Der Unfallchirurg
-
The influence of intermittent prone positioning on pulmonary gas exchange and parenchymal densities was investigated in ten patients. Three patients fulfilled the criteria of "severe ARDS"; seven patients had moderate lung injury as documented by the "lung injury score" (LIS). Nine out of ten were trauma patients and had an average injury severity score of 32.3. ⋯ In moderate lung injury the LIS improved 0.5 (0.25-1.0) points. In lung computerized tomography, we observed the disappearance of posterobasal densities. Repeated prone positioning may therefore be used in ARDS patients as well as in patients with moderate lung injury.
-
In an 8-year period, from 1985 to 1992, 89 children presenting with a supracondylar humeral fracture were treated at the Department for Traumatology, Philipps-University, Marburg. All dislocated fractures (n = 48) were treated surgically. The majority (n = 34) of dislocated fractures were reduced open by a radial and an ulnar approach and subsequently stabilized using crosswise introduced K-wires. ⋯ In these fractures, we perform closed fracture reduction and K-wire stabilization. Type C fractures are fractures with rotational deformity, fractures dislocated in a frontal plane and fractures dislocated in a saggital plane with loss of cortical bony contact between proximal and distal fragments. Type C fractures should be reduced open by both a radial and an ulnar approach and subsequently stabilized using K-wires, introduced crosswise.