Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Oct 2008
Clinical Trial[Surgical treatment of fractures of the distal tibia in adolescents].
Injury to the epiphyseal cartilage during the period of growth plate closure in adolescence results in specific stereotyped injury patterns due to the change in biomechanics. According to the number of fragments, fractures of the distal tibia can be categorized into so-called two-plane and triplane I and II fractures. Since these fractures are involving the joint, the most important aspect for further therapy is the reconstruction of the joint surface. As the growth plate has already begun to close at this stage, relevant growth disturbances are unlikely. ⋯ While short-term results are generally good, data on long-term outcome and possible development of arthrosis is still insufficient.
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Oper Orthop Traumatol · Oct 2008
Clinical Trial[Osteosynthesis in proximal forearm fractures in children].
Closed reduction and fixation of displaced proximal radial neck or ulnar fractures with elastic stable intramedullary nailing (ESIN); prevention of circulatory disturbances and functional deficits following open reduction. ⋯ 78-87% very good and good functional results.
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Oper Orthop Traumatol · Oct 2008
Clinical Trial[Arthroscopically assisted internal fixation of avulsion fractures of the anterior cruciate ligament during childhood and adolescence].
Minimally invasive reduction and internal fixation of anterior tibial spine and anterior cruciate ligament (ACL) without harming knee joint cartilage and physis of the proximal tibia. ⋯ 19 patients were treated from 2001 to 2005 at an age of 7-14 years. All patients achieved free range of motion without pain or growth disturbances. Three patients developed slight joint laxity (anterior drawer test) which did not affect mobility, sports performance, joint surface or menisci on clinical evaluations conducted at least 1 year postoperatively. One patient had bony healing of the tibial spine in slight dislocation without impingement or decrease of range of motion within the knee joint.
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Oper Orthop Traumatol · Oct 2008
Clinical Trial[Elastic Stable Intramedullary Nailing (ESIN) of forearm fractures].
Fracture stabilization and restoration of bony anatomy with elastic stable intramedullary nailing (ESIN). ⋯ Operative treatment of forearm shaft fractures with ESIN was analyzed in 77 children. Average duration of surgery was 44 min (10-140 min). After an average of 7 months (1-13 months), the nails were removed. Postoperative complications were analyzed in 74 patients (96%). In three patients (4%), a superficial pin site infection emerged. One child (1%) fell on his arm again and broke his distal radius during ESIN treatment, and one patient (1%) showed deflected nails after a refall on the arm 1 week after surgery. Assessment of functional outcome in 70 patients revealed only two cases (3%) with minimal functional deficit.
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Oper Orthop Traumatol · Oct 2008
Clinical Trial[Elastic stable intramedullary nailing of femur fractures in children].
Elastic stable intramedullary nailing (ESIN) is a minimally invasive osteosynthesis technique that allows sufficient stabilization of fractures in children. ⋯ The minimally invasive method of ESIN is a well-accepted treatment option for femur fracture in children yielding good and excellent clinical results. It is the treatment of first choice for transverse and oblique femoral fractures (32-D/4.1 und 32-D/5.1). Fractures with several fragments (32-D/5.2) as well as fractures of the metaphyseal region (31-M/3.1 und 33-M/3.1) may be difficult to stabilize with ESIN and might alternatively be treated with an external fixator.