Der Unfallchirurg
-
Due to the advances in prosthesis design and standardisation of implant techniques, the maintenance of implants in arthroplasty of the knee joint has enormously increased during the past few years. Various arthroplastic designs enable an adjustment towards the patient's individual indiction and anatomy. ⋯ Prerequisite for mere joint resurfacing is an intact lateral ligament apparatus, whereas the the symmetrical ligament balancing is essential for long-term analgesia, joint stability and good flexion. Aseptic loosening, discreet infections, instabilities and patellar problems are common reasons for painful knee arthroplastics.
-
Case Reports
[Late reconstruction of distal biceps tendon rupture with fascia lata graft and Mitek anchors].
Ruptures of the distal biceps tendon are rare but well documented. A technique for reinserting the distal biceps tendon into the radial tuberosity with two Mitek anchors and a fascia lata graft is presented and illustrated by a case report. Ectopic ossification as a complication after the procedure is discussed as well as the final outcome. It could be concluded that late reconstruction of the distal biceps tendon rupture with fascia lata and Mitek anchors is a safe procedure that can be advocated in a restricted number of cases where acute injury has been overlooked.
-
Comparative Study
[Changes in stability after cryosurgical treatment of long tubular bones. An animal experiment study].
The incidence of spontaneous fractures after cryosurgical treatment is described in the literature. The purpose of this study in the sheep model was to analyze the possibility of minimizing the potential risk of bone failure using a new miniature cryoprobe with minimal tissue traumatism and exact control of the ablation. In each of 24 sheep ablations at the right femur and left tibia were performed by drilling. ⋯ Spontaneous fractures were not observed during the whole experimental period. The good controllability of the freezing procedure and the low iatrogenic weakening of the bone using a modern miniature cryoprobe minimizes the risk of pathological postoperative fractures. After ablation of larger bone sections, the treated extremity should be partially unloaded or managed by osteosynthesis for at least 3 months.
-
Analgesia is one of the physician's genuine challenges. Pain makes the patient suffering and leads to unfavourable somatic effects as well, which may have negative outcome effects. Sufficient perioperative analgesia depends on well defined organizational conditions. ⋯ Special syringe pumps allow a patient controlled analgesia (PCA) under fixed conditions. Regional anaesthesia via catheter is powerful as well and avoids systemic opioid side effects. In these cases as well, a continuous or patient controlled analgesia is possible.