Der Unfallchirurg
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Comparative Study
[What prognostic factors correlate with activities of daily living (Barthel Index) 1 year after para-articular hip fracture? A prospective observational study].
The aim of this prospective study was to identify prognostic factors predicting post-operative outcome in patients one year after their hip fracture. ⋯ The preoperative Barthel-Index should be seriously considered for therapeutic decision making in patients with hip fractures.
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Clinical guidelines for the treatment of vertebral fractures associated with ankylosing spondylitis are derived from case reports and a review of literature. The coincidence of paravertebral calcifications and fracture formations leads to problems in the establishment of a proper initial diagnosis. ⋯ Operative osteosynthesis is the method of choice in the fracture treatment. A successful stabilization requires an extended spondylodesis comprising at least five vertebral segments by a dorsal or a combined ventral instrumentation.
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Endobon is a porous hydroxyapatite ceramic which has been used as a bone replacement substitute since 1989. Currently there are no data available reflecting long-term effects of Endobon in human bone grafting. In order to assess such effects 35 patients with fractures of the proximal tibia were studied retrospectively over a period up to 91 months. ⋯ A secondary loss of reduction due to mechanical failure of the bone replacement material did not occur even after removal of metal implants. No histological signs of resorption or degradation could be found 18 months after application. Our data show that Endobon provides good mechanical properties during a long term follow-up and can be recommended as a suitable therapeutic option versus cancellous bone graft.
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Anatomical reduction and stabilization of displaced supracondylar humeral fractures in children is necessary to obtain good results. For most cases percutaneous crossed pinning is recommended. Sometimes open reduction is necessary but even in these cases neurological complications and varus deformities have been reported. ⋯ One patient has been reoperated due to displacement of K-wire. Neither iatrogenic nerve lesions nor varus deformities nor infections did occur. The dorsolateral approach combined with the above mentioned technique of pinning shows excellent and good results.
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Within the last few years autologous cartilage-bone-grafting is becoming an established standardized procedure in joint surgery. One significant disadvantage of this technique is the harvesting of the bone plugs from the weight-bearing area of the knee joint. ⋯ The tibiofibular joint contains cartilage, which may be a reasonable donor site even for the elderly patient. Harvesting the graft from this area may avoid iatrogenic damaging of intraarticular weight bearing cartilage of the knee joint.