Rushpin fixation for midshaft clavicular nonunions: good results in 13/14 cases.

We treated 14 patients having a symptomatic mid-shaft clavicular nonunion with intramedullary Rushpin fixation and autogenous bone grafting. 13 nonunions healed within 4 months. There were no complications related to the operation.

Spontaneous remodeling of the spinal canal after conservative management of thoracolumbar burst fractures.

Study Design: Forty-two conservatively treated patients with a burst fracture of the thoracic, thoracolumbar, or lumbar spine with more than 25% stenosis of the spinal canal were reviewed more than 1 year after injury to investigate spontaneous remodeling of the spinal canal.

Objectives: To investigate the natural development of the changes in the spinal canal after thoracolumbar burst fractures.

Summary Of The Background Data: Surgical removal of bony fragments from the spinal canal may restore the shape of the spinal canal after burst fractures.

Prevention of fracture at the distal locking site of the gamma nail. A biomechanical study.

To investigate the origin of fractures at the distal locking site of the Gamma nail, we loaded ten paired human cadaver femora fixed with a Gamma nail in torsion until they fractured. When an awl was hammered in to start the hole for distal locking a fissure appeared in the lateral cortex of all the femora, and the mean torsional load to create a fracture was reduced by 57.8% compared with that in a control group in which the distal locking hole had been started with a centre drill.

CT scan prediction of neurological deficit in thoracolumbar burst fractures.

In 139 patients with burst fractures of the thoracic, thoracolumbar or lumbar spine, the least sagittal diameter of the spinal canal at the level of injury was measured by computerised tomography. By multiple logistic regression we investigated the joint correlation of the level of the burst fracture and the percentage of spinal canal stenosis with the probability of an associated neurological deficit. There was a very significant correlation between neurological deficit and the percentage of spinal canal stenosis; the higher the level of injury the greater was the probability.

Neurological deficit in injuries of the thoracic and lumbar spine. A consecutive series of 70 patients.

Seventy consecutive patients with injuries of the thoracic and lumbar spine accompanied by neurological deficit were prospectively studied and follow-up. In 40 of these patients with a burst fracture, the degree of involvement of the cross-sectional area of the spinal canal, as revealed on first CT after admission, was not correlated with the type and degree of initial neurological deficit. In patients with injuries of the lumbar spine, neurological deficit may be mild, although the sagittal diameter of the spinal canal may be reduced by as much as 90%.

Motor cycle injuries in speed sport for youngsters.

In speedsport motorcycling for youngsters (6-16 years) is gaining an increasing popularity. We had the impression that there was an increase in the number of injured young motorcyclists. Therefore we studied the kind, cause and severity of the injuries sustained to 32 young motorcyclists treated in the Department of Traumatology of the University Hospital Groningen.

Improved tissue perfusion during pressure regulated hyperthermic regional isolated perfusion. A clinical study.

In previous studies on isolated hindlimb perfusions in dogs, the authors proved that the extracorporeal circuit should be regulated at a delta pressure (systemic mean arterial pressure minus hindlimb mean arterial pressure) of not more than 15 mmHg, to achieve adequate tissue perfusion. To confirm this in patients the authors performed clinical perfusions, divided into three groups. In group I and II the extracorporeal circuit was regulated at a delta pressure of 15 mmHg and 50 mmHg, respectively.

Isolated hindlimb perfusion in dogs: the effect of perfusion pressures on the oxygen supply (ptO2 histogram) to the skeletal muscle.

During regional isolated perfusion, neoplasms in extremities are treated with high doses of chemotherapeutic drugs by means of an extracorporeal circuit. The question is whether optimal tissue perfusion, which is essential for the therapy, is obtained by regulation of the extracorporeal circuit on an adequate perfusion flow or on an adequate perfusion pressure. To determine which perfusion pressure is needed to maintain adequate tissue perfusion, hindlimbs of six dogs were perfused at perfusion pressures 0, 15, 25, and 50 mm Hg below systemic mean arterial pressure.

Effects of acute bleeding on oxygen supply to the skeletal muscle in dogs.

To study the effect of acute bleeding on the oxygen supply to the skeletal muscle, heparinized dogs were bled via an arterial cannula until mean arterial pressures of 25 and 50 mm Hg below initial value were reached. The shed blood was retransfused in reverse (50, 25 mm Hg) after correction of the acid-base imbalance in the dogs. Oxygen supply to the skeletal muscle was measured by means of a multiwire polarographic electrode placed on the sartorius muscle and was evaluated by means of ptO2 histograms.

Improved tissue perfusion during pressure-regulated hyperthermic regional isolated perfusion in dogs.

To achieve adequate tissue perfusion during regional isolated perfusion, hind limbs of dogs were perfused for 60 min, regulating the extracorporeal circuit on pressure. The dogs were divided into three groups. In groups I and II perfusions were performed at a delta pressure (systemic mean arterial pressure minus hind limb mean arterial pressure) of respectively 50 and 15 mm Hg; in group III delta pressure was also 15 mm Hg but the cytostatic drug Melphalan was added.