip force measurements of different grip forms was evaluated to discriminate b...
In the assessment of hand and upper limb function, detecting sincerity of effort (SOE) for grip strength is of major importance to identifying feigned loss of strength. Measuring maximal grip strength with a dynamometer is very common, often combined with calculating the coefficient of variation (CV), a measure of the variation over the three grip...
Introduction:
In the assessment of hand and upper limb function, grip strength is of major importance. Use of the JAMAR dynamometer has been an accepted test of grip strength and routinely part of the physical examination.
Purpose of the study:
The aim of this study was to determine by means of a median nerve block simulating a patient group if...
Hintergrund/Ziel: Die endoprothetische Versorgung gehört zu den etablierten Verfahren zur Behandlung der schmerzhaften Fingermittelgelenksarthrose. In unserem Haus wurden zwischen 1996 und 1999 bei 16 Patienten 19 DIGITOS-Fingermittelgelenkprothesen implantiert. Es handelt sich um eine scharniergeführte Prothese mit Kolbenmechanismus. Bereits 2007...
Background: Wrist fusion is still a common treatment for patients with advanced stage arthritis. Since patients are often intimidated by the functional limitations, we intended to evaluate the influence of the lack of wrist motion in different positions on the dynamic grip function and the grip strength of the hand. Methods: We simulated wrist fusi...
Distale Radiusfrakturen bei älteren Patienten stellen einen merklichen und zunehmenden Teil des Fallaufkommens in Rettungsstellen dar. Die aktuelle Literatur gestattet unverändert keine klaren Therapieempfehlungen (z. B. zugunsten einer Reposition und Gipsstabilisierung, der K‑Draht-Osteosynthese, Stabilisierung mithilfe eines Fixateur externe oder...
Der Streckapparat ist ein kompliziertes Geflecht von 2 unterschiedlichen Systemen, namlich dem intrinsischen und dem extrinsischen, und wird in 9 Zonen eingeteilt. Verletzungen in der Zone 1–3 konnen i. d. R. konservativ behandelt werden. Verletzungen in den ubrigen Zonen bedurfen einer operativen Therapie. Die Dauer der Ruhigstellung richtet sich...
Falling on the outstretched hand is a common trauma mechanism. In contrast to fractures of the distal radius, which usually are diagnosed on plain film radiographs, identifying wrist injuries requires further diagnostic methods, e.g., MRI or CT. This article provides a review of the use of MRI in the most common traumatic wrist injuries, including...
Muscle injuries are the most frequent sport injuries in athletes. In addition to a thorough clinical examination and the history of the trauma mechanism, imaging modalities are required to correctly classify the injury and plan the future treatment and rehabilitation. The two major modalities are ultrasound and magnet resonance imaging (MRI). This...
Der Sturz auf die Hand ist ein häufiger Unfallmechanismus. Während distale Radiusfrakturen meist mit konventionellen Röntgenaufnahmen diagnostiziert werden können, bedarf es zur Abklärung von Verletzungen des Handgelenks oft weiterführender Diagnostik wie Magnetresonanz- (MRT) oder Computertomographie (CT). Dieser Artikel gibt einen Überblick über...
Muskelverletzungen stellen die häufigsten Sportverletzungen dar. Neben der genauen klinischen Diagnostik sind bildgebende Verfahren wie MRT-Diagnostik und Ultraschall für die exakte Klassifikation notwendig, um eine Therapie und Rehabilitation zielgerichtet durchzuführen. Dieser Artikel hat zum Ziel, Möglichkeiten und Limitationen des MRT im Bereic...
Complications related to arthrodesis of the ankle or total ankle replacement require a critical assessment of the indication. Using denervation of the ankle, we have the possibility to delay the above-named surgical treatment for a number of years. The aim of this follow-up study was to review the results of ankle denervation after several years.
W...
BACKGROUND: In this study 56 dorsal phalangeal fractures of the distal segment were classified regarding morphological criteria. MATERIAL AND METHODS: Clinical and radiological results after 4 months were analyzed. Fractures including subluxation of the distal interphalangeal joint occurred rarely (n=3) and were treated by surgery. Fractures withou...
Hintergrund
Nach morphologischen Kriterien wurden 56 dorsale Endgliedbasisfrakturen unterteilt und retrospektiv nach 4 Monaten hinsichtlich ihres radiologischen Ausheilungsbildes und ihrer klinischen Funktion ausgewertet.
Material und Methode
Frakturen mit einer Subluxation waren mit 3 Fällen selten und wurden operiert. Die Frakturen ohne Subluxat...
Purpose:
In the treatment of small bone fractures, such as the scaphoid bone, conventional navigation is limited by its dependence on fixed reference arrays. We introduce a new technique based on reference markers in surgical instruments. If visible on a standard fluoroscopic image, static trajectories are overlaid in this image to guide implant i...
The purpose of this study was to assess whether there is a universal pattern of movement of the finger joints while performing a cylinder grip. A sensor glove was used to record the finger joint motion of 48 participants. Our observations showed that when examining the fingers, flexion motion began either at the metacarpophalangeal (MP) or proximal...
