Der Unfallchirurg
-
The orthopedic treatment is the first choice in shaft fractures of the humerus in children. Angulations of more than 10 degrees need reduction, in that case anesthesia should be used for surgical stabilization. The preferred method is the elastic-stable intramedullary nailing (ESIN). ⋯ In severe displaced fractures, reduction and stabilization by ESIN is recommended in patients over the age of 10 years. The method is even applicable to pathological fractures in juvenile bone cysts. In adolescents after the start of epiphyseal plate closure, angle-stable implants are an alternative.
-
Review Comparative Study
[Endoprosthetic replacement of the ankle joint].
Endoprosthetic replacement of the ankle joint is considered to be a modern alternative of the well-tried fusions of the joint. We try to explain indications and limits of alloarthroplasty in comparison to arthrodesis. ⋯ Results of three-component endoprostheses in the literature and our own experiences with implants of both generations especially regarding the time of survival will be discussed. Basing on the actual knowledge, we try to deduce a prognosis of the future way of ankle replacement.
-
Injuries of the wrist are difficult to diagnose because of the complex and narrow anatomic structures. Based on precise clinical examination, X-rays, CT, and MRI are valuable additional tools that can be used. If a fracture is suspected a CT scan is preferable. ⋯ Other diagnostic tools are presently of minor importance for the wrist. Technical innovations allow better visualization and classification of lesions. However, exact knowledge of the tools is important.