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Category Archives: Orthopedy

Hurt crushing of spinal cord

Clinical diagnosis

МРТ и МРА головы

МРТ и МРА

Heavy spinal cord trauma. Unstable fracture dislocation of body. C6. Hurt crushing of spinal cord. Superior flabby Para paresis, lower paraplegia. Dysfunction of pelvis organs on central type. Condition after posterior and anterior spondylosyndesis. Condition after tracheostomy, epicystostomy. Sepsis. Septic shock on background of bilateral infiltrate pneumonia. Serious degree of anemia.

The patient was brought to Regional Medical Centre by these complains:pains on the neck part,nonmovement of hands.
Anamnesis morbi: According to information received from relatives the patient was crashed by crash. He was brought to regional Medical Centre, to reanimation.

Anamnesis vitae

According to information received from mother he didn’t have any skin diseases, never has derma to venerologik,tuberculosis.he doesn’t have genetic disease. The patient had an operation with  problems as anterior spondylosyndesis.C 5-C7 with Atlantis system, and by epicystostomy.After X-ray all problems are solved which he had before.The patient breaths by instrument.he can’t breath himself that’s why they did an operation by putting tracheotomy.His condition was so serious and he consulted at professor and he was advised to be at Regional medical centre..He was output for neurorehabilitation.

Anamnesis vitae

According to information received from mother he didn’t have any skin diseases, never has derma to venerologik,tuberculosis.he doesn’t have genetic disease. The patient had an operation with  problems as anterior spondylosyndesis.C 5-C7 with Atlantis system,and by epicystostomy. had serious type of anemia that’s why he took 473 ml of 2 dose blood transfusion.He doesn’t have bad habits.

Status praesense communis

Condition of patient is so hard,dysfunction of spinal cord.Body structure is normosthenic.Colour of skin is normal,clean,body temperature is  36 C,wetty.Condition of eyes are clean.Shape of nose is not changed, breathing is normal.Type of breathing is mixed.,rhythmical.Breathing is 18 time per minute.Vesicular breathing on lungs’ auscultation,there is not any vibration while breathing.On heart auscultation the sound of heart is normal,rhythmical.The colour of oral cavity is pink,clear.The shape of tongue is normal,dry.Inside is soft,there are n’t any peritonitis  symptoms.

Status nevrosus

He answers all questions very adequate. He has an orientation.Photoreaction is saved. D=S. Tongue’s position is by central stripe. The function of teeth is normal.Tetraplegia. Lower part of  chest  is nonsense to any medicine. Dysfunction of pelvis organs on central type. Pains on spinal cord.
Last: hemoglobin-134,  erythrocyte-3.8, leukocyte-6.6, monocyte-5.4, lymphocyte-35.3.
Previos:  protein-59.2, albumin-33.6, bilirubin-10,20, sugar-5,04, urea-5.1, creatinine-89.0

Treatment

After rehabilitation condition of patient is normal,but after treatment all pains such as Superior flabby Para paresis, lower paraplegia. Dysfunction of pelvis organs on central type is left.

Offers

  • Must be on the observation of neurologist,urologist.
  • Breathing gymnastic,acupuncture,massage.
  • Renal tea.
  • Doesn’t have complication of lungs.
  • To continue rehabilitation at Regional Medical Centre,neurosurgery section.

Paraparesis and lower paraplegia

Full information of diagnoses

МРТ шеи

Paraparesis and lower paraplegia

Heavy spinal cord trauma. Unstable fracture dislocation of body. C6. Hurt crushing of spinal cord. Superior flabby paraparesis, lower paraplegia. Dysfunction of pelvis organs on central type. Condition after posterior and anterior spondylosyndesis. Condition after tracheostomy, epicystostomy. Sepsis. Septic shock on background of bilateral infiltrate pneumonia. Serious degree of anemia,spinal cord trauma,paraplegia.

