Der Unfallchirurg
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The distal forearm fracture is the most common injury (40%) in pediatric traumatology. ⋯ Treatment of distal forearm fractures should be appropriate for children as well as highly efficient, by using a minimal amount of effort. Current forms of overtreatment have to be avoided because of moral and in particular economic reasons.
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Comparative Study
[Abduction/external rotation immobilization after primary traumatic anterior shoulder dislocation : Which ortheses are suitable?]
Immobilization of the shoulder in 60 ° external rotation and 30 ° abduction after primary anterior shoulder dislocation has been shown to allow anatomical reduction and potential healing of the capsule-labrum complex. The purpose of the present study was to evaluate commercially available shoulder braces concerning functionality and comfort as well as for potential problems. ⋯ Ortheses where the main joint is positioned in and not in front of the axilla or which can ensure a jointless stabilization of the shoulder or which allow an improved position by an additional sling on the opposite shoulder, are most qualified for immobilization of the shoulder in an external rotation/abduction position with respect to functionality and comfort.
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Clinical Trial
[Conservative therapy of acute locked posterior shoulder dislocation : Clinical and radiological long-term results.]
Long-term results of conservative treatment of acute locked posterior shoulder dislocation with a reverse Hill-Sachs defect (Malgaigne lesion) <25% are rare. The aim of the present study was to evaluate the clinical and radiological results of patients after conservative treatment. ⋯ Non-operative treatment of acute locked posterior shoulder dislocation demonstrated good to excellent clinical and radiological long-term results in this study. It represents the treatment of choice in patients with a reverse Hill-Sachs defect (Malgaigne lesion) < 25% and a duration of dislocation < 3 weeks.
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Pulled elbow is a common injury in children under the age of 5 years which is usually treated by manual reduction. Supination of the forearm is recommended as opposed to pronation or other maneuvers. The author has developed a manipulative intervention for reduction of pulled elbow in young children on the basis of the pronation technique and called ProFI reduction. ⋯ The application of the ProFI method as a modified pronation technique was shown to provide excellent effectiveness with respect to the patients treated.
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[Growth behaviour after fractures of the proximal radius : Differences to the rest of the skeleton.]
Fractures of the proximal end of the radius in the growth phase have three characteristics: the head of the radius articulates with two joint partners and is therefore indispensable for an undisturbed function of the elbow. The blood supply of the proximal end of the radius is via periosteal vessels in the sense of a terminal circulation which makes it extremely vulnerable. Severe trauma caused either by accidents or treatment, can result in partial or complete necrosis with deformity of the head and neck region of the radius. ⋯ In order to take the special characteristics of the proximal radius into consideration, the vulnerability and correction potential must be weighed up against each other. Therapy must be as atraumatic as possible. The spontaneous correction potential should be integrated into the primary therapy without overestimating this potential with respect to the extent and age of the patient.