Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Apr 2011
[Operative treatment of osseous pull out of the extensor tendon using a hook plate].
Anatomical reposition and stabilization of dorsal distal phalanx fractures with a hook plate. ⋯ From February 2002 to September 2009, 77 mallet fractures type Doyle IVb and IVc were operatively stabilized with a hook plate. In a retrospective study, 59 patients were followed up at a mean interval of 38.3 (3-69) months after the operation. Wound healing problems or inflammation were not observed. Visible disturbances of nail growth were macroscopically seen in 11.9%. Results were very good in 35 patients (59.3%), good in 16 patients (27.1%), sufficient in 5 patients (8.5%), satisfying in 1 patient (1.7%), and insufficient in 2 patients (3.4%).
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Oper Orthop Traumatol · Apr 2011
[Computer-assisted surgery (CAS)-guided correction arthrodesis of the ankle and subtalar joint with retrograde nail fixation].
Restoration of a stable and plantigrade foot in deformities of the ankle and/or hindfoot and concomitant degenerative changes at the ankle and subtalar joint. ⋯ From 1 September 2006 to 31 August 2008, 14 correction arthrodeses were performed. The accuracy was assessed by intraoperative 3D imaging. All achieved angles/translations were within a maximum deviation of 2°/mm when compared to the planned correction. Complications that were associated with CAS were not observed. In all 14 cases completing follow-up, timely fusion was registered.
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Pain relief while preserving wrist motion in advanced carpal collapse. ⋯ Between 2002 and 2008, 36 four-corner fusions (32 male, 4 female) with the spider plate were performed in 24 right and 12 left wrists. The mean age of the patients at surgery was 48 years (range 32-71 years). Follow-up examinations were performed in 11 patients. The Krimmer and Rudolf scores were determined: 1 excellent, 7 good, 2 satisfactory, and 1 poor result were found. The mean grip strength was 51% relative to the opposite wrist. The mean range of motion (ROM) for wrist extension/flexion was 56% of the opposite side. Wrist extension/flexion averaged 24/0/32° and ulnar/radial deviation was on average 20/0/19°. Pain during activity was on average 2.2 based on the visual analogue scale (0-10). One delayed bony union due to a screw breakage, which required total wrist fusion, was observed.
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Evacuation of hematoma, hemostasis, reduction of dead space by vacuum systems for minimization of secondary complications, such as full skin necrosis, deep infections, and secondary wound closure. ⋯ Operative treatment of the MLL with vacuum systems is a relatively new concept, and results on larger collectives have not been published yet. A total of 8 patients in our hospital underwent vacuum therapy after sustaining a MLL, 5 of them with concomitant instability of the pelvic ring. Emergency stabilization and initiation of vacuum therapy were performed on the day of admission. Three patients had initially positive bacterial colonialization. Duration of vacuum therapy was 8.5 days (range 4-14 days). Dressings were changed every 2.6 days (range 1-4 days). While 6 wounds could be closed secondarily, 2 needed split skin coverage. Complications were not observed. Vacuum therapy facilitates wound management and helps reduce bacterial colonialization. It has also been proved to have a beneficial effect on qualitative and quantitative granulation.