Der Unfallchirurg
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Review Comparative Study
[Developments in hip hemi-arthroplasty and theory of the link-chain dimeric hip prosthesis].
Aim of the study was to analyze the developments of hemiarthroplasties from the femur prosthesis to the bicentric bipolar prosthesis of today. Using the theories published 1990 by Nägerl about "dimeric link chains", nineteen bipolar-head systems were analyzed and biomechanically explained. ⋯ Eleven of the sixteen today available systems work like this concept which was reached by try and error. The function of a bicentric system is solved now and explained by physics.
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We report on a 50-year-old female patient with bimalleolar fracture and subsequent posttraumatic arthrosis who was treated by minimally invasive nonresection tibiotalar compression arthrodesis using internal fixation and cancellous bone grafting. The advantages of this technique include minimal exposure of tissues, good control of the relationship between the tibia and the talus, and short hospital stay.
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Fractures of the spine represent a severe complication particularly in patients with ankylosing spondylitis because of high morbidity and mortality. We report on a patient with a hyperextension fracture of the lumbar spine, leading to disruption of the aorta and caval vein.
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Trauma has been described as a "disease of bleeding" [45]. Recognition of acute blood loss after injury, and restoration of homeostasis is the cornerstone of the initial care of the badly injured patient. Hypovolaemia remains the most common cause of death among those killed in action during military conflicts [46] and, in the civilian arena, increasing numbers of patients are being encountered with penetrating injuries, even in societies where blunt injury have previously been the norm. ⋯ Successful outcomes after the treatment of patients with penetrating trauma depend on the integration of many agencies, from prehospital care, initial reception, assessment and resuscitation through the operating room, intensive care and post-injury rehabilitation. Recognition of the importance of time and adherence to sound trauma management principles with conservative management when appropriate should see further improvements in our treatment of this important group of patients. Reducing the incidence of these injuries is the responsibility of us all and must be the focus of all governmental initiatives.
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Comparative Study Clinical Trial
[Precision analysis of navigation-assisted implanted thoracic and lumbar pedicled screws. A prospective clinical study].
A prospective clinical trial was performed to study the accuracy of pedicle screw placement of consecutive computer-aided and conventional techniques. Concerning the clinical performance of the navigation system, the average time of matching has been 8.4 minutes per vertebrae. For evaluation of the results, only complete intraosseous placement of the pedicle screw has been defined as correct position. ⋯ No radicular neurologic damage, caused by a malplaced transpedicular screw has been observed in both groups. In the presented study is shown, that the application of the computer-assisted freehand navigation can improve results concerning the precision of spinal screw placement. Although, the spinal navigator has to consider a learning curve for the clinical inauguration of the system and the qualification of the implant system for computer-assisted application.