Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1981
The gastrocnemius myocutaneous flap (GMF): an alternative method to repair severe lesions of the leg.
A short review of the various methods of closing skin defects associated with severe injuries of the leg raised the question for using a myocutaneous flaps and particularly a gastrocnemius flaps. The surgical technique is described and the versatility of the flap is demonstrated with several examples and discussed showing how both the medial and the lateral gastrocnemius flap, can be used as a pedicle as well as a free flap, ipsi- and contralaterally.
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Arch Orthop Trauma Surg · Jan 1981
Case ReportsDiaphyseal fractures of both bones of the lower leg with associated injury of the ankle mortise.
Fractures of both bones of the lower leg may be accompanied by a disruption of the mortise with a shortening of the fibula. This combination was observed in four cases reported in this paper. ⋯ Any shortening of the fibula should be corrected surgically, preferable at the time of injury. Malunion should be treated by corrective osteotomy.
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Arch Orthop Trauma Surg · Jan 1980
New clinico-pathophysiological studies on the bone cement implantation syndrome.
Implantation of endoprostheses with bone cement is followed by alterations of the circulation. Intoxication, caused by the monomer of bone cement or pulmonary embolism by intramedullary contents constitute the two mostly accepted pathophysiological hypotheses. Because of the lack of pulmonary and circulatory physiological data a clinical decision concerning the value of the hypotheses was not possible until now. ⋯ The device allowed a high rate of data retrieval. The bone cement implantation syndrome reveals itself as cardiorespiratory sequelae of a disseminated pulmonary embolism which is originating in intramedullary contents, squeezed intravasal. Usual prophylactic methods are revisited.
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The roentgenograms of 310 children treated for ankle fractures were evaluated for grouping according to the classifications of Ashhurst-Bromer-Weber, Lauge-Hansen, and Salter-Harris. The mean age of the children at the time of injury was 11.1 years (range 2-14 years). Two hundred twenty-one (71.3%) children had malleolar fractures, 71 (22.9%) had tibial epiphyseal fractures, and 18 (5.8%) had syndesmotic lesions. ⋯ In spite of their complexity, ankle fractures in children can be roughly divided into avulsional and epiphyseal fractures. Adequately reduced avulsional fractures can be expected to heal well; epiphyseal fractures, however, may five rise to late complications. We propose, therefore, that ankle fractures in children be classified on the basis of roentgenological findings with respect primarily to epiphyseal lesions as well as on an additional simple grouping as to risk for clinical purposes: Group I, low risk, avulsional fractures and epiphyseal separations; Group II, high risk, fractures through the epiphyseal plate.
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Arch Orthop Trauma Surg · May 1978
[The fixation of the flail chest with tension band wires (author's transl)].
A new technique of internal fixation of the flail chest was tested successfully in sheep. After reduction a 0.8 mm wire is passed twice intramedullary across the fracture and twisted under tension with two loops on the external side of the rib. ⋯ No respiratory support was necessary postoperatively. The method is simple and needs no special equipment.