L. Kinzl's research while affiliated with Ulm University and other places

Publications (736)

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Schockraummanagement ist Zeitmanagement. Durch einen zeitangepassten, selbstentwickelten 4-Phasenalgorithmus konnte eine deutliche Verbesserung der Erstversorgung von polytraumatisierten Patienten in unserem Schockraum entwickelt werden. Neben einer Optimierung der Infrastruktur unter Einbindung von digitalen Techniken konnte mit relativ einfachen...
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Bei Gelenkfrakturen der Grundphalanxbasis wurde nach der Frakturreposition eine funktionelle Behandlung durch aktives Bewegen der PIP- und DIP-Gelenke in einem Schienensystem durchgeführt. Die Therapie baut auf den periartikulären Weichteilen und deren funktioneller Anatomie auf. Der das Grundgelenk umgebende Zancolli-Haltekomplex führt zu einer St...
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The term “computer-assisted surgery” (CAS) contains a variety of different applications. Priorities in trauma surgery have navigation systems. In fact, two basically different developments can be distinguished: on one hand, the possibility of navigation, based on preoperative CT data sets; and on the other hand navigation in intraoperative C-arm im...
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Computer-assisted and navigation-based therapeutic tools have found their first application in the field of spinal surgery. Meanwhile, the basic principles have been extended to other procedures, such as screw osteosynthesis of the pelvis and navigation of long bones. Commonly, all procedures except C-arm navigation are based on three-dimensional d...
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The anterior interbody fusion with instrumentation seems to be the standard procedure in unstable traumatic lesions of the lower cervical spine. The goal of this study was to objective the outcome of patients, treated by only temporary stabilisation of the injured motion segment (without bone – graft fusion). Between 1990 and 1998 155 patients with...
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To describe the minimally invasive treatment of fractures of the proximal humerus using the Non-Contact-Bridging (NCB) plate. The system allows secondary locking of screws to the plate with a locking cap and polyaxial (30 degrees radius) screw placement. Prospective cohort study. University Level I trauma center. Fifty-four patients with unstable f...
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Surgical treatment of most displaced proximal humerus fractures is challenging due to osteoporosis. Locking plates are intended to provide superior mechanical stability. In a prospective multicentre study 131 patients were treated with second generation locked plating (NCB-PH, Zimmer, Inc.). The open procedure (n = 78) was performed using a deltope...
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Proximal humeral fractures are common in the elderly population and are often associated with osteoporosis. Fixation of unstable proximal humeral fractures is problematic due to loss of fixation in osteoporotic bone. Fixed-angle devices are intended to provide superior mechanical stability due to the principle of an internal fixator. The NCB(R)-PH...
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Introduction Proximal humeral fractures are common in the elderly population and are often associated with osteoporosis. Fixation of unstable proximal humeral fractures is problematic due to loss of fixation in osteoporotic bone. Fixed-angle devices are intended to provide superior mechanical stability due to the principle of an internal fixator. T...
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A follow-up study of 15 (15-17) years of 320 consecutive Zweymuller total hip arthroplasties is presented. Age at surgery was 67 (29-99) years. A total of 164 (51.3%) patients had died. Clinical and radiological examinations were available for 97 (30.3%), phone interviews and radiological examinations for 4 (1.3%) hips, and phone follow-ups for 49...
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Frakturen der proximalen Epiphysenfuge der Tibia sind seltene Verletzungen im Wachstumsalter. Anhand des Fallberichts einer simultanen bilateralen proximalen Epiphysenfraktur eines 13-jährigen Jungen werden dieses Krankheitsbild sowie die erforderliche Diagnostik und die adäquate Therapie dargestellt. Die Verletzung ereignete sich beim Weitspringen...
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Fragestellung: Das Ziel dieser Studie war es, die Bewertung von Rehabilitation nach Unfallverletzungen vorzunehmen und die in der verfügbaren Literatur bis dato nicht geklärte Frage zu untersuchen, ob der Zeitpunkt der Rehabilitation nach Unfallverletzungen einen Einfluss auf das Ergebnis hat. Als „Indikatordiagnosen” wurden Wirbelfrakturen, Ober-...
