Der Unfallchirurg
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Surgery on the meniscus of the knee joint is one of the most frequently performed operations. The arthroscopic technique currently represents the general treatment standard and except in a few cases has completely superseded the open approach. Arthroscopy facilitates precise diagnosis and classification of all forms of meniscus lesions. ⋯ Substitution of lost meniscus tissue is possible with allograft transplantation; good results are possible especially on the lateral meniscus. A novel alternative is arthroscopic implantation of a biodegradable collagen matrix, which replaces partial defects on the medial meniscus. Long-term results of this treatment form must be awaited.
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The aim of primary treatment for eyebrow injuries should be preservation of the original eyebrow under any circumstances. Debridement should be kept to a minimum even when the wound is severe. The treatment of total or partial loss of an eyebrow concerning the exact reconstruction of details and aesthetic aspects is a challenge for the surgeon. ⋯ We present a classification for eyebrow injuries, which considers type and size of defects. Based on this, different techniques and methods of reconstruction are recommended. Advantages and disadvantages are discussed and illustrated by several examples.
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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.