Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera
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Floating Joint Injuries (FJI) are resulting from high energy traumas and are often combined with additional neuro/vascular damage. The high incidence of severe open or closed soft tissue injuries is complicating the initial management and requires a broad surgical know-how also in minimal-invasive fixation techniques. In a retrospective analysis of our cases treated between 1980 and 1995, we try to find out some important therapeutical feedback for the future. ⋯ FJI should be stabilised as soon as possible in a way allowing for early functional aftercare of the affected joint. Most complications are observed in the proximal tibia fracture because of the thin and therefore often severely (open or closed) injured soft tissue cover. Despite a staged procedure, there exists a high complication rate, which probably can be reduced in the future by the single-step use of the hybrid external fixateur.
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Diagnosis of bronchial rupture after blunt chest trauma may be difficult and this is demonstrated on behalf of four patients treated in our institution. Bronchoscopy is mandatory for exclusion or confirmation of a bronchial rupture. In addition spiral CT scan was found to be helpful for diagnosis and localisation of bronchial injury. Early diagnosis allows prompt surgical therapy that will avoid irreversible loss of pulmonary parenchyma.
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Retrospective analysis of the functional and radiographic outcome of a new temporary fixation device in the surgical treatment of acromioclavicular joint dislocation stage Tossy III. ⋯ Our mid- and longterm results confirm the value of the clavicle hook-plate as an alternative to other temporary fixation devices in the surgical treatment of acromioclavicular dislocation stage Tossy III.
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Case Reports
An unusual manifestation of Meckel's diverticulum: bleeding and perforation--a case report.
Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. Bleeding of the diverticulum from a peptic ulcer due to ectopic gastric mucosa makes up 25% of all complications in the disease. ⋯ Segmental small bowel resection was performed. Difficulty of preoperative diagnosis is discussed, indication for incidental diverticulectomy is established and the literature reviewed.