[Acute myocardial infarction after blunt polytrauma -- successful coronary intervention].

Acute myocardial infarction following blunt chest trauma is a well reported but rare finding. Especially in severely injured patients the optimal therapy of the myocardial infarction is not well established, since anticoagulants, platelet aggregation inhibitors or thrombolytics are frequently contraindicated under these conditions. We report a case of a 41-year-old man, who presented with an acute myocardial infarction in combination with a severe polytrauma (multiple rib fractures, hematothorax, pelvic bone fractures, multiple injuries of intestinal organs) after a motorcycle accident with a blunt chest and abdominal trauma.

Ganglion of the hip: report of five cases.

Ganglion of the hip is a rare cause of inguinal swelling. Ultrasound examination and MRI lead to the correct diagnosis. Resection should be considered for large ganglia and in cases with impairment of neighboring structures.

[Bilateral traumatic elongation of the distal biceps tendon].

The rupture of the distal biceps brachii tendon involves characteristic functional deficits and clinical findings that allow easy diagnosis. Well-established surgical techniques will usually largely restore strength of flexion and supination. Lacerations without complete disruption of the tendon, however, pose diagnostic problems due to the absence of the typical gap in the course of the tendon.

[Corrective osteosynthesis of the proximal femur].

Posttraumatic malunions after fractures in the coxal femur area must be corrected if the deformity has reached a certain range, and individual aspects must be considered. Non-weight bearing, painful femoral neck pseudarthrosis absolutely requires osteotomy. With correct technique the deformities can be usually corrected and the results are good.

[Management of pertrochanteric femoral fractures. Bundle nailing or dynamic hip screw].

In a 8 year period (1981-1988) pertrochanteric fractures treated by elastic round nails (ERN) or dynamic hip screw (DHS) are investigated retrospectively. In spite of the more expense operative technical procedure, complications with DHS are rarer, and hospitalisation shorter, with low mortality.

[Expert assessment in the evaluation of the so-called rotator cuff rupture of the shoulder].

The tear of the rotator cuff only in rare occasions is caused by an adequate trauma. Degenerative changes in elderly patients mostly are the reason for the defect called "trophic perforation". In the operative treatment of such lesions an exact description of the macroscopic findings and the histological investigation are necessary.

[Evaluating histologic findings of the rotator cuff of the shoulder].

Tearing of the rotator cuff is normally due to degenerative changes of the supraspinator tendon. The vascular situation as well as histological findings in elderly patients--oedema, necrosis and hyalinosis--are reasons for the defect. A classical rupture caused by a real trauma is very rare; it is therefore better to call these typical findings "rotator cuff defect".

[Eosinophilic granuloma. Risk of fracture and rare site].

The eosinophilic granuloma of bone, Letterer-Siwe's disease and Hand-Schüller-Christian's disease are integrated under the conception Histiocytosis X. The same patho-histological findings, especially on bone and the observation that the 3 diseases can change one into the other are the reason for this conception. In the past the very different prognosis of the 3 diseases was the reason for difficulties of the classification and the therapy.

[Treatment and results in severe craniocerebral trauma].

Treatment of severe craniocerebral traumas in medium and major hospitals not provided with special neurosurgical equipment requires particularly close interdisciplinary cooperation between surgeons, neurologists and anaesthesiologists. CT facilities are an essential prerequisite for best possible patient care. Patient safety during the posttraumatic and postoperative phases is improved by measuring the intracranial pressure.

Biomechanics of the femoral neck. Calculation of pressure and tension distribution in the human femoral neck, applying principles of the theory of elasticity and strength of materials.

Theoretical aspects on the influence of the shape of the human femoral neck in terms of tension intensifying slots are presented. Static stress is calculated. It is shown that tension in the cranial periphery of the neck is twice as high as expected.

[Infected pseudoarthroses of the tibia shaft. A collective study].

A clinical report on 252 cases of infected pseudarthroses of the tibia is given: 72.6% after an open fracture. 218 underwent one stabilising procedure, 59 were stabilised twice to 4 times.

[Valgus osteotomy in treatment of osteoarthrosis of hip (author's transl)].

The article reports on Bombelli's theory on the genesis of arthrosis of the hip. Clinical experience has shown that valgus and extension osteotomy is indicated in dysplasia arthrosis, in cystic changes and formation of osteophytes. Although the good clinical results cannot be accepted as a proof of the biomechanical deliberations, they do extend the range of indications pointing to surgery of the diseased hip joint performed for the purpose of preserving the femoral head.

[Infected tibial shaft pseudarthroses, treatment and results (author's transl)].

In a follow up study of 47 patients with infected pseudarthrosis of tibia therapy and results are declared. The most important matter in therapy is the osteosyntesis with compression of the pseudarthrosis. In the majority of cases externe stabilisation is used; seldom compression plate or medullary nailing is indicated.