Aktuelle Traumatologie
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Aktuelle Traumatologie · Dec 1992
[Arthrodesis of the upper ankle joint. Indications, technique, results].
From 1984 to 1990 a total of 119 arthrodesis of the upper ankle joint were performed at the Hospital of Accident Surgery of the Trade Association in Frankfurt am Main. The results of 98 patients after an arthrodesis of the upper ankle joint are documented by an x-ray control series and patient files, including the expertise on the medical status of pensioners plus a follow-up examination of 34 patients. The indications and the results are discussed on the basis of the various procedures. The results confirm the method of a compressions arthrodesis with an extension screw in case of a posttraumatic arthrosis of the upper ankle joint, while a fixateur externe should be used in case of chronical osteomyelitis, osteoporotic bones, extensive tissue swellings and after a pilon or talus fragment fracture.
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Aktuelle Traumatologie · Dec 1992
[Epidural "sulmycin implant" coverage for local prevention of infection in surgical management of open craniocerebral injuries].
In various series reported in the literature on the operative management of severe head injuries with compound depressed skull fractures and penetrating wounds of the brain, the rates of infection differ from 1 to 17%. In this paper the operative experience with 22 cases of penetrating head injuries is discussed. In conventional operative therapy, depressed skull fracture and lacerated dura were covered by "Sulmycin Implant" containing Gentamycin as a helpful bacteriological barrier. 18 patients survived, 7 patients had severe neurological defects, 5 patients had mild neurological deficits and 6 patients recovered completely. ⋯ Another patient with a frontal base skull fracture suffered a pneumatocele because the fracture was not correctly covered. The revision was done successfully using the "Sulmycin Implant". Presently, however, the intradural use of "Sulmycin Implant" is not recommended without further testing for the level of gentamycin in the cerebrospinal fluid which is released by the "Sulmycin Implant".