In a prospective study a total of 49 fractures in 47 patients were treated with open reduction and palmar plate osteosynthesis. The results were evaluated radiologically, clinically and with the disability of arm-shoulder-hand (DASH) score. The emphasis was on early postoperative results.
The patients consisted of 11 men and 36 women aged 21–85 yea...
In a prospective study a total of 49 fractures in 47 patients were treated with open reduction and palmar plate osteosynthesis. The results were evaluated radiologically, clinically and with the disability of arm-shoulder-hand (DASH) score. The emphasis was on early postoperative results. The patients consisted of 11 men and 36 women aged 21–85 yea...
In the case of a patient with a large pyogenic granuloma of the thumb about three months after the bite of a sheep, we covered the defect after resection with a split thickness skin graft. Although at first amputation was discussed, after a few months a very good functional and aesthetic result was achieved.
Georg Thieme Verlag KG Stuttgart · New Y...
The purpose of this study was to analyse motion patterns of the finger joints dynamically while making a fist. 10 subjects were examined using the TUB-sensor glove, which was equipped with 14 joint angle sensors. The median time it takes the finger joints to complete flexion until reaching the state of a closed fist ranges between 0.5 to 1.0 s. A s...
The present study analyses force distribution patterns during primary grips. 10 subjects were examined using the TUB-sensor glove, which was equipped with 10 pressure sensors. 5 proximal sensors at the MCP joints and 5 distal sensors at the DIP joints were attached palmarly. 9 different gripping motions were examined: the cylinder grip using 4 diff...
Zusammenfassung Bei einem Patienten mit großem, beginnend exulzerierendem Leiomyosarkom der Thoraxwand wurde nach Resektion der Defekt mit
einem übergroßen gestielten myokutanen Latissimuslappen gedeckt. Trotz schwerwiegender Begleiterkrankung mit einer Hämophilie,
gelang es, ein befriedigendes klinisches Ergebnis zu erzielen. Der Patient verstarb...
To determine whether the grip of a healthy subject's hand shows certain universal characteristics. To accomplish this, we examined the complex interactions of the fingers during gripping of different-size cylindrical objects.
A total of 48 subjects (11 women, 37 men) performed 5 cylinder grips with different object sizes. The 14 joint angular profi...
The identification of pathological function of finger movement in nerve palsy is important for clinical diagnostics, rehabilitation and assessment in hand surgery. The goal of the study was to analyze grip pattern changes in simulated ulnar nerve palsy by a sensor glove.
In 20 volunteers, the movement patterns of the fingers were assessed by a sens...
This study examined patterns of grip strength when maximal and submaximal effort are applied. Using a sensor glove, 50 healthy subjects performed two different power grips. Both maximal and submaximal gripping showed characteristic patterns of strength distribution that were independent of the degree of power applied. Significant differences were a...
Most important methods for the surgical treatment of painful arthritis of the proximal interphalangeal joint are the joint fusion or the implantation of a prosthesis. There are a lot of different models for joint replacement. Sixteen patients received 19 middle joint replacements performed with the DIGITOS-prosthesis between 1996 and 1999. Over a p...
Hintergrund: Bei Handverletzungen besteht ein Interesse, möglichst frühzeitig anhand des Verletzungsmusters die voraussichtliche Dauer der Arbeitsunfähigkeit einzuschätzen. Existierende Bewertungsschemata wie z. B. der HISS-Score (Hand Injury Severity Scoring System) sind komplex und aufwändig zu bestimmen. Material und Methoden: Basierend auf bei...
Zur Behandlung der Panarthrose des Handgelenks stehen die Denervation, der Gelenkersatz und die Arthrodese zur Verfügung. Vor dem Hintergrund des zunehmend angewandten prothetischen Gelenkersatzes soll der Stellenwert der Handgelenksarthrodese erörtert werden. Bei 32 Patienten wurde wegen einer schmerzhaften Panarthrose eine Handgelenksarthrodese d...
The estimation of the time off work depending on the injury pattern and severity is of major interest in the treatment of hand injuries. The predictive value of the HISS score (Hand Injury Severity Scoring System) was evaluated.
According to this score, 184 work-related injuries (1999 to 2002) were analyzed prospectively, excluding injuries of both...
In contrast to the standard therapy of flexor tendon injuries in adults, the postoperative treatment program for children remains a controversial topic. Some prefer immobilization therapy in a variety of forms and for different periods of time. Others prefer early mobilization programs. We present results for twenty-eight children with thirty-seven...
Grip strength measurements with the aid of dynamometers are dependent on the cooperation and motivation of the individual examined. Recognising a simulated loss of grip is a hitherto unresolved problem. With a sensor glove developed at the Berlin University of Technology, the force distribution pattern of any form of grip can be captured via ten pr...
Griffkraftmessungen mit Dynamometern sind abhängig von der Mitarbeit und der Motivation des Untersuchten. Das Erkennen eines vorgetäuschten Kraftverlustes ist ein bislang ungelöstes Problem. Mit einem an der Technischen Universität Berlin entwickelten Sensorhandschuh können über zehn Drucksensoren die Kraftverteilungsmuster bei beliebigen Griffen e...
