Zeitschrift für Kinderchirurgie : organ der Deutschen, der Schweizerischen und der Osterreichischen Gesellschaft für Kinderchirurgie = Surgery in infancy and childhood
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In the years 1979, 1980 and 1981 a follow-up of 72 epiphyseal of the distal tibia was made. Half of the cases of epiphyseal fractures were treated conservatively, the other half operatively. Epiphysiolyses were treated conservatively without exception. ⋯ On the basis of these results the classification effected to date of the epiphyseal traumas as well as their prognosis will be critically examined. From the clinicotherapeutic point of view epiphyseal fractures must be classified as joint lesions and epiphysiolyses as shaft fractures, even if the later are still lesions of the growth plate if considered from an anatomical point of view. On the basis of a clinically-orientated new classification of growth plate lesions, therapeutic principles are discussed.
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Case Reports
[Experience with heterotopic autotransplanted splenic tissue in children (author's transl)].
In 5 patients re-implantation of splenic tissue was performed after splenectomy. In all patients growth of the regeneration products was proved by scintiscanning. In two patients only, however, the Howell-Jolly bodies proving the ability of the spleen to perform phagocytosis disappeared from the erythrocytes. Basing on an extensive study of the literature and on the authors' own results, the question is discussed whether re-implantation of splenic tissue after traumatic rupture of the spleen and splenectomy is meaningful or whether splenosis occurring during splenic trauma will already provide satisfactory immunological protection.
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Between 1970 and 1980 53 children with epiphyseal injuries were treated. Analysing these 53 cases we found that metaphyseal lesions of the epiphyseal plate (i.e. epiphyseolysis, separation of the epiphysis with triangular metaphyseal fragment) heal completely, even in those cases in whom an open reduction was necessary. ⋯ We can conclude that epiphyseal injuries do not necessarily end in disturbances of growth or malformation if surgical correction of the injury is done as early as possible and if the injured extremity is immobilised at least 3 to 5 weeks. Destruction of the epiphyseal vascular system can only be avoided by surgical reposition of the epiphyseal injury.
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Report of a newborn child with necrotizing fasciitis, which is characterized by bacterial infection and necrosis of the subcutaneous fat. This rare disease has a high lethality, therefore an immediate surgical and antibiotic therapy is necessary.