Magyar traumatologia, orthopaedia es helyreallito sebeszet最新文献

Authors demonstrate the extremely rare case of articular pinching of the single and not well-developed sesam bone at the metacarpophalangeal joint on over extension without luxation and associated injuries. After reviewing the history and pathology it is described that this alteration can be treated with voluntary muscle function and without operation too.

Authors describe the case of a 56 year old man who was admitted because of soft tissue tumour on the end phalanx of his right second toe, growing since one year. The histological examination revealed a fibroma which made the wear of shoe preoperatively impossible. The case was interesting for its unusual localization and magnitude.

Author describes two cases: in the first, in consequence of a lesion of the deep peroneal nerve during operation, the development a paralytic drop foot, in the second, in consequence of a lesion of unknown etiology of the common peroneal nerve, paralytic club foot could be observed. In both cases the intraosseal transposition of the tendon of the posterior tibial muscle on the second cuneiform bone was performed with good result.

A study on 20 patients undergoing hip prosthetic surgery is reported. Solcotrans Orthopaedic, a sterile, disposable device for the post-operative salvage and reinfusion of drained whole blood was used on all patients. 70% of patients did not require additional homologous blood and there was a saving of 76% in homologous blood usage. The device is safe and simple to use and no clinically significant adverse effects were observed. Its use is recommended in patients undergoing hip prosthetic surgery in the absence of joint infection or malignancy.

Authors report on the results of the operative fusion of the lumbar spine performed by them between 1 March 1987 through 31 December 1990. Based on the assessment of 243 cases they call attention to the importance of the correct indication and operative technique and of the close supervision. It is stated that the use of the internal fixation improves the results of the operative fusions.

Isolated injury of the intact gallbladder following obtuse abdominal injury is rare. In connection with one case authors give a literary review of the occurrence of this injury. The pathogenesis of the rupture of the gallbladder, the clinical course and the difficulties of diagnosis are analysed.

Authors describe an operative procedure, new in this country, for the treatment of acromioclavicular dislocation. In 18 young sportsmen and physical workers, in cases of injury, the joint was fixed with Wolter's crooked plate until the healing of the capsule and ligament sutures. The plate does not damage the joint surfaces, no postoperative external immobilization is necessary and so early functional treatment will be possible. The patients were reexamined 24 months after the operation. No break or loosening of the implant was observed. In spite of the fact that the subcutaneous dehiscence of the wounds on shorter sections healed without complications further investigations are thought necessary for its prevention. In 17 patients complete function of the shoulder was reached. All patients continue their original jobs or sport activity. On the basis of the convincing good results authors suggest the use of Wolter's plate.

Authors made a follow-up of 69 varsus knee arthrosis treated with high tibial osteotomy. Beside the general results the effect of the severeness of the arthrosis before the correction and that of the gain of the axial correction on the result were also investigated. 56 (81 per cent) of the reexamined patient reported excellent or good results. The ratio of the successful operations was even higher in cases in which the femorotibial axis was corrected to physiological valgus (95 per cent). The best prognosis of the osteotomy is in the early stage of arthrosis (Ahlbäck 0-II). In cases of the more advanced process the ratio of the unsuccessful cases increases. In consequence it is stated that the best results can be expected after osteotomies performed in the early stage and leading to the physiological femorotibial valgus position.

Authors show the structures of the knee joint that can be demonstrated by ultrasound. It is stated that in normal circumstances the tendons, the collateral ligaments, the bursae and Hoffa's fat tissue can be easily brought in the visual field. The demonstration of the single parts of the menisci and the cruciate ligaments is more difficult in certain cases (bulky knee, contracture, progressed gonarthrosis). Corresponding to the literary data and on the basis of their results they conclude that the ultrasound is suitable to the correct demonstration of the complicated anatomy of the knee. The examination is noninvasive, it can be repeated any time and with adequate experience it gives possibility to recognise the changes in the knee joint.