Aktuelle Traumatologie
-
Aktuelle Traumatologie · Jun 1993
[Change in treatment procedure after primary external fixator osteosynthesis in polytrauma patients].
In polytrauma patients stabilisation of fractures is of minor importance compared with life-saving surgical interventions concerning the body cavities. Because of persisting instability especially of long bones with disadvantageous effects on the state of shock and the respiratory system (fat embolism, ARDS) early stabilisation of fractures should be achieved. In our experience the majority of cases allows external fixation of long bone fractures simultaneously with or following the life-saving operations. ⋯ An early change of the stabilisation method should be performed as soon as possible if tolerated by the general and soft tissue conditions. Follow-up of 54 patients with 76 fractures stabilised primarily by external fixator demonstrates our experiences with planning and realisation of the change of stabilisation method. The functional and radiological results after an average of 28 months are pointed out.
-
Aktuelle Traumatologie · Jun 1993
[Dislocation fractures of the upper ankle joint. Classification--treatment--results].
Between 1959 and 1989 a total of 1,387 ankle fractures were analysed under different aspects. For several reasons the authors prefer the classification by Lauge-Hansen schematized by Maatz. ⋯ Early complications and late results are presented via smaller groups of patients. Evidently SE fractures have the worst prognosis independent of the success of the operation.
-
Aktuelle Traumatologie · Jun 1993
Case Reports["Extent of damage, previous damage, previous condition, previous disability"--definition of concepts for the legal expert].
Several examples are discussed to explain the most important legal definitions of social and private accident insurance. The importance of disciplined and lucid language in expert opinions is emphasised. Typical cases are described.
-
Injuries of the subclavian artery are rare; still rarer are aneurysms of the subclavian artery due to blunt or penetrating trauma. Diagnosis can be performed by careful clinical investigation. ⋯ This will be of value for planning the surgical approach, which varies with the anatomical site of the injury and the kind of accompanying damage. Subclavian aneurysms should be treated surgically, because embolic or thrombotic complications may threaten the extremity and the brain.
-
Aktuelle Traumatologie · Feb 1993
Case Reports[Transcranial Doppler ultrasound in craniocerebral trauma: valuable method in traumatologic emergency cases?].
Introduction of the transcranial Doppler method 1982 (1) by Aaslid made it possible for the first time to monitor noninvasively the cerebral haemodynamics after severe head injury, or in polytraumatized patients in the emergency room. Mean flow velocities (FVmean) and systolic-diastolic frequency spectrum (PI) in basal cerebral arteries were considered. In that way, influences of different pathological intracerebral processes to cerebral haemodynamics are detectable earlier and triage planning of therapeutic steps is facilitated. ⋯ If this is not possible, interpretation of flow signals and measured flow velocities can be only made by comparing both sides. All measurements should be made at normal mean arterial blood pressure. This method enables rapid orientation of intracerebral haemodynamics after SHI and facilitates the decision of what should be done first of all.