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Stem loosening and stress-shielding are problems encountered in cemented hip arthroplasty. Could proximal stem fixation by partial cementing solve the problem? More physiological transmission of forces with only proximal cement fixation seems to be possible with this recent development (Z-stem, Option 3000, Mathys Orthopaedics, Bettlach, Switzerlan...
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Vacuum-assisted closure (vacuum sealing) is a surgical procedure for the local treatment of severe soft-tissue damage. However, systemic consequences to the host are unknown. The aim of this study was to disclose the effects of vacuum sealing on the host’s immune response and to demonstrate the early time course of endotoxin, interleukin-6 (IL-6),...
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Talus necrosis complicated by osteomyelitis and extensive soft-tissue infection poses a difficult therapeutic challenge, and limb salvage is often difficult to achieve. Between 1986 and 1999, 23 patients were treated for talar osteomyelitis and infection of the soft-tissue envelope. Limb salvage with a tibiocalcaneal arthrodesis was attempted in 16...
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Proximal tibial epiphyseal injury is a rare finding in adolescents. We report the case of a 13-year-old boy with simultaneous epiphyseal fractures of both proximal tibiae to illustrate appropriate diagnosis and treatment of this condition. The injury occurred while performing a long jump: a Salter-Harris type II fracture of the right proximal tibia...
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Irreversible destruction of the forefoot and midfoot generally leads to amputation. So-called limited surgical procedures such as transmetatarsal or Chopart/Syme amputations often result in poor clinical outcomes. Prostheses for these stumps are difficult to fit, a fact that reduces mobility for these patients, so reamputations are not rare. The ve...
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Background Irreversible destruction of the forefoot and midfoot generally leads to amputation. So-called limited surgical procedures such as transmetatarsal or Chopart/Syme amputations often result in poor clinical outcomes. Prostheses for these stumps are difficult to fit, a fact that reduces mobility for these patients, so reamputations are not r...
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To describe a minimal anterolateral acromial approach for minimally invasive (MI) treatment of fractures of the proximal humerus (PH) with the Non-Contact-Bridging (NCB) plate. 1) Cadaver study and 2) clinical case series. 1) University Institute of Anatomy and the 2) University Level I trauma center. SPECIMENS/PATIENTS: 1) Ten fresh frozen human h...
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Pathological fractures are dreaded complications due to skeletal metastasis. Modern oncological therapies and more sophisticated new radiological techniques such as MRI and positron emission tomography have improved multimodal treatment concepts. Surgical intervention is determined by the primary disease, general condition and life expectancy of th...
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Non-steroidal anti-inflammatory drug (NSAID) is well known to significantly delay fracture healing. Results from in vitro studies implicate an impairment of osteoblast proliferation due to NSAIDs during the initial stages of healing. We studied whether diclofenac, a non-selective NSAID, also impairs appearance of osteoblasts in vivo during the earl...
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Pathologische Frakturen sind die gefürchtete Komplikation von Skelettmetastasen. Verbesserte chirurgische wie medikamentöse onkologische Therapiekonzepte zum einen sowie die verbesserte Diagnostik mit MRT und PET-CT zum anderen, welche die Tumorausbreitung lokal sowie die Metastasierung wesentlich früher erkennen lässt, sind wesentliche Faktoren, d...
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Fractures of the proximal humerus are common in elderly patients, especially in osteoporotic bone. Requirements for surgical treatment are high primary stability to allow early functional physiotherapy. The Non-Contact Bridging (NCB) Plate for the proximal humerus (PH) is a new head locking system for treating fractures of the proximal humerus whic...
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Current treatment regimens that are designed to prevent deep venous thrombosis in patients undergoing orthopaedic procedures rely predominantly on drug prophylaxis alone. The purpose of this randomized clinical study was to evaluate the effectiveness of a mechanical adjunct to chemoprophylaxis that involves intermittent compression of the legs. Dur...
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Background Proximal stem fixation by partial cementing is a new concept in hip arthroplasty. We conducted a prospective clinical and radiological analysis to evaluate the preliminary outcome of this new technique with the Option 3000® stem (Mathys Orthopaedics, Bettlach, Switzerland). Methods and focus One hundred and thirty-three hip replacements...