Anamnesis morbi

Carcrash on 16.12.12.Operation on 18.12.12. On 18.12.12 the patient had an operation with  problems as anterior spondylosyndesis.C 5-C7 with Atlantis system,and by epicystostomy.After X-ray all problems are solved which he had before.The patient breaths by instrument.he can’t breath himself that’s why they did an operation on 24.12.12 by putting tracheostomy.

Anamnesis vitae

According to information received from mother he didn’t have any skin diseases, never has derma to venerologik,tuberculosis.he doesn’t have genetic disease.

Status nevrosus

Level of consciousness of 15 points on a scale of Glasgow. Photoreaction is alive, symmetrical face, swallowing and phonation are not violated. urinating by epitsistostome. muscle strength in the legs and in the bones is 0. Dysfunction of pelvis organs.

Local

Injury without signs of inflammation with sluggish granulation and fibrin coating in the area of ​​the scar in the area of ​​the projection of the vertebral.C4-Th1.

Survey

Indicators of laboratory and instrumental examinations for admission to the respective lists of hospitalization at Scientific Medical Centre. fracture-dislocation of the spine, chronic bronchitis, blood negative for HIV, hepatitis B negative blood, some reduction in the size of the left kidney;
Conclusion urologist: disruption of the pelvic nitrogen bladder, cystitis secondary.
Operation 1: Front access parafaringialny left, the removal of metal, resection of the body.
Operation 2: rear access, spinal fusion neurological status in the dynamics unchanged, there is not any active movement of the lower limbs.Was output home in a satisfactory condition. recommended: observation by a neurologist, avoid colds and physical activity, occupational therapy courses at the neuropathologist.

Rehabilitation treatment

Some reduction in the size of the left kidney;

Course of rehabilitation treatment is completed, the patient is discharged home in a satisfactory condition. during treatment with positive dynamics. improved overall health. stable hemodynamics, pain in the cervical vertebra.
When you receive a complaint: pain in the cervical spine, enhancing when turning the head. Weakness  and violation sensibility in the limbs, limitation of movement in the hands, disruption of the pelvic weakness.

Physiotherapy

A laser-projection of the bladder: magneto-on the distal upper and lower extremities. bladder to the distal upper and lower extremities: mineral wax on the distal lower extremities massage of the lumbosacral spine of the lower extremities.
postural exercises in neck braces, dosed.

Мultiple Myeloma

Treatment of multiple myeloma in Germany

Diagnosis of multiple myeloma in Germany

Question:

Hello,
my sister in ’32 she recently was diagnosed with multiple myeloma.
Prior to this, she is 3 years old were treated with renal insufficiency only when it started to hurt very badly paid attention and took a bone marrow analysis.
Tell me what to do and what are our chances?

Аnswer:

We will be happy to help organize a diagnosis, consultation and treatment in Germany, your sister with our professors oncologists.
To concretize the proposal, please provide us with your sister’s case history (medical records)
Maybe (?) Would make sense to get a prior written advice from our oncologist, MD, chief physician of the Institute University Hospital of Munich. But for that he would need a full set of its documents.

Treatment of bunion in Germany

Treatment of bunion (hallux valgus) in Germany.

Treatment of bunion (hallux valgus) in Germany.

What is a bunion (hallux valgus)?

Bunion – valgus deformity of the foot (Latin: Hallux valgus) is one of the common strains interphalangeal joints (Latin: Articulatio interphalangealis) arising on the big toe (Latin: Articulatio metatarsophalangealis).

Epidemiology and causes.

Statistically, only about 10% are caused by genetic because of flat feet, but for the remaining 90% of cases are caused by incorrect selection of shoes.
Stronger forms of deformation primarily affect women. This is due to the weakness of the connective tissue in women. In addition to the features of the form of women’s shoes, which are contributing to this negative trend.
There are three factors forms of footwear:

  1. Heel height.
    At an altitude of more than three inches observed significantly increased pressure on the forefoot. On the one hand, it contributes to the appearance of flat feet, and on the other hand, the toes are pressed into the shoes.
  2. Narrow toe shoes.
    If the toe of their shoes are too tight, then you do not see your toes freedom. As a result, they have to be in a bad position, which eventually leads to permanent deformation at the ankles.
  3. Too short shoes.
    If the shoe is too short, the toes do not have to be in a natural position, and this contributes to bursitis of the big toe.

