Zeitschrift für Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft für Kinderchirurgie = Surgery in infancy and childhood
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Avulsion fractures of the tibial tuberosity occurred in 7 adolescents. Their ages ranged from 13 to 16 years. With one exception the fracture occurred while the patients were engaged in vigorous sports, particularly soccer and jumping. ⋯ Closed reduction was successful in 1 patient while two patients were treated via cast immobilisation. In all patients there was a total disappearance of symptoms within 3 months to 4 years. A classification scheme and the indications for surgery are discussed.
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On 27th August 1986, the 5th David Vervat Lecture was presented in Rotterdam by Professor emeritus Gordon Jackson Rees, M. B., Ch. B. (Liverpool). ⋯ Mr. David Vervat is likewise a legend in his own lifetime for his pioneering work in paediatric surgery in the Netherlands, during which he felt so deeply the need for paediatric anaesthesia for his patients. As such this lecture represented a real tribute to David Vervat.
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In the last decade we treated and followed up 48 children in the Department of Paediatric Surgery in Heidelberg with fractures and cartilaginous injuries of the knee joint. In 13 cases we could see severe osseous injuries localised at the epiphyseal plate. With decreasing frequency, the following conditions occurred: avulsion fractures of the intercondylar eminence, fracture of the tibia head in children, fractures of the patella and avulsions of the tuberositas tibiae. Furthermore, we report about the special problems of foreign bodies incorporated in the knee joints of children, particularly if sewing needles are involved.
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Pyloric atresia is a congenital anomaly manifested by gastric outlet obstruction. The radiographic signs are characterised by the presence of the gas-bubble sign, the pyloric dimple sign and the absence of the beak sign. The differential diagnosis of these signs is discussed in view of other gastric outlet obstructions. Ultrasonography is of value in demonstrating the absence of the normal echo pattern of the pyloric muscle and the pyloric canal, thus confirming the diagnosis of pyloric atresia, or even may replace the fluoroscopy of the upper gastrointestinal tract.
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Guidelines for the choice of conservative or operative treatment of fractures of the proximal radius are derived from a study comprising 21 children. Postoperative complications and long-term failures are specifically stressed. ⋯ Displaced marginal fractures below 3 mm are suited for early functional treatment using conservative procedures. 18 patients suffered a fracture of the radial neck type III and IV (Judet). Despite low failure rates of the operative therapy, we have recently been refraining from the operation.