Der Unfallchirurg
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In 1997 six patients with posttraumatic ankle arthritis aged 54 (45-71) years were treated with a LINK S. T. A. ⋯ Two patients had an excellent outcome and 1 patient had a fair result. In three patients secondary arthrodesis had to be performed, due to loosening of the implant. Based on our experiences we cannot recommend this implant for patients with posttraumatic arthritis at this time.
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We report an unusual case of incarceration of small bowel between the 4th and 5th lumbar vertebrae in a patient with rheumatoid spondylitis. Incarceration of the loop of jejunum within the fracture or between dislocated lumbar vertebrae is an uncommon entity. The cases of traumatic jejunal entrapment have been previously reported in the literature [1, 2, 3, 4, 5, 6, 7, 8, 9, 11]: 2 cases occurred in adults and 8 in children. There has been no report on this injury in patients with rheumatoid spondylitis (Bechterew arthritis).
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The purpose of the present study was to evaluate the effectiveness of a special sensorimotor exercise rehabilitation program on shoulder function. In a prospective intervention study we evaluated 32 patients with subacromial pain syndrome, all of whom took part in a conservative rehabilitation program. No patient had surgery on the shoulder involved prior to the study. ⋯ The sensorimotor test also showed an increased proprioceptive capability especially in the threshold to motion test. The angle reproduction test showed only moderate improvement, whereas the isokinetic strength test showed no improvement at all. The present study shows that patients with subacromial pathology suffer from a proprioceptive deficit which can be improved by a special rehabilitation program within only 4 weeks.
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This article reviews the current body of knowledge on the adverse effects of smoking on soft-tissue and bone healing, with emphasis on tibial fractures in combination with severe soft-tissue injury. The pathophysiological effects are multidimensional, including arteriolar vasoconstriction, cellular hypoxia, demineralisation of bone, and delayed revascularisation. Several animal and clinical studies have been published about the negative effects of smoking on bone metabolism and fracture healing. ⋯ Nowadays, there is strong evidence to be very insistent that patients presenting with a (open) tibial fracture should refrain from smoking immediately to promote bone healing and to lower the complication rate. In case of elective reconstructive procedures, patients should refrain from smoking at least 4 weeks before surgery. In both situations, cessation should continue during the full rehabilitation period.