Der Unfallchirurg
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To determine whether in patients with specific types of osteoarthritis of the shoulder not only a fixed but also a functional decentering of the humeral head exist. ⋯ This study demonstrates, that in most of the patients with osteoarthritis of the shoulder, a significant functional decentering occurred during abduction and external rotation, even if they showed no fixed decentering of the humeral head at 30 degrees of abduction.
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Results after total ankle arthroplasty in the 1970s and 1980s were poor. The outcomes of these surgeries deteriorated rather dramatically with time. Causes of failure were multifactorial, but the two main reasons for failure were constrained designs and cement fixation. ⋯ Because of the associated pain and functional limitations that can follow ankle fusion, efforts to develop a workable total ankle replacement continue. At present, the long-term results of new designs are unknown. Today, total ankle arthroplasty should be limited to centers where patient volume and infrastructure allows critical review and prospective clinical trials to determine the factors leading to successful and unsuccessful outcomes.
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Comparative Study
[Differential therapy of radial head fracture: a critical analysis based on outcome of 53 patients].
We investigated 53 patients with 57 radial head fractures (4 patients with bilateral fractures) treated between 1993 and 1998. We focused on patients with radial head fractures asking about (1) the relation between fracture type and therapy and (2) the correlation between chosen treatment and result. We saw the following fractures: Mason I: 3 cases, Mason II: 26 cases, Mason III: 11 cases, and Mason IV: 15 cases. ⋯ Of 11 patients with a Mason III fracture, 10 were treated by resection of the radial head, and in 1 patient we implanted a prosthesis due to an intraoperatively detected elbow instability after resection and achieved good postoperative results. Only one patient (9%) had poor long-term results subjectively. Of 15 patients with a Mason IV fracture, 11 were treated by resection of the radial head: 5 patients (33%) had poor long-term results, only 3 of whom (20%) subjectively considered the results poor.
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Until now no case of a traumatic tear of the subascapularis muscle in children was described in the German speaking literature. Using the example of 2 cases of a 12 and 14 year boys youth history, clinic, diagnostics and therapy will be presented. ⋯ Isolated traumatic SCP-tears can be occur also in young patients. As major consequence, it is necessary to perform a thorough clinical examination with additional apparative diagnostics (Sonography, MRI). This way, this rare but important lesion can be detected early and lead to adequate surgery without any delay.
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Tumoral calcinosis is a very rare benign soft tissue calcification. It occurs in all age-groups and prefers the shoulder, hip and elbow region as localisation. ⋯ The adequate therapy is the complete surgical removal. Our presented case describes an extended occurrence at an unusual localisation and discusses characteristic signs in contrast of the differential diagnoses.