Der Unfallchirurg
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Hackethal developed the nailing procedure named after him in 1959. The original method consisted in two steps: a non-sterile step in which mechanical reduction was performed with a traction device and a sterile step, i.e. nailing. The rationale of Hackethal nailing is an elastic jamming, which can only be achieved by obeying four rules: jamming of the nails in the cortical window, jamming then in the waist of the medullary cavity, spreading the bunch of nails in the metaphysis and filling up the conus of the medullary cavity with short nails. ⋯ All second- and third-degree open fractures were treated with fixators. In a 13-year period we performed Hackethal nailing of the humerus in 53 cases, of the radius in 20, of the ulna in 17, and in both of the forearm simultaneously in 12 cases. Plating and Hackethal nailing were combined for the treatment of forearm fractures in 10 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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[The possibilities of osteoplastic measures in mid-foot amputation and osteomyelitis of the tarsus].
Osteomyelitis after trauma or after operations and amputations at the midfoot or tarsus leads to a disadvantage in terms of motion and of weightbearing on the foot. Once local fistula, exophytic bone growth, skin defects and instability of the metatarsus have arisen, hygiene and recovery of joint function are difficult. Four patients were treated by reamputation at the midfoot and bone autografts. ⋯ The result at follow up showed painfree stumps without recurrence of infection within 3 years. Little support is needed in the way of orthopedic appliances, and all four patients can walk easily with no pain. This operation is recommended for the primary surgical procedure.