[Atypical blast injury of the left hand : Multiple trauma with severe injury especially of the left hand].

There is an accumulation of blast injuries on New Year's Eve due to fireworks.During an attempt to manufacture a firework the substances being mixed in a mortar exploded. The left hand of the patient was severely injured.

The influence of the alloy of megaprostheses on infection rate.

We retrospectively reviewed 197 patients who underwent reconstruction with a megaprosthesis of the lower extremity. A cobalt-chrome alloy system was used in 77 patients and a titanium alloy system in 120 patients. The overall infection rate was 20.

[Not "only" a dislocation of the hip: functional late outcome femoral head fractures].

Background: Traumatic hip dislocation combined with fracture of the femoral head is a rare condition for which little known in terms of long-term prognosis. The aim of the retrospective study presented here was to evaluate the clinical and radiological outcome of this specific injury.

Patients And Methods: In a 23 year period, 18 patients (17 male) with an average age of 25.

Comparable efficacies of the antimicrobial peptide human lactoferrin 1-11 and gentamicin in a chronic methicillin-resistant Staphylococcus aureus osteomyelitis model.

The therapeutic efficacy of an antimicrobial peptide, human lactoferrin 1-11 (hLF1-11), was investigated in a model of chronic methicillin-resistant Staphylococcus aureus (MRSA) (gentamicin susceptible) osteomyelitis in rabbits. We incorporated 50 mg hLF1-11/g or 50 mg gentamicin/g cement powder into a calcium phosphate bone cement (Ca-P) and injected it into the debrided tibial cavity, creating a local drug delivery system. The efficacy of hLF1-11 and gentamicin was compared to that of a sham-treated control (plain bone cement) (n=6) and no treatment (infected only) (n=5).

[Surgical therapy of unspecific and specific Spondylodiscitis].

Aim: The aim of this study was to evaluate the clinical and radiological results of surgical treatment of thoracic and lumbar vertebral osteomyelitis by means of one-stage extrafocal posterior stabilisation, anterior debridement, and anterior column reconstruction.

Method: A retrospective analysis of the peri- and postoperative parameters of 62 patients with a clinical and radiographic follow-up of 2.6 years that were available for 46 patients was performed.

Effectiveness of hydroxyapatite-vancomycin bone cement in the treatment of Staphylococcus aureus induced chronic osteomyelitis.

In the field of local application of antimicrobials, a number of novel drugs and/or new drug delivery systems have been developed in recent years. The present study aimed to investigate hydroxyapatite cement (HAC) as a carrier for vancomycin in the treatment of chronic osteomyelitis due to Staphylococcus aureus strains with various mechanisms of resistance. The release of vancomycin from standard test cylinders was determined in vitro and the efficacy of the delivery system was measured in vivo using a rabbit model of chronic osteomyelitis.

Evaluation of an in situ setting injectable calcium phosphate as a new carrier material for gentamicin in the treatment of chronic osteomyelitis: studies in vitro and in vivo.

A study was performed to investigate the effectiveness of hydroxyapatite cement (HAC) as a new carrier system in the treatment of chronic, posttraumatic osteomyelitis. In the in vitro study, release of gentamicin from standard cylinders of HAC were measured by agar diffusion test. As a representative for mechanical properties, compression strength was measured in order to detect changes when mixing HAC with gentamicin.

[A new irrigation-suction boring system facilities low-pressure intramedullary boring of isolated swine femurs].

Aim: Intramedullary nailing is the treatment of choice for the stabilization of fractures of long tubular bones. An important disadvantage of this method is the increase in intramedullary pressure and the resulting release of fat into the venous blood system during reaming of the medullary canal. We have developed a new type of rinsing-suction-reamer (SSB) in order to minimize these disadvantages.

A case of "boomerang" bullet ricochet.

A .375 Holland & Holland Magnum Winchester Fail Safe bullet was fired against a steel plate. The big-game hunting bullet (17.

[Late sequelae and treatment strategies of distal radio-ulnar dissociation after undetected Essex-Lopresti lesion].

The Essex-Lopresti lesion, a combination of radial head fracture and distal radioulnar dislocation, rarely occurs but nevertheless represents a frequently unknown result after forearm fracture. The responsible physician soon has to initiate surgical treatment to prevent his patient from permanent pain of the wrist. Previously unrecognised distal radioulnar dislocation remains to be an unsolved problem.

[Callus distraction of the first metacarpal bone for thumb reconstruction after traumatic amputation].

From 1990 to 1997, callus distraction of the first metacarpal bone was performed on 34 patients with a traumatic amputation of the thumb, if replantation was not possible. After a period of 7 +/- 11 months (range, 1-48), a corticotomy and continuous distraction with an external fixator was carried out. Of the patients, 31 (91%) were reviewed after treatment.

[Therapy and prognosis of enchondroma of the hand].

Enchondromas are the most common bone tumors of the hand. In a retrospective study, medical records and radiographs of 112 patients were reviewed. These patients were operated on between January 1973 and June 1997.

The use of an in situ curing hydroxyapatite cement as an alternative to bone graft following removal of enchondroma of the hand.