Clinical manifestations

When valgus deformity of the foot significantly increased the angle between I and II metatarsals. In this case, I-I metatarsal bone starts to grow in, because of this, her head begins to form a mound, named “bone on his feet.” Since in this case the big toe can not continue to look inside, it gradually deviates outward.

Complications

As the result of constant pressure were “Bones” as inflamed conflicts with the shoes.
This usually leads to bursitis, ie inflammation of the mucous bag replacement.
In addition, as a consequence of the constant pressure begins bone changes in the head I-th metatarsal bone. Changes in bone lead to swelling, sensitivity, pain and excessive irritability “bones” on a thumb.
Wrong location and angle of the big toe leads to premature wear of the fixed joints affected cartilage and significantly increase the size of the bone growth on his leg.

Treatment in Germany

There are more than 150 different methods of operating adjustments arising valgus deformity of the foot. The overall goal of these methods is to reduce the angle between the metatarsal bones, as This will put the base of the big toe to the right position. German orthopedic surgeons use about five different methods of solving these problems.
In German clinics surgery to correct bone of the thumb is conducted:

  1. Transection of the metatarsal I (known as: Corrective osteotomy).
  2. The so gennante Scarf osteotomy procedure.
  3. The preferred proportion of the toes downward metatarsal move in direction of the second metatarsal.
  4. With heavy sutures are again just put the big toe.
  5. From the first metatarsal the abnormal bony enlargement will be removed.
  6. At the phalanx of the big toe is the damaged portion of the joint is removed and reinforced in a good position again (called arthrodesis).
  7. Then either a special redressierenden association or the removal of the skin sutures.

The postoperative wound healing takes about 1 to 2 months. It is recommended to wear within 1.5 months of the orthopedic shoes.

See also

Wikipedia “Hallux valgus“.
Wikipedia “Bunion“.

Notes

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References

Leitlinien der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und des Berufsverbandes der Ärzte für Orthopädie

Areas of treatment in Germany

Obstetrics and gynecology – pregnancy and childbirth, treatment of gynecological diseases.

Conception and pregnancy childbirth and the postpartum period, the prevention and treatment of complications during pregnancy and fetal disease.
Infertility and IVF egg freezing and preservation of pregnancy.
Gynecology cervical erosion mammography and fibroid tumors of the uterus, nephropathy eclampsia in pregnant women endometriosis.

Center for medical treatment in Germany "German Doctor"

Center for medical treatment in Germany “German Doctor”

Angiology and treatment of disease of blood and lymphatic vessels.

Angiology diseases of blood and lymphatic vessels.
Thrombocytopenia or thrombosis, thrombophlebitis thrombocytopathies
Struggle with acute and chronic pain, phlebology, insult cerebral infarction cerebral hemorrhage and subarachnoid hemorrhage.

Gastroenterology, proctology and internal medicine in Germany.

Diseases of the liver, gall bladder and bile ducts, probelmy rectum and colon, as well as anal abscess cholecystitis
Surgery abdominal obesity and overweight radical echinococcectomy hydatid cyst removal “gidatida” Escherichiosis ulcer
Pancreatitis – inflammation of the pancreas and loloproktologiya.

Hematology – treatment of blood disorders in German hospitals.

Hematology – treatment of diseases of the blood and blood kroverazrusheniya.
Splenomegaly pathological enlargement of the spleen or erythremia polycythemia blood cancer leukemia leukemia white sickness.

Dermatology Allergy allergic reactions and parasitology.

Skin disease, psoriasis and demodicosis trichophytia, nevus skin fistula seborrhea and eczema of the skin erythema sepsis.
Sudamen abrasions acne neyrodermitis onychomycosis fungal disease scleroderma pyoderma trichophytia female cellulite.
Hay fever Allergic rhinoconjunctivitis allergic reaction to pollen.

