Der Unfallchirurg
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The implantation of distal interlocking screws in interlocking nailing can be difficult and time-consuming. With the AO Universal Femoral Nail as the basis, an implant was designed with which distal interlocking is accomplished from the inside of the nail by means of a simple claw mechanism. Instrumentation and interlocking are possible from the proximal standard approach, so that an additional operation adjacent to the knee (which is necessary when interlocking bolts are used) is superfluous; neither for the insertion nor for the removal of the interlocking mechanism is an image intensifier necessary. ⋯ Full weight-bearing was allowed after a mean of 4.4 weeks (0.7-8.2 weeks). In 1 case we saw a deep venous thrombosis with pulmonary embolism obvious on clinical examination and scintigraphy. Two patients died of their multiple trauma, and of cachexia the patient with the CML metastasis died 6 weeks after stabilization.(ABSTRACT TRUNCATED AT 250 WORDS)
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In a retrospective study of 59 patients the results obtained with elbow arthrolysis performed for the treatment of posttraumatic stiffness were analyzed. The intraoperative functional result was classified as excellent in all cases, while an average of 27 months after the operation the range of movement was decreased again to varying extents. This deficit correlated with the type of injury, timing of arthrolysis, duration of metal implants and timing and type of postoperative rehabilitation program. ⋯ The results show that the prognosis of elbow arthrolysis is determined by optimal operative planning and a meticulous rehabilitation program. The time to arthrolysis should be as short as possible, as should the time to removal of metal implants. The aim of the rehabilitation program is immediate postoperative mobilization.(ABSTRACT TRUNCATED AT 250 WORDS)