Magyar traumatologia, orthopaedia es helyreallito sebeszet最新文献

Authors analyse, based on an all-round inquiry, the operations performed for pseudarthrosis of the scaphoid in 1988. It was found that 344 of 472 operations were reconstructive, 128 palliative. The single types of operation are briefly described. They hint at the fact that the operative treatment of scaphoid pseudarthrosis in Hungary is carried out mostly in Centers.

Author describes now the third time this very rare injury. New cases are demonstrated and the knowledge originating partly from all other authors, partly developed by himself is summarized.

Authors want to call attention with the presentation of 4 cases to the significance of the agricultural injuries and to the difficulties of the therapy. The importance of the primary wound care is stressed. An adequate excision of the wound, debridement and an open wound care are essential in severely crushed, soiled cases. Therapy of severely crushed injuries, complicated with multiple fractures needs individual weighing and a reconstruction in more sittings.

Authors report, based on a retrospective examination of 103 dislocated hips of 85 children, on experiences with the overhead treatment of congenital hip dislocations, resistant to Pavlik harness or lately recognized. The results are compared with those of 23 hips of 20 children treated with Pavlik harness and plaster casts. Follow-up time was 3-15, in average 7 years. It is stated that the overhead extension treatment not followed by stiff fixation resulted in 92 per cent reduction in resistant and lately recognized hip dislocations. This procedure has caused in only 4 per cent severe necrosis of the femoral head with lasting consequences. Their experience with Pavlik harness combined with plaster cast are unfavourable as in 4 of 23 hips treated subtotal, in another 7 partial femoral head necrosis has developed.

Author reports on experiences gained during 10 years the diaphyseal fractures in childhood. Whereas certain types of fracture near to the joints have a generally accepted absolute operative indication, the surgery in diaphyseal fractures is rarely held to be indicated. Osteosynthesis was performed in 18 per cent of all cases. Surgery is thought to be indicated in open fractures, in fractures that cannot be reduced or that are unstable, in polytrauma and in bilateral cases. In closed fractures plate osteosynthesis, in severe open fractures the fixateur externe was found to be the best solution. In certain cases Kuntscher nailing of the femur, medullary splinting of the lower arm or diafixation of the lower leg are performed in older children.

Authors report on a new osteosynthesis based on the double nailing of femoral neck fracture and screwing, and developed from the "Uppsala" double screwing. The preliminaries of the double cannulated screwing method, its advantages, the experiences gained in 30 cases operated in one year and the early results are described.

As the literary data are contradictory, authors examined in 489 operated femoral neck fractures the significance of Garden's classification. Based on their material it was found that this classification gives help in the judgement of the single fractures and in the choice of the adequate treatment. For a more exact assessment however they think the consideration of the lateral Roentgenograms also necessary.

Authors analyse the 1684 bicycle accidents, observed in the county Vas in one year, compared with the international data. It is underlined that no sufficient attention is given to the bicycle accidents, reaching 6 per cents of all traumas, and the increase of which can be still expected, and to the prophylaxis of these accidents. Especially endangered were found the little children transported on bicycles, those aged 11-14 years and the drunken drivers. Prophylactic measures are suggested.

Authors used for the supplementation of the soft parts of the lower extremity reversed fasciocutaneous flaps in 8 cases; 6 of them were burned patients. In the Hungarian literature no paper on the use of distally pedicled flaps was published until now.