Der Unfallchirurg
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Case Reports
[Perthes syndrome. The classical symptom triad as a rarity in trauma surgery practice].
Perthes syndrome or traumatic asphyxia is a condition characterised by subconjunctival hemorrhage, cervicofacial petechiae and cyanosis caused by severe compression of the chest. Diagnosis is made by history and clinical examination. Associated injuries such as intrathoracic or abdominal lesions can be life-threatening and must be strictly assessed. This report demonstrates an illustrative case of this rare injury.
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A 54-year-old patient suffered overnight a double thoracic burst-fracture. One week later during the investigation for a metabolic or endocrinological cause, a witnessed seizure led to an unstable fracture of the humerus and the scapula. ⋯ Forces generated during a tonic-clonic seizure can result in axial skeletal trauma, including thoracic and lumbar burst fractures. Vertebral fractures unrelated to an exogenous trauma are therefore always suspicious of an underlying epileptic disease.
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Case Reports
[Scapho-lunate ligament reconstruction with Mitek suture anchors. Initial clinical results].
The scapholunate dissociation is an often misjudged lesion of carpal ligaments as clinical and radiological signs often don't allow a clear interpretation. Apart from chronical courses with increasing arthrosis the consequences are limited and more difficult operations. The application of Mitek suture anchors is a new and simple supplement to large-scale operative reconstructions of ligaments or partial arthrodesis. Of nine reconstructions of the scapholunate interosseous ligament using this anchor method so far only one relaps occurred.
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Clinical Trial
[Quality of life of severely injured patients 1 year after trauma. A matched-pair study compared with a healthy control group].
Severe trauma is accompanied not only with functional disabilities, but also with pain, social and psychological problems of the patient. Those four aspects are important components of the construct quality of life (QoL). The purpose of this study was to evaluate different questionnaires and to compare results between multiply injured patients and healthy controls. ⋯ One year after trauma, patients suffer from severe impairments, some even in all four aspects of QoL. The questionnaires used are very well applicable to patients after severe injuries. A trauma-specific Quality of Life Instrument is lacking--and is currently developed by the german trauma registry group.
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The retrospective study included 42 patients who have been treated with a palmar opening wedge osteotomy after malunion of distal radius fracture. 31 patients could be reexamined clinically and radiologically. The corrective osteotomy on the distal radius was done only radiopalmar with an insertion of a corticocancellous iliac graft. ⋯ The evaluation of the x-ray pictures showed an improvement from 3.7 to 1.9 points, the functional improvement from 3.7 to 2.6 points. The improvement of the subjective complaints results in a diminution of 3.3 to 2.2 points.