Der Unfallchirurg
-
Case Reports
[Bony avulsion of the extensor carpi radialis longus tendon from the base of the second metacarpal : A rare injury.]
We report on a 19-year-old male patient with a rare injury: a basis fracture of the second metacarpal with avulsion of the extensor carpi radialis longus (ECRL) tendon. The patient was treated with open reduction and internal plate fixation of the fragment. The functional results after 10 months of follow-up were pronation/supination 90/0/90° (90/0/90°), extension/flexion 70/0/70° (70/0/70°) radial/ulnar duction 20/0/40° (25/0/40°), bilateral grip strength was 115 kPa. ⋯ The Mayo wrist score reached 100 points. Radiologically, the fracture was consolidated. Consistent diagnostics and surgical therapy lead to functional and radiological recovery following fracture of the second metacarpal base with avulsion of the extensor carpi radialis longus tendon.
-
Cements based on polymethyl methacrylate (PMMA) can be used without any problem in a variety of clinical augmentations. Cement-related complications in surgical procedures involving PMMA cements, such as embolism, thermal necrosis, toxicity and hypersensitivity, are often due to other causes. Knowledge about the properties of the cement helps the user to safely employ PMMA cements in augmentations. ⋯ In patients with hypersensitivity to antibiotics, there is no need to avoid the use of PMMA as there are sufficient PMMA-based alternatives. The PMMA cements are local drug delivery systems and antibiotics, antiseptics, antimycotics and also cytostatics can be mixed with the cement. Attention must be paid to antagonistic and synergistic effects.
-
Case Reports
[Combination of a universal antidote and temporary skin substitute for chemical burns : Extended case report].
In this article we describe our experiences in the treatment of chemical burns with Diphoterine(®) solution and Suprathel(®) as a temporary skin substitute material, a treatment which in the past was not commonly used for this pattern of injuries. In the study period from October 2012 to December 2013 we treated five patients (four male and one female including two children and three adults) with chemical burns by decontamination with Diphoterine(®) and wound covering with Suprathel(®). ⋯ In four cases the skin areas with IIa-IIb degree damage showed good wound healing and only slight scarring in the follow-up after 3 months and one of the five patients had to be treated surgically. Suprathel(®) can be used as a temporary skin substitute for the treatment of skin burns and is also available for the treatment of chemical burns.
-
As Lisfranc joint injuries are rare and standard radiographic examinations can be difficult to interpret the correct diagnosis is often initially overlooked. Delayed treatment frequently results in painful and disabling arthritis, consequently, primary targeted diagnostics are essential for the functional outcome. We report on a patient with a Lisfranc fracture dislocation, with the injury severity only becoming obvious by dynamic examination with the patient under anesthesia. Due to the massive swelling we performed a minimally invasive primary stabilization using one K-wire and a mini-TightRope®.