Archiv für orthopädische und Unfall-Chirurgie
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Arch Orthop Unfallchir · Jul 1977
[Measurements of stability of operative osteosynthesis on the proximal femur (author's transl)].
Bending burdening of stable and unstable per- and subtrochanteral fractures after osteosynthesis with Y-nails (Küntscher), Ender-nails, 130 degrees and 95 degrees angled plates of the AO were tested in a comparative experimental study. The unstable fractures were also tested after treatment with osteosynthesis and additional application of bone cement in the artificial defect. ⋯ The 95 degrees-angled plate-osteosynthesis combined with bone cement bearing more than 300 kp was superior to the other procedures in the unstable per- and subtrochanteral fractures. In our investigation the stabilizing forces of muscles and fascia have not been taken into consideration.
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Sciatic block with Mepivacaine (3-4 mg/kg) revealed successful in 91.9% of 340 rheumatoid patients with Keller/Clayton operation. In unsufficient blocks (8.1%) supplementary anesthesia by femoral nerve block, reblocking the sciatic nerve or local anesthetics secondarily gave good operating conditions. In three cases it was necessary to use additional spinal anesthesia. The concomitant sympathetic block gives an immediate cessation of sweating and a long lasting evaluation of skin temperature.