Der Unfallchirurg
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Review Comparative Study
[Proximal and distal ruptures of the biceps brachii tendon].
Proximal ruptures. Ruptures of the long head of the M. biceps humeri are commonly caused by degenerative changes within the tendon. Non-operative treatment gives good results, the loss of power regarding elbow flexion and supination amounts to only 8-21%. ⋯ If supination strength is to be restored, the tendon has to be fixed anatomically. Preparation of the tuberosity bears the risk of heterotopic ossification or nerve damage. Mini-open techniques, using only a limited anterior approach, may decrease risks.
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Comparative Study
[The prosthesis nail -- a new stable fixation device for periprosthetic fractures and critical fractures of the proximal femur].
Increasing numbers of total hip arthroplasties in combination with increasing age and growing daily activities of the elderly lead to increasing numbers of periprosthetic fractures and revision arthroplasties in osteoporotic bone. The prosthesis nail is a hybrid of a hip prosthesis and an intramedullary nail allowing immediate full weight bearing and early rehabilitation. The prosthesis nail consists of three self-locking components: a distally locked intramedullary nail, different lengthening modules, and a hip prosthesis module. ⋯ The prosthesis nail can be applied according to the requirements of the fracture as a reamed or unreamed nail and immediate full weight bearing is possible. Considering the high average age of the patients, low morbidity, short rehabilitation time, and low costs are the major advantages of this new device. Taking into account the unfavorable preoperative conditions associated with elderly and multimorbid patients, the rate of complications is relatively low.
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Traumatic posterior dislocation of the sternoclavicular joint is a rare injury, most commonly occurring in childhood. Computed tomography should be performed on all patients with suspected or established injuries of the sternoclavicular joint to ensure differentiation between fracture and dislocation. Tridimensional computed tomography provides the best imaging for describing and classifying the lession. After closed repositioning, transarticular Kirschner wires were used for stabilisation.
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In patients suffering from multiple injury, chest trauma is often the main cause of fatality. A case report is given and the literature reviewed. A 49 years old motorcyclist hit a car frontally in a road accident. ⋯ This case shows that the severity of chest trauma does not necessarily correlate with the initial clinical and radiological findings. Even with all diagnostic and therapeutic procedures, a fatal outcome could not be prevented. This demonstrates the role of chest injury as a major and unforeseeable cause of death in multiple trauma patients.
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Case Reports Comparative Study
[Rupture of the azygos vein by blunt thoracic trauma. A case report and literature review].
Blunt chest trauma is a common injury in traffic accidents. Thoracic vessel trauma frequently affects intercostal arteries, the aorta and less often the subclavian artery. Azygos vein injury is uncommon and has previously been described in only 19 cases. ⋯ Fractures of ribs and/or thoracic spine (T3-5) were found in nine patients, while neither were found in 11/20 cases. Pathognomonic signs have not been described in the literature. Early resuscitation and immediate thoracotomy with recognition and treatment of azygos vein rupture is necessary to avoid a fatal outcome.