Beitrage zur Orthopadie und Traumatologie最新文献

The fracture of the femur near the hip-joint as the typical fracture in the higher age is causing a high multi-morbidity. In the period 1969-1986 821 patients have been attended to. The application of methods of operation which are stable under charge have led the reducing the fatality and the duration of stationary medical attendance and to better functional early results.

In patients looking out for a total hip replacement so called "silent thrombosis" were recognised (8 of 168 examined patients) by the help of preoperative unilateral phlebography of the leg. Postponing these patients from operation the decrease of postoperative complication (thrombo-embolism) was only small. After critical analysis our invasive method cannot recommended as a screening. In a modified way we will continue this method in high risk patients.

The arthroscopic surgery of articular cartilage of the knee is beside conservative therapy and invasive surgical procedures an important enrichment in treatment of chondromalacia stage II and III. In the Department of Surgery of the Municipal Hospital of Berlin-Weissensee 3250 arthroscopic operations were performed between January 1983 and December 1988. In 227 patients chondromalacia stage II and III was found which had to be treated by arthroscopic surgery. Four different operation methods were used.

A compartment-syndrome can't be provoked experimentally in the upper arm sphere. The pressure does not change in adjoining spheres. In the tibial-anterior-loge enormous pressure values are reached by the extension of volume but adjoining and subcutaneous spheres are hardly influenced.

150 knees were re-examined after operative therapy because of chondromalacia patellae. We found good and very good results in 52.7%. The results after lateral release were statistically significant better than the results after after the other methods. Because of 82% good results the lateral release operation can be recommended.

Since 1984 the perioperative prophylaxis was carried out using the antibiotics Oxacillin or Halospor in artificial joint replacement of the hip. We started with 1 g Oxacillin at the very beginning of the anaesthesie. Further 0.5 g Oxacillin were administered 2 and 6 hours later. 964 hip joints operated between 1982-1988 were followed up. We observed a marked decrease of the rate of infection from 7.2% to 1.0% after the introduction of the perioperative prophylaxis.

We studied the importance of internal diseases in 110 patients with an age of more than 70 years. Most of the patient (85%) were handicapped by several diseases with an increasing of the operative risk. Special importance has the prophylaxis of thromboembolism and the elimination of essential local infect. In this way it is possible to avoid essential postoperative complications. There is nearly no restriction of the older patients in reference to the endoprosthesis of the hip if we notice the risk factors and the optimal pre-, intra- and postoperative treatment of the patients.

In case of 380 patients (286 operated), who were followed up, we will prove the usefulness of an already some years ago by us recommended step-program with timely, personal and economically defensible expense for opportune and complete diagnosis of frequent fibular ligamentous injuries in the ankle joint. Measurements of x-rays in stress are demonstrated, also principles of treatment including operative-technical details. Only consistent measures offer good prerequisites for healing with restored function.

The Leukocyte-Migration-Test (LMT) is a sensitive method for the proof of metal sensitivity in organism. There were no difference in the sensitivity of chromium, cobalt and/or nickel in 42 patients suffering for coxarthrosis and 41 patients after total hip replacement. We found no connection between metal sensitivity and loosening of artificial hip joints in two groups of patients suffering as well from metal sensitivity as from loosening of the artificial hip joint.

A total of 175 cases of valgus tibial head corrective osteotomy were carried out from 1973 till 1983 and 1988 respectively. It's long term results and the short term results were respectively compared. The importance of the preoperative planning, attention to the operation's indications and operating at the early stage of the complaint were found to be the most important factors for good results.