Der Unfallchirurg
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The prevalence of cancerous diseases in Germany is rising. The skeletal system represents the third most common localization for metastases. ⋯ The treatment of patients with osseus metastases is nowadays an integral component of orthopedic trauma surgery practices. This article presents the principles of the diagnostics, provides aids for estimation of the prognosis and danger of fractures and discusses the various surgical treatment procedures for skeletal metastases with the accompanying advantages and disadvantages.
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A patient with spondylosis deformans of the cervical spine with no neurological deficits developed rapidly progressive tetraparesis 1 day after a whiplash injury due to a car accident (rear end collision), although initially there were no clinical symptoms. Surgical decompression and spondylodesis led to relief of the neurological deficits. This case demonstrates that even a low grade whiplash injury (grade 1) can cause severe neurological symptoms later and that a degenerative disease of the spine is a predisposing factor.
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Case Reports Clinical Trial
[Dynamic intraligamentary stabilization of the anterior cruciate ligament : Operative technique and short-term clinical results].
Reconstruction of tears in the anterior cruciate ligament with a tendon graft is the current gold standard. ⋯ Dynamic intraligamentary stabilization in combination with microfracturing of the notch can provide biomechanical and biological conditions for self-healing of the anterior cruciate ligament. Further clinical and biomechanical research is needed to identify appropriate patients and rupture types suitable for this new technique.