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There is evidence that non-steroidal anti-inflammatory drugs (NSAIDs) delay both epithelialisation and angiogenesis in the early phases of wound healing because of an antiproliferative effect. We investigated the influence of diclofenac, a non-selective NSAID, on incisional wound healing. Ten male Wistar rats were given 5 mg diclofenac per kg bodyw...
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Potential adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on bone metabolism and fracture healing are contradictive to their wide application in post-traumatic treatment. Our objective was to investigate changes to periosteal callus formation with respect to NSAID and central analgesic drug application. Our hypothesis was that call...
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In a prospective study 104 patients >or=65 years with distal radius fractures (DRF; n=52) and proximal forearm fractures (PHF; n=52) were followed up for a period of 4 months after injury. As an inception- cohort study, influence on treatment pattern was not part of the examination. A total of 53% of the DRF and 74% of the PHF patients underwent su...
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In the clinical examination it is possible to determine the absolute difference in leg length by the board method or, more quickly, the PALM method (accurate to 1.5 cm either way). Determination of the difference in leg length with a measuring tape is even less accurate. The use of radiological methods to determine the relative leg length is consid...
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To investigate the effects of 2-day and 10-day immobilization of the cervical spine on pain, range of motion (ROM), and disability of patients with Quebec Task Force (QTF) grade II whiplash injuries. Randomized controlled trial. University hospital emergency department. Seventy patients with acute QTF grade II whiplash injuries. At the intake exami...
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In a prospective study 104 patients ≥65 years with distal radius fractures (DRF; n=52) and proximal forearm fractures (PHF; n=52) were followed up for a period of 4 months after injury. As an inception- cohort study, influence on treatment pattern was not part of the examination. A total of 53% of the DRF and 74% of the PHF patients underwent surge...
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Orthopaedic surgeons are being increasingly confronted with complex ankle problems that cannot be reliably treated by conventional arthrodesis procedures. The Ilizarov technique can be an alternative salvage method in such cases. Twenty-two Ilizarov tibiotalar arthrodeses were retrospectively reviewed. There were 16 men and six women (mean age 49 y...
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Several techniques for knee fusion have been described with success rates ranging from 29% to 100%, with worse results occurring in patients with joint sepsis. We treated 21 patients with persistent infections using knee arthrodesis with a hybrid Ilizarov frame at our institution. There were 13 men and eight women ranging from 21 to 75 years (mean,...
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Infections of the locomotive system appear in many different forms such as acute inflammation of joints or bone following injury or surgical or chronic processes, often lasting for years. They demand an exact treatment plan not only to remove necrotic tissue but also for reconstruction of defects. A special problem is infection following alloplasti...
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Infektionen des Bewegungsapparates kommen in vielen Erscheinungsformen vor. Sie reichen von akuten Infekten an Gelenken und knöchernen Strukturen der Extremitäten nach Frakturen oder chirurgischen Maßnahmen bis hin zu chronischen Verläufen. Neben dem radikalen Debridement des nekrotischen Gewebes ist ein genauer Behandlungsplan zur Defektrekonstruk...
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Pedicle breach with screw implantation is relatively common. For clinical application of computer-assisted orthopaedic surgery, it is important to quantitatively know the accuracy and localization of any guidance modality. We ascertained the accuracy of computed tomography and C-arm-based navigated drilling versus conventional fluoroscopy using an...
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Torsional malalignment and mechanical axis deviation (MAD) are worrisome complications after nailing of distal femoral fractures. Variable, sometimes contradictory, reports about these problems have been published. In a retrospective nonrandomized study, 41 patients (mean age, 44.5 years) with distal third femoral fractures that were operatively tr...
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Prospective clinical study. Computer-assisted surgery (CAS) means improved accuracy in inserting screws. Usually the required time of the intraoperative use of a C-arm device is reduced. The aim of the study was to quantify the radiation doses during spine surgery in different types of computer-assisted surgical procedures (i.e., computerized tomog...
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Objective: The aim of this study was to figure out, if low intensity pulsed ultrasound (LIPUS), already used in delayed unions, increases bony regeneration after callus distraction. Methods: We examined two groups of patients: All of them suffered from bony defects after tibial fractures and were treated with callus distraction using llizarov's rin...
