Helvetica chirurgica acta
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Helvetica chirurgica acta · Feb 1991
[Does partial anterior cruciate ligament rupture really exist?].
From 1983 to 1989 129 partial tears of the anterior cruciate ligament were diagnosed by arthroscopy. To confirm the diagnosis of a partial rupture of the anterior cruciate ligament, we began to split the synovial sheath of the anterior cruciate ligament in 1986 in order to prove the continuity of the fibers. ⋯ The overall results were very good in 12% and good in 14%; 41% showed a fair, 26% a poor result. Because of this unfavourable outcome, we believe that most of the partial tears of the anterior cruciate ligament should be regarded as complete ruptures.
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Helvetica chirurgica acta · Feb 1991
[Follow-up results of osteosynthesis of medial femoral neck fractures with the dynamic hip screw].
The operative treatment of subcapital femoral neck fractures of stages Garden III and IV in the young patient is still a problem. The current methods of osteosynthesis show a high rate of avascular necrosis of the femoral head. We controlled 24 patients with subcapital femoral neck fracture, who were treated with a dynamic hip screw (DHS). ⋯ Fourteen patients of the group with femoral neck fractures of stages Garden III and IV had no pain and wer satisfied with the result. But in this group we found 7 patients with partial avascular necrosis of the femoral head. These results are discussed and compared with data published elsewhere.
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Helvetica chirurgica acta · Jan 1991
[Peritoneal dialysis in treatment of postoperative heart failure after correction of complex heart defects in young children and infants].
Low cardiac output can be encountered after corrective surgery for complex congenital malformation in children and infants and is often accompanied by an impairment of renal function, ascites, hyperosmolarity and hyperpyrexia. In most instances, combined afterload-reduction and inotropic stimulation will be effective. If low cardiac output persists, a peritonealdialysis (PD) may allow correction of fluid balance and consecutive improvement of hemodynamics. ⋯ We used a PD-solution with 1.5% and/or 4.5% glucose. Fluid balance was monitored hourly. Just after introduction of the catheter a mean of 65 ml +/- 25 ml/kg ascites could be removed and the total quantity of removed fluid was 175 ml +/- 45 ml/kg bodyweight.(ABSTRACT TRUNCATED AT 250 WORDS)
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Helvetica chirurgica acta · Oct 1990
[Severe thoracic trauma: under what accident and resuscitation conditions can it still be treated?].
Severe thoracic trauma is a major cause of early death following road accident. 569 non-surviving and 112 surviving victims of traffic casualties were documented by the Accident Research Unit of the Clinic of Trauma Surgery, Hannover Medical School from 1973 to 1987. Medical data and measures of rescue were evaluated with a view to way of clinical therapies, lethal outcome and time of death. Primary intubation and chest draining seems to be the most successful initial treatment on the scene and during transport.
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Helvetica chirurgica acta · Oct 1990
[Serial rib fractures: a differentiated treatment concept, illustrated by 59 severely injured intensive care patients].
In a group of 59 consecutive ICU trauma patients with blunt chest injury and considerable injury severity (ISS = 29) a three-staged therapeutic approach was followed, depending seriousness of chest injury, overall injury severity and age. Stage 1: i.v. analgesia and conventional respiratory therapy. ⋯ Only 44% of the patients needed intubation, and none died. The authors recommend this three-step approach towards blunt chest injury and serial rib fractures.