Fixation technique influences osteogenesis of comminuted fractures.

Comminuted fractures most often are associated with compromised soft tissue conditions and diminished vascularization leading to a reduced osteogenesis. In contrast to stable fixation by compression plating with lag screws, the less stable but also less invasive techniques of external fixation, unreamed nailing, or bridging plates have become increasingly popular. The aim of this study was to compare the bone healing and osteogenesis of these fixation techniques.

[New methods for effective prevention of thromboembolism in surgical medicine exemplified by trauma surgery].

Under conventional prevention (pharmacological and physical) of thromboembolism 30-40% of surgical patients develop deep vein thrombosis (DVT). Mechanical methods significantly increase the efficacy of prophylaxis for thromboembolism: these include intermittent pneumatic compression, A-V impulse systems and ankle motion devices. For all trauma patients it is advisable that conventional prophylaxis of thromboembolism be supplemented with elements of mechanical prophylaxis in order to reduce the continuing high thrombosis rate significantly.

High stability of the Ilizarov ringfixator in a metacarpal fracture of an Arabian foal.

In a case of I degree open multifragmentary metacarpal fracture of a 4-week-old Arabian foal, an osteosynthesis with the Ilizarov ringfixator was performed. Immediate full weight-bearing (100 kg) was possible, demonstrating the high stability of the Ilizarov ringsystem. After 12 weeks, sufficient bony union was achieved, and the fixator could be removed.

[Ultrasound diagnosis of acute rupture of the anterior cruciate ligament. An experimental and clinical study].

In an experimental study on 20 cadaver knee joints we found examined the ventral translation of the tibial head, which is otherwise shown by the Lachmann test, by dorsal sonography. These examinations were performed in knees in which arthroscopical examination had confirmed intact ACL. After endoscopical partial and complete rupture of the ACL the examinations were repeated.

[Physical prevention of thrombosis with the ankle joint with the motorized ankle joint movement device. Initial results of a clinical study].

Between 1993 and 1994 the value of the "Artroflow" device in deep venous thrombosis was tested in 95 trauma surgical high risk patients. Parallel to the application of Heparin and physical methods, the "Artroflow" device was employed. The test and compare group showed an equal amount of risk parameters and comparable injuries.

[Ultrasound criteria of fresh rupture of the anterior cruciate ligament].

In a prospective, controlled, monocentric clinical study 193 recently traumatized knee joints, suspicious of a ruptured anterior cruciate ligament, were examined sonographically. Three indirect signs of rupture were analyzed and compared to the results of the clinical tests of stability (Lachmann). Arthroscopy and arthrotomy were regarded as approved methods of reference.

[Dynamic skin suture for closure of the incision defect after compartment incision].

Dynamic skin suture consists of a technique that diminishes local pressure on skin and permits progressive tightening of the sutures for stepwise incisional closure. A clinical series of 28 repairs after release of compartment syndromes shows complete closure in 22 incisions, the other 6 defects could be reduced in size. Technique, results and biological basics are discussed.

[Treatment of closed dislocations of the knee joint].

Nineteen knee dislocations in 18 patients (one bilateral) occurred over a period of twelve years. The age range was 17 to 70 years with an average age of 33 years. There was no injury of the popliteal artery and five peroneal nerve injuries in the group.

[Three-dimensional computerized tomography in trauma surgery. A case presentation].

Three-dimensional images of bone structures can easily be reconstructed from computed tomography data. The technique and the advantages of contemplating reconstructions of bone defects in different directions are described. A special software programme allows to combine all data which are given by the standard CT.

[Indications, choice of procedure and results of conservative therapy of spinal injuries].

For conservative treatment of injuries of the cervical spine, two different methods are available: The HALO fixator and the collar. The choice depends on the kind and extension of the injury. Stable thoracic and lumbar vertebral fractures are treated in a conservative functional way in order to strengthen the muscular apparatus.

[The fibula-pro-tibia operation--indications, results].

We report on 21 cases with combined soft tissue and far reaching bone defects of the lower leg. The bone defects were bridged by the fibula-pro-tibia-operation. In eleven patients the restoration of the full weightbearing leg was achieved.

[Indications for a bridging plate osteosynthesis of compound femoral shaft fractures].

We performed the clinical and radiological follow-up of 29 comminuted fractures of the femoral shaft treated by bridging plate osteosynthesis. Complete bone healing in 6 open fractures took place within 33 weeks, in 15 closed fractures within 22 weeks. We had to meet 5 postoperative complications: 2 cases of osteomyelitis following open fractures, 1 early wound infection and 2 haematomas.

[Analysis of the collective term "periarthritis humeroscapularis"].

The functional and anatomical consideration of the shoulder joint in relation to the clinical aspects can differentiate the general term of "scapulohumeral periarthritis". The most frequently pathological findings are seen in the rotary cuff and the long head of the biceps muscle. Significant causes are further arthrosis of the acromioclavicular joint, the instability of the shoulder joint and the frozen shoulder.

[Incidence and causes of typical injuries in popular sports].

The increasing participation in extensive athletics and leisure time activities correlates with increasing sport injuries. The surgeons tasks include being involved in preventing sport injuries and ensuring a correct diagnosis, as well as providing adequate surgical therapy. After sport injuries, the true diagnosis can be obscured by functional compensation.

Back school for patients with vertebral fractures.

Back school is behavior training for the prevention and treatment of back problems arising from faulty body posture and muscular dysfunction. This paper describes the conception and evaluation of a back school program for patients with vertebral fractures. The curriculum includes the provision of detailed information as well as physiotherapy, training in the right way to perform activities of everyday life, counseling, relaxation training, and self-monitoring.

[Dorsal plate osteosynthesis of the tibial shaft. Results of a collective study of the German section of the International AO (Study Group for Osteosynthesis Problems)].

This collective study was conducted by the German section of AO International to work out the indications for fixation of the tibial shaft by means of dorsal plating. Primary dorsal plating was done in 70 cases. Most of the patients had second- or third-degree open fractures with severe ventral soft tissue injuries or closed fractures that could not be reduced and fixed conservatively.