Der Unfallchirurg
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Regarding the controversial discussion about how and when to operate a patient with an ACL lesion and still open physes,we routinely perform ACL reconstruction in those patients. We evaluated 30 patients with a mean age of 14.2 years at the time of operation (range: 10-18) and a mean follow-up of 30.8 months (range: 13-77). The ACL reconstruction was performed using a four-strand hamstring graft. ⋯ In three cases an ACL insufficiency recurred during the first 12 months postoperatively. There was no growth disturbance. Expecting a poor outcome when treating an ACL lesion conservatively during the growth period and carefully performing the operation, we were able to show that the method provided satisfactory results and should be considered an operative method of choice.
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Treatment of traumatic trans-symphyseal instability by internal plate fixation is the most common procedure. Besides the trauma-induced muscle damage, the implantation induces additional damage at the symphyseal origin of the m. rectus abdominis. The aim of this clinical case study was to examine whether it is possible to reduce the iatrogenic soft tissue damage while correcting trans-symphyseal instability using an internal fixator. ⋯ As a result of the mobility of the skin and subcutaneous tissue, the implantation of the crossbar beneath the m. rectus abdominis is possible. Stabilization of traumatic trans-symphyseal instability by internal fixation is a safe and easy method. Additional soft tissue damage can be prevented, but to achieve multidirectional stability some small modifications of the implant are necessary.