Zentralblatt für Chirurgie
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Aim of the study was to evaluate typical complications in osteosynthesis of inter- and subtrochanteric femur fractures with intramedullary nailing systems. In the literature screw perforation of the femoral head into the acetabulum, postoperative fracture of the femur shaft, intraoperative shaft fracture, problems in placing of distal locking screws and deep infections are mostly described. ⋯ In an analysis of internationally published data on 2 241 GAN and 365 GLN the cut-out rate was 2.3 %/0.5 %, postoperative shaft fracture 2.2 %/1.4 %, intraoperative shaft fracture 1.2 %/0.3 % and deep infection 1.2 %/2.2 %. GLN shows lower complication rates with regard to femoral head perforation and late shaft fracture than GAN.
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Case Reports
[Triangular vertebropelvine stabilisation of unstable posterior pelvic ring fractures].
It is the objective of this investigation to describe the early results (2 years outcome) after triangular vertebropelvine stabilisation (TVPS) of unstable fractures of the posterior pelvic ring. ⋯ The following advantages of the TVPS could be demonstrated: anatomical reduction and stable retention of instable pelvic fractures, full weight bearing from the first day after surgery, and only slight restriction of the quality of life two years after operation
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Although improved techniques of internal fixation and prosthetic replacement were introduced successfully in the field of operative fracture care, treatment of complex fractures of the proximal humerus also involving the humeral head remains to be a challenge to the trauma surgeon. We therefore investigated clinical and radiological long-term results after humeral head preserving procedures. ⋯ These data show that regarding to clinical and radiological long-term results also complex fractures of the humeral head should be treated by head preserving procedures.
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Symptomatic dissecting aneurysms of the extracranial internal carotid artery after blunt trauma are not frequent. Medical treatment of these lesions can be ineffective and surgical options present high morbidity. We describe a case successfully treated with endovascular therapy, using a self-expanding stent. The advantages of the endovascular treatment are outlined, the literature on carotid artery injuries by blunt trauma and management strategies are reviewed.
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The new method of antegrade intramedullary fixation of humeral head fractures is based on a straight proximal humeral nail with special head fixation screws and conventional interlocking screws at the proximal end of the shaft fragment leaving an axillary nerve shelter space in between. The nail acts as a central load carrier. The head fixation screws run through threaded holes in the proximal end of the nail thus being held in a stiff angle and without gliding. ⋯ We found an ongoing improvement of the postoperative results up to an average Constant Score of 85.7 pts after one year. The complication rate was 16 %. The main complication was the screw protrusion into the joint.