Magyar traumatologia, orthopaedia es helyreallito sebeszet最新文献

Authors analyse 1792 fractures in children, treated during 10 years in their Department and distributed in age groups. They take the part of conservative treatment of the majority, about two third, of fractures in childhood. They consider as operative indication certain forms of epiphyseal injuries, the dislocated intraarticular fractures, the unstable fractures, certain cases of polytrauma and the open fractures.

Authors followed for 4 months the life of 753 patients with femoral fractures of the hip and state, that with an extension of the operative indication the hospital mortality was decreased to the half during 15 years in spite of the further rise of the age. It is contributed first of all to the inadequacy of the rehabilitation that the later mortality is high and it is the double of that in the hospital: not more than 3 of 4 injured reaches the 4 months control.

Authors report on experiences gained during the treatment of the injury of the lower thoracal spine in a 64 year old male patient and review the relating literature. As a consequence of the basic disease fractures may occur following rather trivial traumas. As all ligaments are calcified a particular unstable state will develop following the fracture.

Authors examined the results of the 4 months rehabilitation of 753 cases of hip fractures treated in one year in their Institute. It was stated that a significant part of the patients had to be discharged too early. It is contributed to the inadequacy of the rehabilitation possibilities of the patients that 3/4 of those living after 4 months have complaints, only half of them can leave their flat, only 1/5 walks without a stick and 1/3 with one stick. On the basis of Swedish experiences they see the possibility of improving their results in a closer cooperation with the primary health care.

Author reports on the result of treatment in 22 patients with idiopathic femoral head necrosis. Altogether 25 hips were treated with insertion of conserved bone graft. Improvement occurred in only about 1/4 of the operated hips, the other hips deteriorated both clinically and radiologically. The author thinks, reviewing the literature, that the cause of the partly failure was the inadequate selection of patients and the insufficiency of the method. The possibilities of further progression are outlined.

Authors report on the results of 15 synovectomies of the knee for iligoarticular juvenile rheumatoid arthritis. The operation was performed in every case in the early stage before the development of the radiological destruction. Excellent and good results were obtained in 11 cases; in 4 cases the operation was unsuccessful. It is stated that there is good chance to prevent destruction of the knee with juvenile rheumatic arthritis with an early synocvectomy. The operation is suggested after 6 years of age. The key of the good result is the early intensive mobilization of the joint.

Authors have observed in 1978-1984 in 87 of 214 polytrauma cases injuries of the abdominal organs. The data concerning children in whom the high ratio of injuries of the abdominal organs and the low mortality are conspicuous are shown separately. The necessity of urgent diagnosis to which especially the abdominal irrigation has given great help is stressed. After a review of the literature and a control of their own material the problem is considered as actual, as in polytraumas the abdominal injuries are frequent, the valuation of the abdomen in the patient, generally in shock or unconscious is problematic, the many times simultaneous therapy of the abdominal and joined injuries is difficult, the mortality high.

Authors present the parts of the shoulder that can be represented by ultrasound. Beside the rotator cuff of accentuated significance (within this, first of all the tendon of the supraspinatus muscle) the subacromial bursa, the tendon of the long head of the biceps, the muscle-tendon junction of the infraspinatus muscle are analysed. It is stated that the ultrasonography is suitable for a reliable representation of the soft tissues, surrounding the shoulder joint, further in possession of literary data they see possibility for a very exact judgement of the pathological alterations, too.

Authors assess the results of 17 Bristow's operations performed in the therapy recurrent anterior dislocation of the shoulder. The literature of the subject is reviewed, the technical details of the operations are described and the possibilities of complications are pointed out. On the basis of literary data and their own favourable experiences the wider use of this method is suggested.