Der Unfallchirurg
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Clinical Trial
[Results of balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures].
The aim of this study was to evaluate the reduction of pain, improvement of sagittal alignment, complications and intermediate term results of balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures (VCF). The study group consisted of 87 patients with 145 VCFs which were not responsive to non-operative treatment. All data were collected prospectively. ⋯ In two patients an asymptomatic moderate loss of reduction was detected. These intermediate term results indicate that kyphoplasty reduces pain and improves sagittal alignment in patients with VCF. However, in 26% of patients new fractures occurred, predominantly in adjacent levels but approximately 50% of these fractures were clinically asymptomatic.
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Accidents with the risk of exposure to hazardous nuclear, biological, or chemical materials are rare. Most emergency rooms are not familiar with the management of contaminated patients after this kind of incident. There are also ambiguous cases concerning the contamination status of the patient. ⋯ The security arrangements should protect both (medical) personnel and third persons. Early medical treatment combined with decontamination should be the aim. Based on the case of a contaminated patient who was brought to our emergency department after an explosion of a fog grenade with red phosphorus, we discuss our management concept and the current literature.
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Due to their excellent osteoinductive, osteogenetic, and osteoconductive properties, autologous bone grafts possess biomechanical advantages over synthetic bone substitutes. Furthermore, unlike cadaveric allografts and xenografts, they carry no risk of immunogenic response or transmission of infectious diseases. However, the limited availability of autologous bone grafts requires the use of the above-mentioned bone substitutes for management of large bone defects. ⋯ We report on intramedullary reaming by the RIA technique to obtain autologous bone graft for a nonunion of the proximal femur. The contralateral femur was reamed and the bone graft was applied to the nonunion. The patient showed clinical and radiological healing of the nonunion without donor site complications.
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Case Reports
[Possibilities for the operative treatment of traumatic posterior shoulder dislocation].
Traumatic posterior locked shoulder dislocation is very rare. The dislocation is often combined with fractures of the humeral head or reversed Hill-Sachs deformities. This case report shows two different possibilities for treatment.
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Ankle fractures belong to the most frequent injuries to the human skeleton. Correct treatment requires knowledge of the trauma mechanism and thorough analysis of the injured bony and ligamentous components. ⋯ The most important prognostic factors after operative treatment are exact reconstruction of the articular surfaces and correct position of the distal fibula within the tibial incision after a mechanically relevant syndesmosis rupture. Besides malalignment, negative prognostic factors include delayed reduction, injury of several ankle components and hereditary or acquired neuropathy.