Der Unfallchirurg
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For young athletic patients with a primary traumatic shoulder dislocation a surgical treatment is recommended. The operation of choice is the Bankart-Repair. ⋯ In the surgical treatment of a traumatic shoulder dislocation, the open Bankart-Repair remains the "gold standard". In reviewing the literature, arthroscopic Bankart-Repair has not been shown to be equal or superior to the open technique.
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The case of an 22-year-old man is presented, who sustained a dislocated fracture of the left acromion process and a not dislocated fracture of the left scapular body with a large subcutaneous décollement as well as a dammage of nervus axillaris occurring during a traffic accident. After resuming diagnostics by means of CT, a tension banding of the ventral part of the acromion and a plate osteosynthesis of the dorsal part was performed. 7 weeks after injury neurolysis of nervus axillaris has been done. 4 months after accident the patient shows a satisfying functional result in the Constant score. Diagnostic, treatment and functional results after operative treatment of dislocated fractures of the acromion are shown and discussed.
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The disease of tumorous calcinosis is presented in order to one case and a survey of literature. The epidemiology and etiology are discussed, because of a rare manifestation of metabolic disorders. ⋯ The way of treatment is given by radical excision and metabolic supervision. The multiloculated presentation of periarticular, dental, subcutaneous and other lesions is pointed out.
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Preclinical evaluation of a new mobile C-arm image amplifier with an option for three-dimensional computed tomography (CT) imaging (prototype Iso-C3D) with respect to high-contrast resolution and possible clinical applications. Cadaveric specimens (n = 30) of different joints of the lower and upper extremities and specimens of the spinal column were examined with the Iso-C3D and evaluated for image quality. In addition, using a high-contrast phantom (Catphan, Phantom Laboratory, Salem, N. ⋯ In smaller joints, the image quality of the mobile C-arm CT imaging system (Iso-C3D) is comparable to that of helical CT. Image quality in examinations of the hip and lumbar and thoracic spine seems to be sufficient for intraoperative control studies of osteosynthesis. Problems still occur in shoulder examinations.
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The goal of blood management in orthopedic and trauma surgery is to minimize exposure to allogenic blood transfusion in elective surgical procedures. Pre-, intra- and postoperative techniques are available. In a retrospective study at our department we could show, that postoperative reinfusion in primary knee arthroplasty is an effective way to avoid allogenic blood transfusion. ⋯ Group II required per patient 1.3 units of allogenic blood (totally 26 units), group I needed only 0.25 units of allogenic blood per patient (totally 5 units) by using the same guidelines for transfusion in both groups. There were similar preoperative and postoperativ hemoglobin and hematocrit levels in both groups. We recommend the use of postoperative reinfusion in addition with other blood saving techniques to reduce allogenic blood transfusion in primary knee arthroplasty.