Langenbecks Archiv für Chirurgie
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The aim of a rib osteosynthesis is entirely the physiological restoration of the chest wall compound. Elastic rib clamps are very suitable for this purpose; rigid plates hinder the breathing movement of the ribs and often work loose. An examination meant to evaluate the best form of osteosynthesis has to consider these aspects. Crush tests of rib osteosyntheses, however, are not representative for the respiratory physiology of a stabilized thorax.
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Langenbecks Arch Chir · Jan 1980
[Surgical treatment of congenital heart disease in infants without use of extracorporeal circulation (author's transl)].
Between 1970 and 1978 135 infants with congenital malformations underwent operations due to congestive heart failure, progressive pulmonary hypertension, and severe cyanosis. Of them, 63% were acyanotic; 68% of all operations became necessary during the first 6 months of life. The late mortality rate was 5% and the hospital mortality rate 17%. ⋯ Because of a recurrence rate of 20%, the authors think that operations are only indicated in symptomatic cases of coarctation. In complex cyanotic malformations, a higher operative risk was observed in both pulmonary artery banding (38%) and shunt operations (44%). If surgical treatment is necessary, the earlier, the better.
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Langenbecks Arch Chir · Jan 1980
[Biomechanical problems in elbow joint dislocations with coronoid and capitulum radii fractures (author's transl)].
Dorsal dislocation occurs in 80% of all fracture dislocations of the elbow joint. In 10-15% of these njuries the coronoid process and the radial head are involved. ⋯ Advisable for fixation is the use of a lag screw. In some cases the reconstruction with autogenous bone graft or osteotomy of the olecranon is indicated.
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Langenbecks Arch Chir · Jan 1980
[Thoracic epidural analgesic (TEA) or controlled ventilation in the treatment of patients with multiple rib fractures (author's transl)].
In the last seven years 283 trauma patients were treated for multiple rib fractures and/or flail chest. Primary management consisted of only morphine analgesia in 16 patients, TEA in 112 patients, and mechanical ventilation in 155 patients. The indication for mechanical ventilation was always associated injuries (cerebral contusion, para- and tetraplegia, aspiration, severe lung contusion) and not the instability of the thoracic cage.
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Langenbecks Arch Chir · Aug 1979
[Influence of pyloroplasty and pyloric stenosis on motoric and secretory function of the stomach after selective proximal vagotomy--an experimental study (author's transl)].
In conscious fullgrown minipigs simple SPV alone, SPV and pyloric stenosis and SPV and pyloroplasty were performed. After a liquid test meal the motoric and secretory function of the stomach were examined simultaneously by a modified method of intestinal perfusion and aspiration. After simple SPV initially a marked decrease of gastric volume and normal emptying into the duodenum were found. ⋯ After food stimulation there was a delayed increase of gastrin after SPV which differed from that after SPV with pyloric stenosis or pyloroplasty only during the first hour. These results show that after SPV no further improvement of the motoric and secretory function can be achieved by an additional pyloroplasty. Furthermore these findings permit the conclusion that even after SPV with additional artificial pyloric stenosis no delayed gastric emptying occurs and that there is no negative effect postoperatively on the acid secretion and gastrin production.