Aktuelle Traumatologie
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Aktuelle Traumatologie · Dec 1993
[Effect of external cervical spine immobilization on intracranial pressure].
We measured the intracranial pressure (ICP) in 18 patients with severe head injury in the neurosurgical intensive-care unit before and after placement of a rigid collar for cervical spine immobilisation. The purpose of the study was to determine whether the rigid collars, commonly used to, prevent cervical spine movement during transport to the treatment facility could lead to an increase in ICP. Patients who had an epidural transducer in place were studied and their ICP recorded during placement of either the Spieth cervical collar (n = 12) or the Philadelphia cervical collar (n = 6). ⋯ No significant changes in ICP could be demonstrated during this study. Placement of the cervical collar is a simple and practical measure to immobilize the cervical spine during rescue and transport of intubated and ventilated patients. Its risk of increasing the ICT appears to be low even in the patient with severe head injury.
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Aktuelle Traumatologie · Dec 1993
[Subacute and chronic epidural hematoma after craniocerebral trauma].
During an 8-year period, fifteen patients with subacute or chronic epidural haematoma were seen among 110 treated cases of extradural haematoma corresponding to a frequency of 13.6%. Increasing headache, nausea, vomiting, mild drowsiness and cranial nerve palsy were the symptoms resulting in the correct diagnosis in most cases. ⋯ The most important factors are cerebral atrophy, age, source of bleeding and location. By means of early CT (computed tomography) diagnosis of haematoma, fatal outcome could be prevented in most of the cases.
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Aktuelle Traumatologie · Nov 1993
Comparative Study[Secondary management of tibial fractures with plate osteosynthesis--applications of an old, but reliable procedure].
During the time period from May 1990 through October 1992, a total of 70 tibia fractures were treated in the Department of Traumatology of the University of Bonn. 35 patients with 37 tibial fractures were treated according to a regimen including primary stabilization, usually in an external fixateur, soft tissue reconstruction and delayed open reduction and internal fixation using an AO-plate. A majority of the patients were involved in motor vehicle accidents leading to multiple injuries in 22 instances. An open fracture was seen 16 times. ⋯ Only one infection, following a grade 2 open fracture, was seen. Bony union was achieved after 15.7 weeks. Considering the complications associated with nailing such as fat or air embolism, heterotopic ossification and non- or malunions, the use of the tibial plate seems not only to offer logistic advantages but is a viable alternative for the delayed stabilization of tibial fractures.
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Aktuelle Traumatologie · Oct 1993
[Classification of unstable pelvic ring injuries--treatment methods].
Any classification of pelvic ring injuries has to take respect of the mechanism of injury, the anatomy and the dimension of instability. These factors involve a base for a standard conception of treatment and evaluation of the results of treatment. ⋯ Indications and operative procedure of the anterior and posterior stabilisation will be presented. Only stability of the pelvis will guarantee the early mobilisation and rehabilitation of any patient.
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Aktuelle Traumatologie · Aug 1993
Case Reports[Measuring intracranial pressure after trepanation in traumatized patients].
Between 1.1.1990 and 30.9.1991 32 neuro-traumatological operations were carried out. With 22 patients the intracranial pressure probe was used. With 11 injured persons the ICP (intracranial pressure) values were unchanged. ⋯ In this way expansive intracranial changes which occur postoperatively can immediately be seen and diagnosed or treated. On the other hand, if the intracranial pressure values are unchanged, postoperative computed tomography may be carried out later i.e. after the vulnerable phase. Further advantages result from monitoring the patients in the intensive care unit.