Effect of glycerol-L-lactide coating polymer on bone ingrowth of bFGF-coated hydroxyapatite implants.

Basic fibroblast growth factor (bFGF)-coated hydroxyapatite (HA) cylinders showed good bony incorporation in a previously conducted animal study. However, some cylinders exhibited focal inhomogeneous bone ingrowth. The purpose of the current study was to test whether glycerol-L-lactide polymer coating could improve release properties and bone incorporation of bFGF-coated HA implants.

[Proximal femur fracture with secondary hyperparathyroidism].

We rarely see trauma patients with secondary hyperparathyroidism. We report about a case of a 68-year-old African female with a pertrochanteric femur fracture after a falling accident. As a secondary result we noted a Looser zone (pseudofracture) in the fractured femur.

[Rupture of the tibialis anterior tendon--a rare sports injury].

Rupture of the anterior tibial tendon is a very rare injury in sports. The rupture is based on degeneration of the tendon and caused by a forced plantarflexion. Main symptoms of this often "missed injury" are impossibility of dorsal extension of the foot and a palpable gap.

[Indications for surgical treatment of clavicular fractures].

Most fractures of the clavicle can be successfully treated by conservative management. In few cases however primary or secondary operative stabilisation is necessary. Good results can only be obtained considering clearly defined indications and correct surgical techniques.

[Ideal indications for the use of a textile ligament of high strength Trevira in alloplastic replacement of the anterior cruciate ligament in chronic isolated rupture].

Between August 1980 and December 1986, 120 patients suffering from chronic instabilities of the knee ligament were submitted to corrective surgery at the Berufsgenossenschaftliche Unfallklinik Frankfurt am Main. A textile ligament made of polyethylene terephthalate (Trevira hochfest type 730) was substituted in all cases for the disturbed or missing ligament structure. 67 out of 100 patients came to the check-up appointments.

[Alloplastic replacement of the anterior cruciate ligament in chronic instability--indications and technic].

Since August 1980, missing or no longer present cruciate ligament structures have been replaced in many patients suffering from chronic instability of knee-joint ligaments, by an implanted ligament made from Trevira hochfest. 158 operations of this kind were supervised by the author. Although results have been good so far, the indication for such an operation should be extremely restricted.

[Cement-free implanted total hip endoprosthesis of the Mittelmeier model. Clinical experiences and results following 6 years of use mainly in accident-induced hip changes].

We give a review of the results of 165 implantations in 143 patients. Uncemented endoprostheses (type Mittelmeier) for replacement of hip joints were implanted from September 1979 to December 1985 at the Berufsgenossenschaftliche Unfallklinik Frankfurt/Main. When we started to implant uncemented prostheses the complication rate was higher than in conventional implantations.

[A foreign body in the knee joint--a very rare injury in children].

Cause of uncertain knee-complaints in children can be foreign bodies which penetrated unnoticed the joint cavity. Here we report an unusual injury of this kind. A glass-foreign body intruded the knee joint in childhood.

[Alloplastic replacement in chronic isolated rupture of the cruciate ligament--technic and results].

A report is given on 48 inveterate isolated cruciate ligament ruptures of the knee joint which were treated by corrective reconstruction surgery with an alloplastic material made of polyethyleneterephtalate. 36 patients could be checked up almost five years after the implantation. It is of great importance that the described implantation technique is strictly observed.

[Alloplastic reconstruction of the ligament of the knee in chronic rotation instabilities--technics and results].

During the years from 1980 through 1985, 23 patients with chronic rotation instabilities of the knee joint underwent alloplastic reconstruction of the knee ligament system at the Berufsgenossenschaftliche Unfallklinik Frankfurt am Main. Twenty out of these patients could be checked up after an observation period of more than four years. The examinations showed that in 90% of the patients an essentially improved ligament stability was achieved by the surgical intervention.

[Traumatic ureteral rupture by the indirect effect of force].

We report a rare case of complete ureteric avulsion as the result of indirect force and discuss the mechanism of injury in the light of relevant literature. The special problems of this injury with regard to diagnosis and therapy are explored. Every polytraumatized patient with involvement of the trunk should have an IVA at the earliest possible moment as a basic investigation.

Alloplastic correction of chronic knee ligament instability with polyaethyleneterephthalate.

The results of treatment by alloplastic ligament replacement are generally comparable to those achieved with autologous pedunculated or free tissue transplants with regard to band stability as well as total function. We consider the indication for this not yet universally recognised surgical technique with alloplastic material to lie exclusively in patients with multiple previous knee operations and for whom autologous tissue was not present in adequate quality intraoperatively. Here the usage of the polyester band was a last resort.

[Correction of post-traumatic malpositions in the area of the femoral bone with intramedullary nailing].

Locking by nailing subsequent to correction osteotomies has been found very successful in conditions where surgery had to be performed long after occurrence of the fracture, especially in the region of the femur. Basing on the results obtained in 52 patients treated in this manner, the article describes the original situation before corrective osteotomy, determines the indication for surgery and explains the surgical technique of nailing. The advantages of locking by nailing, yielding excellent and good functional and x-ray film results in 90% of the cases, are emphasized.

[Treatment of inveterate knee ligament lesions with alloplastic material (author's transl)].

Early surgical treatment of a complex instability of the knee joint is not always possible. Even the autologous ligament graft indicated in such a case is not always successful. Furthermore, there is often a lack of autologous material due to previous operations.

[Initial experience in accident surgery performed in an operation theater equipped with ASID sterile filter partition screen (author's transl)].

The article reports on initial experience in accident surgery performed in an operation theater equipped with an ASID sterile filter partition screen. This filter screen is representative of, and corresponds to, the room-within-room solution with laminar airflow in horizontal direction. The advantages of this sterile filter partition in the performance of the broad spectrum of accident surgery operations are explained.

[Extended diagnosis for lesions of the capsule and the ligament of the knee joint (author's transl)].

X-rays taken under mechanical positioning of the joint with standardized conditions are helpful aids in the diagnosis of injuries of the knee capsule and ligaments. In comparison to the non-affected knee the extent of instability of the joint can be exactly demonstrated. Arthrography is of little help in fresh injuries to the knee capsule and ligaments, but can be useful to assess the residuals of old damage to the joint.

[Results after surgical treatment of injuries to the capsule and ligaments of the knee joint (author's transl)].

Between 1974 and 1978 at the "Berufsgenossenschaftliche Unfallklinik" Frankfurt/Main 124 patients with lesions to the knee ligaments were treated; 117 patients could be followed up. All cases were classified according to the accident, the impact and the mechanism of the injury. The case-reports were supplemented by a graduation of the rotation stability and a general description of the own surgical technic and the postoperative care.