Der Unfallchirurg
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42 patients with complete acromioclavicular dislocation treated operatively and 38 patients managed non-operatively were examined retrospectively with a mean follow-up of 6.3 +/- 2.5 years. The dislocations in both groups included type III and type V injuries according to the Rockwood-classification. The operative technique was suturing of the tom ligaments and stabilization of the acromioclavicular joint using resorbable coracoclavicular PDS-banding. ⋯ Posttraumatic osteoarthritis developed mainly in those patients whose acromioclavicular joint healed in partial dislocation. Non-operative treatment was equal even in less severe dislocations in the subgroup of type Rockwood V injuries. The persisting deformity which must be expected in non-operative treatment did not affect the patient's outcome regarding pain, function and strength of the shoulder.
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Clinical Trial
[Morbidity and mortality in para-articular femoral fractures in advanced age. Results of a prospective study].
This study was designed to determine risk factors and individual dispositions associated with morbidity and mortality in the operative treatment of hip fractures in elderly patients. ⋯ During the preoperative course high risk patients should be identified according to the data presented above in order to take all measures necessary in critical care during the perioperative period. Furthermore, the results underline the importance of an early operative treatment within a posttraumatic period of 12-24 hours. Concerning the method of fracture stabilization procedures allowing a primary full loading should be favoured with regard to early rehabilitation.
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Dupuytren's disease is the "classical" hand illness of the north: it affects people of Celtic or Viking descent throughout the whole of northern Europe, whereas it is an unknown disease in the Mediterranean region. Dupuytren's contracture appears to be an extremity-related disease. Owing to the unclear etiology and a lack of up-to-date demographic data for northern Germany this study aims--together with the literature--to elucidate the role of associated illnesses in an attempt to discover pathogenic explanations. 566 patients suffering from Dupuytren's disease in the area around Hanover were analysed with respect to epidemiological features and their Tubiana contracture stage. 91.2% were of pure northern German stock, 12.5% had a family predisposition. ⋯ Drinkers, smokers and heavy manual workers present a more severe affliction, while diabetics suffer from a significantly less severe form. Although the ulnar type dominates, the radial type accounts for 14.4% of cases. 1.9 million Germans are chronically ill because of Dupuytren's disease. Despite a trauma history, Dupuytren's disease is not recognized as an occupational disease.