Magyar traumatologia, orthopaedia es helyreallito sebeszet最新文献

Authors discuss, based on the experiences gained in the operative treatment of posterior sternoclavicular dislocation in two patients, the frequency, the symptoms, the classification, the diagnosis and treatment of this rare injury. One of the two injuries was fresh the other inveterated. No description of the operative treatment of similar injuries was found in the literature of this country. Finally the importance of the early recognition and the definitive treatment of this rare dislocation are stressed.

The case of a 42 years old man is described who had complaints in his left hip since 9 years for synovial chondromatosis. During the operation 38 cartilaginous free bi dies were removed and at the same time synovectomy was also performed. The chondroma not observed and not removed at the exposure was spontaneously resorbed during the follow-up time. Authors think the case interesting because during the last 30 years no similar description was found in the Hungarian literature.

Authors report on the possibilities of the operative treatment of the corpus scapulae. In chosen cases--young patients, isolated occurrence, great dislocation--they have performed the plate osteosynthesis of the corpus fractures. The frequency of the occurrence, the classification of fractures, the possibilities of the operative technique, the indication of the operations, the postoperative therapy are mentioned and their cases are described.

Authors have treated 37 fractures of the scapula during 3 years. The questions of the aetiology, classification, diagnosis and therapy of this injury are reviewed. It is stated that the majority of the scapula fractures heal on conservative therapy; in consequence the functional treatment has a leading role. The fractures of the articular surfaces with step formation, the fractures of the scapular neck process dislocated in a high degree, or unstable fractures of the scapular neck combined with the comminutive fractures of the operative therapy are assessed. Attention is called to the most frequent operative complications and to the possibility of their prevention.

The better knowledge of the biomechanics of bone tissue and fracture healing resulted in the development of the AO principles and its methods of treatment. I have demonstrated on the femora of rabbits that the consequence of progressive dynamization versus the current unchanging stability of fracture fixation was a more rapid healing. According to our knowledge the more elastic, dynamizating or dynamizable fixation of the fracture are the methods of future. The new biodegradive implantates make not only their removal superfluous but help the fracture healing, too.

Authors briefly describe the etiology of Köhler II. disease and the possibilities of the operative treatment. The osteotomy of the proximal end of the metatarsus, performed by them, the biomechanical basis of the operation, the indication are detailed and the favourable experiences gained with this procedure are reported.

Authors examined the circumstances of bacteriological infection of open fractures and large size injuries of the soft tissues. Bacteriological examinations were made from the ichor before the primary wound care and immediately after its finishing. It is stated that in open injuries there is only a potential possibility of infection and with an early wound care its danger can be substantially decreased. In the purulent infection after open injuries one has always to think on the possibility of secondary hospital infection.

Authors report on the result of Helal's metatarsal osteotomies performed on 62 feet of 48 patients for metatarsalgia. In 85 per cent the result proved to be excellent, in 15 per cent there was no improvement. Analysing the causes of the postoperative complaints they call attention to the overload of the marginal arches and to the metatarsalgia developing on the non osteotomized neighbouring arch. These complaints appeared in 1/3 of their material and could be generally well influenced with conservative treatment.

Authors report on the first use of bicondylar surface substitution knee prosthesis of a new type. The prosthesis and the instruments developed for implantation are demonstrated. In the first five operations the appropriateness of the implantation instruments, the exactness of their handling, the assortment of the series of prosthesis have met the plus which, compared to the types known until now, can secure the exactness of the operation and improve the ratio of the lasting good results.

Authors call attention with the demonstration of pictures of a few cases of their own to the significance of the ultrasound examination in cases of shoulder injuries. They stress that beside the demonstration of rotator cuff injuries the examination of the surrounding muscles and the labrum glenoidale should not be forgotten either. The modernization of the ultrasound devices, the improvement of the methods of examination and the obtaining of the necessary practice ensure a more and more important place to echography in the diagnosis of traumas of the motion organs.