Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1992
Diagnosis and treatment of retroperitoneal hematoma in multiple trauma patients.
From 1984 to 1991 20 multiple trauma patients with pelvic fractures and retroperitoneal bleeding from pelvic vessels underwent angiographic localization and embolization of massively bleeding arterial vessels. Nine patients survived (multiple trauma index grade III, Hanover polytrauma index), three patients with very severe injuries died immediately (multiple trauma index grade IV). ⋯ This underlines the importance of early angiography in multiple trauma patients with pelvic fractures and persisting hemorrhage. Embolization has proven to be effective in the treatment of such injuries.
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Arch Orthop Trauma Surg · Jan 1992
Comparative StudyOsteochondrosis dissecans of the talus. Comparison of results of surgical treatment in adolescents and adults.
Clinical results in two groups of patients treated for osteochondrosis dissecans tali were examined in a follow-up examination: adolescents up to age 16 years versus adults. Thirteen patients were reexamined in each group. Clinical comparison revealed distinct differences between the groups. ⋯ In conclusion, adolescents without any signs of joint locking or loose body formation should first be treated conservatively. The older the patient the shorter the period of nonsurgical treatment should be. In cases of increasing stages, joint locking, or formation of loose bodies surgical intervention is recommended.
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Arch Orthop Trauma Surg · Jan 1992
Computed tomography in traumatology with special regard to the advances of three-dimensional display.
There is a variety of methods to aid in the diagnosis of fractures requiring operative treatment. A computer program that produces pseudo-three-dimensional (3D) images from sets of axial computed tomograms is used for examining fractures in areas of complex skeletal anatomy. ⋯ The 3D information can be used to define the size, shape, and location of the various fracture types. We have used the technique in more than 500 patients with injuries to the skull, spine, acetabulum, sternoclavicular joint, shoulder, knee, and calcaneus and are able to demonstrate the benefit of special investigation protocols.
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Arch Orthop Trauma Surg · Jan 1992
Case ReportsTraumatic rupture of the quadriceps tendon in a 16-year-old girl. A case report.
Traumatic rupture of the quadriceps tendon is well known to occur in middle-aged men in patients on hemodialysis for renal failure and in patients with diabetes, but only very rarely in young and healthy women. We report a case of traumatic rupture of the quadriceps tendon of a girl without any of the predisposing factors listed.
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Arch Orthop Trauma Surg · Jan 1992
External fixation of the distal end of the radius: the same technique for different patient populations?
A series of 56 consecutive patients with 59 fractures of the distal end of the radius, treated with a unilateral Hoffmann external fixator between 1980 and 1988, is presented. Forty-seven of these patients underwent clinical re-examination at home. We could distinguish two different groups of patients: an older female group with an average age of 59.2 years and a younger male group with an average age of 40.1 years. ⋯ Functional end results can be ameliorated by paying more attention to anatomical reconstruction of the wrist joint. It may be necessary to supplement the external fixation with open reconstruction of the wrist joint and/or a cancellous bone transplant. In some cases, a change of procedure to plate osteosynthesis could be the treatment of choice.