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The cervical spine in a patient with ankylosing spondylitis (AS) (Bechterew disease) is exposed to maximal risk due to physical load. Even minor trauma can cause fractures because of the spine's poor elasticity (so-called bamboo spine). The authors conducted a study to determine the characteristics of cervical fractures in patients with AS to descr...
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Objective Severe chest injuries are still associated with significant morbidity and mortality. This systematic review assesses the early operative management of severe chest trauma in multi injured patients with special regard to the priority of the operative therapy. Methods Clinical trials were systematically sought and collected (MEDLINE, Cochra...
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Severe chest injuries are still associated with significant morbidity and mortality. This systematic review assesses the early operative management of severe chest trauma in multi injured patients with special regard to the priority of the operative therapy. Clinical trials were systematically sought and collected (MEDLINE, Cochrane and hand search...
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Blunt chest trauma is accompanied by an early increase in plasma cytokine concentrations. However, the local sources of these mediators are poorly defined. We investigated the impact of blunt chest trauma on the inflammatory mediator milieu in different compartments (lung tissue, bronchoalveolar lavage, liver tissue, Kupffer cells, plasma) along wi...
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Deep infection is one of the most devastating complications after knee fractures. It may be related to the initial fracture status or, more commonly, the surgical intervention. From 1991 to 2003, 12 patients underwent knee fusion to treat resistant infection after complex knee fractures or arthrodesis fractures using the Ilizarov method and frame....
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Maligne Knochentumoren sind im Rahmen von multimodalen Behandlungskonzepten zu therapieren. Gerade im Fall einer initial oder während der Behandlung auftretenden pathologischen Fraktur muss die Therapie dieser Tumoren in geeigneten Tumorzentren erfolgen. Im Rahmen dieser Arbeit werden die aktuellen interdisziplinären Therapiekonzepte unter Berücksi...
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Untersucht wurden Patienten, die zwischen dem 1. 1. 1980 und 31. 12. 2005 an der Klinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie der Universität Ulm einer Amputation oder aber extremitätenerhaltenden Operationen unterzogen wurden. Es wurden die einzelnen Verfahren und Therapiestrategien beschrieben und analysiert, sowie die En...
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Platelet-rich plasma (PRP), a platelet concentrate made of autogenous blood, has been used in recent years to improve bone defect healing particularly in maxillofacial reconstructions. The aim of the present study was to assess the effect of PRP on new bone formation in a critical diaphyseal long bone defect. A critical size defect (2.5 cm) in the...
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Endoscopic minimally invasive techniques have become an established method of fracture stabilisation in the spine. In view of this fact, anterior stabilisation strategies must be reconsidered, as monosegmental A 3.1 compression fractures are increasingly being stabilised endoscopically from the anterior aspect using minimally invasive techniques. T...
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To achieve analgesic, anti-inflammatory and antipyretic effects in traumatology and orthopedic surgery without side effects or with the least possible side effects, with special emphasis on bone healing. Acute and chronic inflammatory conditions, e. g., rheumatoid arthritis, ankylosing spondylitis. Degenerative joint disease. Posttraumatic and post...
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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...
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Verletzungen des thorakolumbalen Übergangs resultieren im Wesentlichen aus Kompression, Flexion/Distraktion und Torsion. Kompression und Torsion führen überwiegend zu knöchernen Verletzungen, Flexion, Distraktion und Seitneigung v. a. zu ligamentären Instabilitäten. Der Terminus physikalische Instabilität der Wirbelsäule ist aus klinisch-medizinisc...
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2D- und 3D-Navigation nehmen zwischenzeitlich einen hohen Stellenwert in der operativen Versorgung von Wirbelsäulenverletzungen ein. Bei 2D-Navigation wird ein modalitätsbasierter Datensatz aus dem Bildwandler genutzt. Für die 3D-Navigation steht ein nicht modalitätsbasierter Datensatz aus einem konventionellen CT zur Verfügung oder es kann eine dr...
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Objective To achieve analgesic, anti-inflammatory and antipyretic effects in traumatology and orthopedic surgery without side effects or with the least possible side effects, with special emphasis on bone healing. Indications Acute and chronic inflammatory conditions, e. g., rheumatoid arthritis, ankylosing spondylitis. Degenerative joint disease....
