Der Unfallchirurg
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The clinical results after DFN-osteosynthesis of n = 56 AO-classification 33A-fractures (32%), 33C-fractures (43%), 32X-fractures (21%) and treatment of non-union (4%) are presented. ⋯ The mechanical stability of the implant allows a save osteosynthesis of unstable supracondylar and complete articular femoral fractures without additional bone grafting. Mechanical stability and minimal invasive operative technique permit a safe bone healing without major complications.
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The most frequent form of bone infection is haematogenous osteomyelitis (HOM), typically affecting infants and children. Dependent on the virulence of the pathogen and the patients immune response, one can distinguish between the acute (AHOM) and primary subacute haematogenous osteomyelitis (PSHO). ⋯ The here demonstrated case of a 12 year-old girl shows that PSHA may imitate a sarcoma very closely, even concerning such usually fairly reliable radiographic aspects like osteolysis and lamellar periostal bone reaction. Despite the use of MRI, the diagnosis initially remained uncertain and a malignant bony lesion could only be ruled out after open biopsy and histopathological evaluation.
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We present a case of two patients with a distal femur shaft fracture due to a high velocity trauma. Both were treated with a distal femur nail (DFN). After mobilisation a fracture of the neck of the femur was diagnosed which was not seen in the x-rays on admission. ⋯ Immediately after operative treatment of a femur shaft fracture specifically after high velocity trauma or in polytraumatized patients an x-ray of the hip in two plains should be made in the same narcosis. A possible fracture of the neck of the femur could be treated at same time. Post-operatively a further diagnostic should be done in case of suspicion, e.g. pain during mobilisation.