Venereology and virology – treatment of viral diseases, immunology and infectious diseases.

HIV infection is AIDS papilloma aureus trichomoniasis encephalitis FMD sarcoidosis chlamydia.

Diagnosis of diseases in German hospitals.

MRI, CT, ultrasound …

Cardiology and cardiac surgery at the world-renowned cardiology Munich.

Cardiovascular Surgery heart arrhythmia heart failure atrial fibrillation pericarditis endocarditis. Cardiac mitral valve prolapse, angina tachycardia extrasystoles

Neurology – treatment of a disease of the nerves in Baden-Baden.

Brain disease neuralgia neuritis neuroses neuropathy neurofibromatosis Reklingauzena Parkinson’s disease Alzheimer Huntington.
paresthesia synesthesia sclerosis epilepsy
Treating Child Spinal polio paralysis (ICP) and spinal cord diseases.

Oncology – modern methods of cancer treatment in cancer patients.

Treatment of cancer using nuclear medicine, minimally invasive surgical oncology radiotherapy and radiology.
Kaposi teratoma brain tumor early diagnosis of cancer metastasis cancer neuroma shell nerves – a benign tumor. neuroblastoma of the sympathetic nervous system – cancer, cirrhosis of the liver.
Uterine fibroids cervicitis fibrosis pheochromocytoma cholangitis exostosis

Orthopedics – treatment of diseases of the musculoskeletal system and traumatology.

Arthrology treated joints arthritis and arthrosis, coxarthrosis and bony growths osteoarthritis and osteochondrosis. Nose osteomyelitis arthroplasty osteochondropathy spinal hernia flat sore arthritis and diseases of the joints. Prosthetic joints treatment of scoliosis spondylitis tendinitis tendon tissue degeneration.

Otolaryngology – diagnosis and treatment of diseases of ear, nose, throat, head and neck pathology.

Otosclerosis otitis ENT disease inflammation of the ear, tonsillitis, pharyngitis.
Chronic rhinitis treatment and diagnosis of different types of sinusitis: sinusitis ethmoiditis sphenoiditis front.

Ophthalmic treatment of eye diseases using modern technology.

Detachment of the retina, the treatment of retinoblastoma tumor eyes blinding trachoma tremor uveitis.
Retinopathy is damage to the retina, that is, the retina, the eye.

Pediatrics and Pediatric clinics in Germany.

Pediatrics pediatrics, and treatment in pediatric clinics in Germany. Treatment of dental fluorosis in Munich.

Psychiatry in Munich.

Treatment of psychosis and psychopathy.

Pulmonary diagnosis and treatment of pulmonary diseases.

Pulmonary effusion pneumoconiosis silicosis pneumothorax
Toxocariasis is a bot from the group nematosis characterized by bronchitis, pneumonia, tracheitis hepatosplenomegaly or eosinophilia focal emphysema.

Rheumatology.

Sciatica rheumatism and gout.
Rehabilitation in German hospitals.

Oral and Maxillofacial Surgery.

Prosthetic implants installation bite correction. Orthodontics – dental implants, orthopedic orthopedic prosthetic dental pulpitis, periodontitis.

Urology and Kidney Disease in the German urological clinic.

Prostatitis, urethritis pyelonephritis renal nephritis kidney transplant diagnosis of diseases of the urinary system Male reproductive system adrenal disease pathological processes in the treatment of prostate retroperitoneum urologists and oncologists in German hospitals. Cystitis urinary organs epididymitis

Surgery and plastic surgery.

Brain surgery removal of polyps – giperplazicheskih outgrowths of human tissues in the nose, uterus, stomach or ear.
Organ transplant abdominal abscess Thoracic Surgery Neurosurgery purulent pleural enuresis

Endocrinology.

Grave’s disease pituitary goiters thyroid disease diabetes.

For more information about Areas of treatment in Germany please go to medical advice.