Der Unfallchirurg
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Case Reports
[Lateral tibial head fracture and avulsion fracture of the tibial tuberosity: a rare combination of injuries].
The rare combination of a lateral tibial head fracture and an avulsion fracture of the tibial tuberosity requires treatment that differs from the therapy of the single occurrence of each of these injuries. Especially postsurgical treatment is not yet standardized. ⋯ We performed a multimodal osteosynthesis followed by postsurgical treatment which is different from the postoperative treatment for the individual injuries: immobilization of the knee joint with a thigh splint for 6 weeks, isometric physical therapy, and prohibition of movement in the knee for 4 weeks. This therapy appears to be an effective and successful approach for this combination of injuries, where no standardized treatment has been established yet.
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Melorheostosis is a rare, benign, and sporadically occurring osteosclerosis of unknown cause. The onset of the disease is usually in early adulthood. Melorheostosis affects both genders, develops progressively, and is usually limited to one side of the human body. ⋯ Melorheostosis is usually diagnosed by radiograms. Pain relief and restoration of the full range of motion are the primary goals of the therapeutic approach. A good outcome cannot always be achieved and a recurrence of the disease happens very often.
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Clinical Trial
[Transfer of the flexor hallucis longus to replace the Achilles tendon: indications, technique and results].
Transfer of the flexor hallucis longus (FHL) tendon is a therapeutic option to replace a dysfunctional Achilles tendon in cases of rerupture with large defects, loss of the Achilles tendon after postoperative infection or severe tendinosis. ⋯ FHL transfer to the Achilles tendon provides favorable results in cases of complicated cases with defects, infections or severe tendinosis after Achilles tendon rupture.
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The authors present two case histories of children with synovial soft tissue tumor of the ankle. Synovial soft tissue tumors of the ankle in childhood are rare. ⋯ In both cases the children came primarily to the clinic with painful swelling at the ankle after trauma, which further complicated the diagnosis. It should be taken into consideration that the rare differential diagnosis of pain at the ankle could be synovial soft tissue tumor especially when the clinical course is protracted.
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Can additive fiber cerclage (FC) reduce secondary displacement in unstable 3-part proximal humeral fractures stabilized by angle-stable plates? Is there any effect of different head screw configurations? ⋯ In cases of anatomical reduction and optimally placed implants, FC did not show an additional stabilizing effect in the unstable 3-part fracture model. Different head screw configurations did not influence stability.