The Netherlands journal of surgery
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Anatomic reduction and internal fixation of the lateral malleolus are the key to management of ankle fractures. The usual application of one-third tubular plates to the lateral surface of the distal fibula has certain disadvantages. In selected cases we prefer a dorsal approach to the lateral malleolus. Indications, technique and experience are discussed.
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A review of the recent literature concerning the Adult Respiratory Distress Syndrome (ARDS) and Multiple Organ Failure (MOF) is presented. We hypothesize that the two syndromes probably have a common pathophysiology, with ARDS as the first occurring organ failure. The clinical situations that may cause ARDS and MOF are characterized by massive and prolonged activation of the complement system. ⋯ Oxygen diffusion in the peripheral tissues is impeded by the same mechanism, ultimately resulting in organ failure. Hypoxia may cause additional microvascular lesions, as toxic oxygen radicals are produced during reoxygenation. The implications of this hypothesis for the prevention and therapy of ARDS and MOF are discussed.
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During the period 1974 to 1980, 260 displaced ankle fractures were treated by open reduction and rigid fixation. The results of this treatment were evaluated in 193 patients as excellent 50%, good 38% and poor 12%. The Danis-Weber classification, operative treatment, complications and results are discussed. In our opinion, if performed properly, the best treatment of displaced ankle fractures is operative intervention.
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Ischemic damage to the spinal cord after reconstructive procedures of the abdominal aorta is a rare complication. The literature up to and including 1980 records 46 of these cases. In this paper we present four additional cases and discuss the etiological factors and the practical measures available to minimize the risk of this unpredictable complication.