[Recreational or professional participants in Nordic skiing. Differences in injury patterns and severity of injuries].

A total of 441 Nordic skiing injuries were observed and analysed for a period of two winter seasons. The data showed that athletes in squads (0.02/1000 days) or professional clubs (0.

Prospective documentation and analysis of the pre- and early clinical management in severe head injury in southern Bavaria at a population based level.

Treatment of patients suffering from severe head injury is so far restricted to general procedures, whereas specific pharmacological agents of neuroprotection including hypothermia have not been found to improve the outcome in clinical trials. Albeit effective, symptomatic measures of the preclinical rescue of patients (i.e.

Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomized study of four hundred and fifty patients.

Background: The treatment of open fractures of the tibial shaft is often complicated by delayed union and nonunion. The objective of this study was to evaluate the safety and efficacy of the use of recombinant human bone morphogenetic protein-2 (rhBMP-2; dibotermin alfa) to accelerate healing of open tibial shaft fractures and to reduce the need for secondary intervention.

Methods: In a prospective, randomized, controlled, single-blind study, 450 patients with an open tibial fracture were randomized to receive either the standard of care (intramedullary nail fixation and routine soft-tissue management [the control group]), the standard of care and an implant containing 0.

[Programmed debridement, combined with jet lavage in extensive hand infections].

108 patients with a distinct infection of the hand were treated according to a protocol with serial debridements in combination with jet-lavage. In 106 patients the infection could be controlled with good functional result (79%) and normal neurological findings (85%). Microbial count in different tissues showed a significant decrease during the serial debridements.

[5-year results of dia-/supracondylar femoral fractures, managed with the dynamic condylar screw].

In 118 patients with intra- and extraarticular distal femoral fractures we used open reduction and internal fixation with a dynamic condylar screw. We recorded general implant related complications in a very low percentage of patients. In evaluation of the long-term results in eighty one patients after follow-up of more than five years we found occasional pain in eighteen patients and frequent pain in two patients.

[Chronic osteitis--modern therapy].

The results of the clinical trials with ofloxacin in the treatment of osteitis are presented. The drug was used according to 3 regimens: 200 mg thrice a day, 200 mg twice a day and 400 mg once a day for 6 to 24 months. The disease diagnosis was based on the bacteriological investigation of the biopsy specimens and hemocultures.

[Reducing the risk of infection by use of an unreamed intramedullary nail in open tibial fractures].

An intramedullary stabilisation with an unreamed tibial nail (UTN) was carried out in 75 patients suffering from first (n = 45) and second (n = 30) degree open fractures. In 23 cases (8 of which had a second degree and 15 a third degree open fracture) the treatment regime was changed from external fixation (EF) to an UTN. The results were compared with 112 patients with first degree open tibial fractures treated with a reamed tibial nail (RTN).

[Possibilities for the use of the basic cephalosporin cefuroxime in bone surgery. Tissue levels, effectiveness and tolerance].

In a prospective study with 725 patients we demonstrated the effectiveness and tolerability of cefuroxime as antibiotic prophylaxis in trauma surgery. The infection rates were 0.5 to 1.

[Aggressive debridement and early soft tissue coverage of 3d degree open tibial fractures].

93 patients with grade III open tibial fractures were treated without a treatment protocol from 1980 to 1982. This group is compared to 147 pts. managed between 1983 to 1986 according to a standardized prospectively designed protocol with aggressive debridement augmented by pulsatile Jet-lavage.

Gas-gangrene following arthroscopic surgery.

An arthroscopic anterior cruciate ligament repair was followed by gas-gangrene and the development of a compartment syndrome. Treatment consisted of extensive fasciotomy, debridement, and antibiotic therapy with penicillin G, cefotiam, and metronidazole. The patient was also treated with five sessions of hyperbaric oxygen in a pressure chamber for a duration of 2 h per session.

Use of ofloxacin in open fractures and in the treatment of post-traumatic osteomyelitis.

In two open prospective studies, the efficacy and tolerance of ofloxacin in the prevention of infection in patients with open fractures (n = 58) and in the treatment of chronic post-traumatic osteomyelitis (n = 115) were examined. In the study with open fractures, bone and/or soft tissue infection occurred in only four cases (6.5%).

Ofloxacin treatment in the management of chronic osteitis.

In an open prospective study, the efficacy and tolerability of ofloxacin in the treatment of chronic post-traumatic osteitis was examined in 83 patients. 103 different pathogens were isolated. More than 75% were Gram-positive bacteria with Staphylococcus aureus occurring in 61% of cases.

Effectiveness of imipenem in the treatment of chronic post-traumatic osteitis.

In 61 patients the effectiveness of imipenem in the treatment of chronic post-traumatic osteitis was examined. The diagnosis of post-traumatic osteitis was based on clinical and radiological signs of infection, as well as a positive bone culture from a surgical specimen. The average duration of treatment was 10 days with a dosage 3 X 500 mg imipenem daily.

[Determination of surgical status: stomach cancer].

In spite of a decrease in the frequency of gastric carcinoma as shown in some statistics this malignoma still is an almost daily challenge in surgery. The prognosis of the gastric cancer, in general, depends upon the time of onset of therapy and the tumor grading. At present, chemotherapy and radiation therapy cannot be regarded as alternatives to surgical therapy.

[Control of the intragastric pH value in infection and peritonitis by ranitidine versus cimetidine. A double-blind study].

12 patients of an intensive care unit on respirator with peritonitis respectively septic complications were treated with 300 mg/die Ranitidine or 2000 mg Cimetidine/die administered via perfusor infusion under the conditions of a randomized double blind study. Both groups under investigation were comparable in respect to age, sex and grade of risk of stress induced bleedings. With ranitidine under the dosage mentioned above, a prophylactic sufficient control, yet not a complete control of intragastric pH-value was accomplished.