Der Unfallchirurg
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Follow-up was possible after an average of 23.4 months in 26 cases of pelvic ring injury. These were made up of 7 type A, 8 type B, and 11 type C injuries. Every type A lesion was treated conservatively. ⋯ Because of their pelvic injuries 6 patients (23%) were completely or partly disabled and thus unfit for work. The follow-up examinations showed good results in 20 (76%) of the cases. While type B pelvic ring injuries can heal completely when treated by means of a supra-acetabular pelvic fixator, reliable retention cannot be achieved in the case of type C lesions.
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Results of the treatment of 60 intraarticular distal fractures of the femur (AO classification: 33-B and 33-C fractures) are summarized. Frequencies of the different types of fractures were B1, 7; B2, 10; B3, 4; C1, 10; C2, 1; C3, 8. In 36 patients an isolated fracture, was present, in 9 patients, one additional injury, and in 16 patients there was more than one fracture or multiple trauma. ⋯ In 32 cases the result was excellent, in 18, average and in 4, unsatisfactory. Failure had to be recorded in 1 case. The combination of locking nails and lagscrews is an alternative method of osteosynthesis for distal femural fractures with an intra-articular component, provided strict selection criteria are applied.
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We identified 107 consecutive patients with anterior cruciate ligament (ACL) rupture who underwent arthroscopy after trauma. The results of the preoperative clinical examination and the arthroscopic findings of associated injuries to the knee are shown. Some 55% of the acute ACL ruptures involved a tear of the lateral meniscus, 45% of the medial meniscus, and 34% had a lesion of the medial collateral ligament. ⋯ The preoperative examination revealed the ACL rupture in 94% of uses but the lateral meniscal lesion in only 32%. At the time of operation 29% of all associated injuries had not been discovered. These results show that--independent of the time of reconstruction of the thorn ACL--acute rupture of the ACL is an indication for arthroscopy.
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Ice hockey is considered to be one of the fastest and roughest of all sports. Prospective injury reports of the North American National Hockey League, the Canadian Amateur Hockey Association and of several European teams (UdSSR, CSSR, Sweden and Switzerland) are reviewed to evaluate the patterns, anatomic locations, circumstances and sequelae of ice hockey-related injuries. Although different injury reporting systems are used in North America and Europe, knee injuries (sprains of the collateral ligaments) accounted for the majority of games missed (40%), followed by injuries to the shoulder (dislocation, acromio-clavicular joint separation, rotator cuff strain and tears, 20%), the groin (15%), and the back (10%). ⋯ It is also considered to be one of the roughest of all sports. In recent years, ice hockey has grown tremendously in popularity, not only in the United States and in Canada but also in many European countries [1]. The number of both professional and amateur hockey players has increased with the expanding interest in the sport around the world [1].(ABSTRACT TRUNCATED AT 250 WORDS)
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Multicenter Study
[Femoral neck fractures in adults: joint sparing operations. I. Results of an AO collective study with 328 patients].
In a multi-center study in 14 trauma hospitals 328 patients with fractures and osteosyntheses of the femoral neck were investigated with reference to time between accident and operation implants used, early and late complications, and results in the years from 1974 to 1987. A follow-up examination was possible in 266 patients a mean of 46.7 months after their accidents. General postoperative complications were recorded in 12.2% and local complications in 11.6%. ⋯ The best results (significantly better than in other groups) were obtained in patients who were operated on early (< 24 h after trauma) (P < 0.05) and those in whom dynamic hip screws (DHS) were used (P < 0.01). Of all cases of aseptic necrosis 70% were seen within 3 years and 86% within 6 years after trauma. The rate was dependent on the degree of dislocation of the fracture (Garden III and IV), the time from trauma to operation, and the implant used (130 degrees blade plate 30.5%, DHS 9.2%).