Following curettage of enchondromata of the phalanges we filled the resultant bone cavity with hydroxyapatite cement in eight patients to avoid cancellous bone grafting. This material differs significantly from the ceramic hydroxyapatite commonly used in clinical practice. It is produced by the combination of two calcium phosphates which, in the presence of water, form a paste that cures to a solid implant with a microporous structure.

[Fractures of the distal forearm. Which therapy is indicated when?].

Every 15th case of a bone fracture in patients aged more than 65 years concerns the distal radius in Germany. This means the second rank of all geriatric fractures following fractures of the hip. According to the approved and increased apply of operative stabilisation there are arising more and more reports upon poor results of nonsurgical treatment.

Results of transarticular fixator application in distal radius fractures.

From January 1989 until October 1993, 102 patients with 103 distal radius fractures were included in a prospective study with the Pennig wrist fixator (Orthofix, Srl, Italy). 90.5% of these patients were reviewed with a minimum follow-up of 12 months.

CT of metal implants: reduction of artifacts using an extended CT scale technique.

Purpose: The purpose of this work was to use an extended CT scale technique (ECTS) to reduce artifacts due to metal implants and to optimize CT imaging parameters for metal implants using an experimental model.

Method: Osteotomies were performed in 20 porcine femur specimens. One hundred cobalt-base screws and 24 steel plates were used for osteosynthesis in these specimens.

[Significance of score systems in open complex trauma of the pelvis].

A quantitative analysis of the injury severity of 40 patients with open pelvic fractures was performed. Data were analyzed using the Statistical-Analysis-System (SAS Institute Inc., Cary, NC) with regard to patients' age, gender, trauma mechanism, classification and nature of the pelvic injury, associated lesions, and mortality.

[The treatment of unstable fractures of the distal radius using a bridging external fixator. Results from a long-term evaluation].

Introduction: The aim of our study was to evaluate external fixation in the treatment of unstable distal radius fractures in a long-term follow-up.

Methods: Within 8 years 174 patients with severely displaced distal radius fractures were included in a prospective study and treated with an external wrist fixator (Orthofix Srl, Italy). A total of 148 patients were reviewed with an average follow-up time of 28 months.

Photoablation of bone by excimer laser radiation.

Background And Objectives: The aim of the present study was to compare the usefulness of mechanical osteotomy tools and common laser systems with the ultraviolet (UV) laser in the field of the central nervous system and its bony capsule.

Study Design/materials And Methods: The cranial bones of 42 living rats were treated with UV laser radiation with wavelengths of 193 nm and 248 nm. The morphology and physical effects were evaluated by means of optical and scanning electron microscopy.

[Gangrene of the fingers caused by accidental intra-arterial injection of diazepam].

History: A 51-year-old woman was accidentally given an intra-arterial injection of 10 mg diazepam to control an acute claustrophobic anxiety attack. She complained of severe knocking pain in the entire left arm during the injection. On the second day the hand and lower arm were red an swollen and she complained of increasingly feeling cold and having paraesthesias.

Anterior interosseous nerve compression after supracondylar fracture of the humerus: a metaanalysis.

Object: The authors conducted a metaanalysis of reports of anterior interosseous nerve syndrome, a rare nerve compression neuropathy that affects only the motor branch of the median nerve. This syndrome is characterized by paralysis of the flexor pollicis longus, the flexor digitorum profundus to the index finger, and the pronator quadratus, with weakness on flexion of the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger without sensory loss.

Methods: The authors reviewed reports of 34 cases of anterior interosseous nerve syndrome combined with supracondylar fractures of the humerus in children.

[Differential anterior interosseous nerve syndrome diagnosis].

The differential diagnosis of the rupture of flexor pollicis longus tendon and profundus tendon to index finger to the interosseus anterior nerve syndrome can be difficult and can lead to misinterpretation of the clinical impression. Two cases are reported to demonstrate this problem. In the first case a spontaneous rupture of flexor pollicis longus was found, when first an interosseus anterior nerve syndrome was suspected.

Early postoperative enteral immunonutrition: clinical outcome and cost-comparison analysis in surgical patients.

Objective: To determine if early postoperative feeding of patients with upper gastrointestinal malignancy, using an enteral diet supplemented with arginine, dietary nucleotides, and omega-3 fatty acids (IMPACT, Sandoz Nutrition, Bern, Switzerland) results in an improved clinical outcome, i.e., reduced infectious and wound complications and decreased treatment costs when compared with an isocaloric, isonitrogenous control diet.

[Implantation of oxidized, regenerated cellulose for prevention of recurrence in surgical therapy of carpal tunnel syndrome].

Recurrences and persistent symptoms of carpal tunnel syndrome after its surgical treatment is most commonly due to inadequacies of the first procedure, recurrent tenosynovialitis and in particular adhesion formation between the median nerve and its surrounding tissue and scars. Because of the encouraging experiences with oxidized regenerated cellulose (INTERCEED) as an absorbable adhesion-barrier in abdominal surgery, we began using INTERCEED in carpal tunnel surgery. In nine patients who underwent division of the flexor retinaculum combined with epineurotomy or synovialectomy, we covered the median nerve with a monolayer of INTERCEED.