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Vacuum therapy is a routine and successful method for wound treatment and for the temporary covering of soft-tissue defects. It is an occlusive method that can be used for treating acute, chronic and infected wounds. To date, no data are available regarding secretion transit times and pressure conditions in lesions treated with vacuum therapy. The...
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Einleitung: Die Vakuumtherapie ist ein gängiges und erfolgreiches Verfahren der Wundbehandlung bzw. der temporären Weichteildeckung. Sie ist eine okklusive Methode zur Behandlung von akuten, chronischen und infizierten Wunden. Bisher existieren keine Untersuchungen zu Durchflusszeiten und Druckverhalten bei der Vakuumtherapie. Ziel unserer Untersuc...
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Arthrodesis of the sacroiliac joint (SI) usually requires a large surgical exposure using the lateral approach. Computer-assisted surgery based on intraoperative 3D fluoroscopy imaging can reduce the approach to stab incisions. The clinical example shows the insertion of two screws and a cylindrical bone graft to achieve an arthrodesis of the SI jo...
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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...
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Zusammenfassung Die Versteifung des Iliosakralgelenks (ISG) erfolgt in klassischer Weise über die Darstellung von lateral mit entsprechend großer chirurgischer Exposition. Das navigationsgestützte Verfahren unter Benützung eines dreidimensionalen (3D-) intraoperativen Bildwandlers unterstützt durch die erhobenen Datensätze (Iso-C3D) die minimal-inv...
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Simultaneous measurement of intramuscular pressure (IMP), tissue oxygen partial pressure (pO(2)) and EMG fatigue parameters in the multifidus muscle during a fatigue-inducing sustained muscular contraction. The study investigated the following hypotheses: (1) Increases in IMP result in tissue hypoxia; (2) Tissue hypoxia is responsible for loss of f...
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Die zunehmende Umverteilung der Alterspyramide in Deutschland hat als unmittelbare Folge eine Zunahme der altersbedingten Frakturen. Die häufigsten Frakturtypen in der Alterstraumatologie sind die proximale Femurfraktur, gefolgt von Frakturen im Bereich des proximalen Humerus und distalen Radius. Darüber hinaus findet sich eine steigende Inzidenz o...
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Studienziel: Ziel der Studie war zum einen die Entwicklung eines neuen Scores zur Risikoabschätzung einer heterotopen Ossifikation (HO) nach Hüft-TEP, andererseits die Darstellung unserer Ergebnisse nach kombinierter Therapie der HO (chirurgische Resektion, Radiatio und medikamentöse Therapie). Methode: Von 1990 bis 2003 wurden 50 Patienten die weg...
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Pulmonary contusion is frequently followed by acute respiratory distress syndrome, pneumonia, and sepsis. However, immunologic alterations of circulating and resident immune cell populations contributing to the posttraumatic immunosuppression are poorly understood. We therefore characterized the influence of pulmonary contusion on peripheral blood...
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The treatment of proximal humerus fractures with intramedullary nails with angle stable bolts is contradictory to the classic intramedullary nailing with elastic nails. However in osteoporotic bone stock these nails allow a multi dimensional bracing of the fragments with the locking bolts leading to sufficient primary stability even in complex case...
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The purpose of this retrospective study was to evaluate arthroscopy in upper ankle osteoarthritis. In the period from 1988 to 1997, 358 arthroscopies of the upper ankle joint were performed in 178 cases due to arthritis. Of 132 accessible patients, 124 replied to our questionnaire: 90 (73%) of the responders underwent clinical examination 94 (37-15...
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Objektive: The purpose of this retrospective study was to evaluate arthroscopy in upper ankle osteoarthritis. Methods: In the period from 1988 to 1997, 358 arthroscopies of the upper ankle joint were performed in 178 cases due to arthritis. Of 132 accessible patients, 124 replied to our questionnaire: 90 (73%) of the responders underwent clinical e...
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The indications for physiotherapy after supracondylar humeral fractures in children are not clear in the literature, even in the presence of an active or passive limitation of elbow joint motion. The authors therefore performed a prospective randomized study to assess the effectiveness of physiotherapy in improving the elbow range of motion after s...