Der Unfallchirurg
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Comparative Study
[Changes in the injury pattern of polytraumatized patients over the last 30 years].
This study aims at describing the changes in injury patterns in traffic accidents in Germany that have taken place over a 30 year period. The basis for the analysis is the in-depth investigations by the scientific research team at the Trauma Department of the Hanover Medical School. Real accidents were investigated based on an on site random selection process. ⋯ For pedestrians and cyclists, the impact of the body on the windscreen of the car is the major reason for severe injuries. We conclude that the currently used safety methods have led to a change in the injury pattern of polytraumatised victims. Injuries with much higher energy levels can nowadays be survived, but when the safety limits are exceeded immediate death at the scene is more common.
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Comparative Study
[External or internal fixation for arthrodesis of the ankle -- a comparative study of perioperative and long-term results].
This study evaluates the results of external and internal fixation techniques for arthrodesis of the ankle. ⋯ Both surgical techniques applied mostly guarantee a safe and stabile fixation in arthrodesis of the ankle and provide convincing long-term results without showing a difference in comparing the outcome.
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Isolated fractures of the os triquetrum are a very rare condition, since they are usually combined with other fractures of the carpus. An undetected isolated fracture of the os triquetrum in a 28-year-old pieceworker revealed an osseous consolidation with a misalignment of the joint surface on presentation 6 months after his primary injury. During the whole time he was unable to work due to the severely painful restricted range of movement of his wrist. ⋯ Instead of correction of the anatomy of the os triquetrum, we decided to perform a subperiosteal pisiform excision according to Palmieri. As early as 6 weeks later, the patient was able to go back to work and demonstrated a pain-free full range of movement of his wrist. We encourage this procedure not only for degenerated joint disease but also for posttraumatic lesions in the early onset of painful blocking of the joint between the os triquetrum and os pisiforme.
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Comparative Study
[Results of the surgical treatment of arthro-fibrosis of the knee].
This retrospective study reports the evaluation of the surgical treatment of arthrofibrosis of the knee joint. Patients (n = 53) developed arthrofibrosis due to different index operations and various causes. Based on severe preoperative disability, patients of our series can be considered as difficult to treat. ⋯ By the additional procedure of a posterior capsulotomy, the average extension deficit (absolute) was significantly (P < 0.01) more reduced than for patients without this treatment. Our data support an early therapeutic intervention for patients with a large restriction in the range of motion. Patients with an extension deficit after arthroscopic arthrolysis and gentle manipulation will improve with the additional procedure of posterior capsulotomy.
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Comparative Study
[Influence of processing and sterilization on the mechanical properties of pins made from bovine cortical bone].
In a biomechanical study pins made of xenogenous cortical bone were tested in vitro. Forty pins of 3 mm diameter and 60 mm length were made of eight different cattle tibiae and allocated to five different treatment groups. Freeze-dried pins served as control group. ⋯ We found that bending strength and shearing strength were most increased after sodium chloride and acetone treatment, whereas after sterilization with ethylene oxide or autoclaving, the stability of the pins was similar to the control group. The stability was considerably diminished after gamma radiation. Taking into account possible toxic side effects of ethylene oxide, we conclude that Tutoplast processing followed by autoclavation presents a reliable preparation method for the clinical use of implants made of bovine cortical bone.