Aktuelle Traumatologie
-
From 1976 to 1986 1.003 polytraumatized patients were treated at our institution. 88% had suffered fractures of spine, pelvis and limbs. Of particular relevance are the femoral fractures (36% of all cases) in the management of those patients. In not adequately immobilized femoral fractures the rate of general and local complications in this group is elevated. ⋯ Further assessment of the date showed a significant drop of 27.3% in mortality, mainly due to a decreased rate in late ARDS-related deaths. The advantage of the DAF concept in the stabilization of these fractures in polytrauma victims we see in the less time consuming fixation, the minimal blood loss, easier ICU care and fewer local complications. The DAF device is used as a definitive management tool and does not generally require a change to another method of fixation.
-
Aktuelle Traumatologie · Dec 1987
[Arthrolysis in the treatment of post-traumatic joint stiffness of the knee and elbow joints].
In the treatment of posttraumatic limitation of the range of motion, arthrolysis is a proved procedure in the hand of an experienced surgeon. In this paper, indication, operative details and postoperative treatment are discussed. The results of 51 cases of arthrolysis of the knee joint and 33 cases of arthrolysis of the elbow joint carried out over a time of seven years are reported.
-
Aktuelle Traumatologie · Aug 1987
Case Reports[Rupture of the distal tibiofibular syndesmosis without ankle fracture].
Rupture of the distal tibiofibular syndesmosis without fracture of the fibula may be a rare event, but in the presence of certain clinical signs, it should be investigated (pain and haematoma above the syndesmosis, pain at eversion and dorsal flexion, history of dislocation of the joint). The diagnostic procedure of choice is the arthrography of the ankle-joint. A so-called isolated posterior tibial fragment may lead to the diagnosis of a complex ligamentous injury.
-
Osteosynthesis by Kirschner-wires still maintains its importance in the treatment of certain fractures. This kind of stabilization is either used temporarily within the scope of an internal fixation as well as in adaptation osteosynthesis or in applying a tension band wiring. Especially in fractures of the growing skeleton and in fractures of elderly patients K-wire fixation often represents the method of choice. The various indications for stabilization by means of Kirschner-wires is demonstrated in some typical fracture localizations.
-
Aktuelle Traumatologie · Dec 1986
Case Reports[Ileus in enterothorax caused by right-sided rupture of the diaphragm. A case report].
The case described in this article shows an almost typical course with blunt abdominal trauma that occurred a long time ago, a primarily recognized but not surgically treated rupture of the diaphragm on the right side, and subsequently developing intestinal signs with recidivating attacks of jaundice caused by displacement of the liver with kinking of the bile duct. The relatively rare late complication of a right-sided enterothorax with ileus makes this a remarkable case and underlines once again the need for immediate or at least early surgery to avoid late complications.