Der Unfallchirurg
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Knee and hip dislocations are often serious injuries with an uncertain outcome. Simultaneous ipsilateral dislocation of the knee and hip joints is very rare; consequently, there is an inadequate amount of literature on the subject. In this case report we present a 35-year-old male patient with this combination of both injuries and discuss it in comparison with the available literature. This case report shows, that a methodical and sequential treatment can lead to good results in spite of this complex combination of injuries.
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Comparative Study
[Prosthesis implantation in the proximal ankle joint--a real therapeutic alternative in post-traumatic arthrosis?].
The results of total ankle arthroplasty were poor in the 1970s and 1980s compared to those of the arthrodeses. Because of the good long term results this technique has been accepted as the treatment of the choice for posttraumatic arthritis of the ankle. Recently the development of an unconstrained total ankle arthroplasty with an additional mobile polyethylene inlay between the fixed tibial and the talar component which enables a three dimensional range of motion seems to improve significantly the long term results of total ankle replacement. ⋯ Furthermore, these data are obtained yet only by a few experienced surgeons in specialized centers. Further clinical trials have to be performed to answer the question whether the total ankle arthroplasty is a reliable alternative treatment of posttraumatic arthritis of the ankle. At present, the arthrodesis should be regarded as the treatment of choice for the posttraumatic arthritis of the ankle joint.
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The clinical results after DFN-osteosynthesis of n = 56 AO-classification 33A-fractures (32%), 33C-fractures (43%), 32X-fractures (21%) and treatment of non-union (4%) are presented. ⋯ The mechanical stability of the implant allows a save osteosynthesis of unstable supracondylar and complete articular femoral fractures without additional bone grafting. Mechanical stability and minimal invasive operative technique permit a safe bone healing without major complications.
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Case Reports
[Extracorporeal lung support and endovascular stent in traumatic aortic rupture and severe lung failure].
Blunt thoracic injury in association with aortic rupture represents a life-threatening situation. Surgical repair used to be the preferred method of treatment. ⋯ We present here an alternative treatment protocol including pumpless extracorporal lung assist and endovascular aortic stent graft placement in a 20-year old traffic accident victim. This procedure may be an especially useful treatment option in managing patients with complex lung and aortic pathology primarily not suitable for transportation or surgery.
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Patients with spinal cord lesions suffer injury even by marginal trauma, especially in the area of the knee joint. Because of lost sensitivity and proprioception, the treatment of the fracture has to be minimally invasive but stable enough for physiotherapy. ⋯ We saw in this study that the GSH nail is an excellent method for stabilizing supracondylar fractures of the femur in paraplegic patients because the treatment is minimally invasive and the fracture is stable enough for physiotherapy. The retrograde nailing of proximal fractures of the tibia is a good alternative method for treatment of patients with spinal cord lesions.