Der Unfallchirurg
-
A good functional outcome of the hand is important in the rehabilitation of severely burned patients. The aim of the study was to evaluate the late functional outcome of deeply burned hands using a computer aided system and to correlate the function with the distribution of the hand burns. Over a 12-year-period 378 patients whose acutely burned hands had been operated on at the burn center of the university hospital Aachen were invited to a follow-up examination. 67 burned and operated hands were evaluated 57 (3-364) months after the burn by the computerized evaluation system EVAL. ⋯ Late functional results in group IV (n = 9) depended on the reconstructive procedure. Between the 4 groups there were significant differences in function. The results were well correlated to the burn pattern and its extent according the classification.
-
Knee and hip dislocations are often serious injuries with an uncertain outcome. Simultaneous ipsilateral dislocation of the knee and hip joints is very rare; consequently, there is an inadequate amount of literature on the subject. In this case report we present a 35-year-old male patient with this combination of both injuries and discuss it in comparison with the available literature. This case report shows, that a methodical and sequential treatment can lead to good results in spite of this complex combination of injuries.
-
Comparative Study
[Prosthesis implantation in the proximal ankle joint--a real therapeutic alternative in post-traumatic arthrosis?].
The results of total ankle arthroplasty were poor in the 1970s and 1980s compared to those of the arthrodeses. Because of the good long term results this technique has been accepted as the treatment of the choice for posttraumatic arthritis of the ankle. Recently the development of an unconstrained total ankle arthroplasty with an additional mobile polyethylene inlay between the fixed tibial and the talar component which enables a three dimensional range of motion seems to improve significantly the long term results of total ankle replacement. ⋯ Furthermore, these data are obtained yet only by a few experienced surgeons in specialized centers. Further clinical trials have to be performed to answer the question whether the total ankle arthroplasty is a reliable alternative treatment of posttraumatic arthritis of the ankle. At present, the arthrodesis should be regarded as the treatment of choice for the posttraumatic arthritis of the ankle joint.