Der Unfallchirurg
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A 68 year old patient with persistent feeling of sickness and increasing pain in the left forearm was seen. A complex both bone fracture of the distal forearm shaft had been stabilized with Küntscher nails in radius and ulna 35 years ago. The loose ulna nail had been removed after ten weeks. ⋯ Whereas local pain is disappeared three month after removal presenting bland local findings the general condition is improved slowly. Already Küntscher described the blockage of his nail after a short distance extraction. In addition to a number of not always successful means of extraction this method is described for the first time.
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Injuries of the posterior pelvic with combined anterior and posterior instability require the stabilisation of both the anterior and posterior pelvic ring. If the injury only involves the ligamental connections, then a transileosacral osteosynthesis with screws is the minimal invasive and biomechanically suitable method of choice. The difficulty with this approach is the correct placement of the screws. ⋯ The postoperative CT scans showed no intraspinal or intraforminal malplacement of the screws. In two cases a slight tangential screwthread penetration through the ventral sacrum was found. Our first experiences with this novel technology are encouraging and clearly demonstrate the advantages of fluoroscopic supported passive navigation systems for the optimal placement of ileosacral screws.
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Multicenter Study Comparative Study
[Supracondylar humerus fracture in childhood--an efficacy study. Results of a multicenter study by the Pediatric Traumatology Section of the German Society of Trauma Surgery--II: Costs and effectiveness of the treatment].
The following are the results and conclusions of a retrospective research study done on 886 patients with supracondylar fractures of the humerus. The study evaluates how effective the treatment procedures of the fractures are. The patients' fractures were categorized into four groups. ⋯ The patient will be hospitalized for a short period. The blount procedure will not be sufficient for this type of fracture. Therapy and procedure will be translated put in a perspective research study.
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In the view of efficiency and cost effectiveness the increasing incidence of gunshot wounds in Europe demands a modification of treatment protocols. The general basis are debridement of soft tissue injuries, antibiotics and fracture stabilization. ⋯ Small caliber gunshot wounds can be treated more conservatively. The following review presents an overview on the ballistic and surgical basis for the treatment of gunshot wounds of the musculoskeletal system.
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In this retrospective study of the pediatric trauma group of German trauma society, issued to investigate the state of the art treatment of the supracondylar fracture of the humerus, 13 clinics took part. In this first part of our study we tested the epidemiology and effectivity of therapeutic interventions based on the classification of v. Laer. 886 fractures were included with an average patients age of 5.8 years (+/- 2.9). ⋯ Therefore the classification was modified based on 4 groups: Type I undisplaced, Type II displacement in one plane, Type III displacement in two planes and Type IV displacement in three spatial planes. Using this classification we could found that in group II 25% of reduction an 7% of retentions were ineffective. For group III and IV we found that > 20% of the retention proofed to be ineffective.