Der Unfallchirurg
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Randomized Controlled Trial Multicenter Study Comparative Study
[Local therapy of grade IIa burns: efficacy and tolerability of a new hydrosome wound gel for the local treatment of grade IIa burns as compared with silver sulfadiazine ointment].
A new hydrosome wound gel is based on a new mechanism of action. It contains hydrosomes that penetrate to the wound bed and supply the wound with phospholipids, which are identical to membrane phospholipids of human cells. In this manner it supports the proliferative processes during wound healing. ⋯ In this study, the treatment of grade IIa burn wounds with hydrosome wound gel led to faster wound closure compared with treatment with sulfadiazine cream. Therefore, hydrosome gel represents a good alternative to sulfadiazine cream.
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Calcaneal fractures (CF) are uncommon injuries in childhood; most data concerning CF originate from studies of adult trauma. In a retrospective analysis, we evaluated CF in children treated in our department over the last 5 years. In addition, we reviewed the current literature concerning the mechanism of injury, diagnostics, and complications after conservative and operative treatment. ⋯ Treatment strategies and recommendations are still inconsistent. In extraarticular and nondislocated fractures, conservative treatment does not seem problematic. But in intraarticular fractures with dislocation of the joint, operative treatment with anatomic reduction is advised in order to avoid long-term consequences.
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Comparative Study
[Therapeutic outcome in tibial pseudarthrosis: bone morphogenetic protein 7 (BMP-7) versus autologous bone grafting for tibial fractures].
Depending on the type and localisation, nonunions of tibial fractures will occur in 10-40% of cases. Bone morphogenetic protein 7 (BMP-7; Osigraft), a recombinant bone growth factor, can be implanted locally as an alternative to autologous bone grafting. The objective of our study was to compare the efficiency of the two procedures. ⋯ Healing was considered successful if x-rays showed bony consolidation and if no further procedure was necessary. Group 1 had no signs of consolidation in 24 cases (28%), whereas group 2 had only two (8%) such patients (p=0.025). The BMP-7 group showed a significantly higher success rate compared with patients with autologous bone grafting, despite the fact that the BMP-7 group contained more complicated cases.
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We report on a 71-year-old male farmer who sustained an injury to the tendons of the triceps brachii and the Achilles tendon on the left side. The diagnosis was based on clinical investigations and ultrasound. The triceps brachii tendon was repaired with open transosseous sutures. ⋯ Six months after the operation the patient no longer had any problems with his injury. Injuries of the tendon of the triceps brachii are very rare, with an incidence of 0.8%. We could not find case reports of a simultaneous injury to another tendon in the literature.
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In orthopaedic surgery and emergency medicine, patients of the age groups with a HIV risk represent the largest part of the entire population. As necessary steps have to be taken immediately at the scene of an accident and in the emergency room, contact with HIV-positive blood is often unavoidable, so that there is an increased risk of transmission for doctors and personnel. Due to the immunological state, the HIV patient is exposed to considerable post-operative complications such as wound infection, pneumonia and even sepsis. With the case of a 35-year-old HIV-positive patient who was multiply injured in a traffic accident, we want to present an interesting example of the problems that occur in the treatment of this patient group.