Magyar traumatologia, ortopedia, kezsebeszet, plasztikai sebeszet最新文献

The authors report cases of complex bilateral autologous breast reconstruction performed at one sitting after bilateral ablation as a result of non-malignant disease. During planning, as well as execution of the operations, up-to-date pre- and intraoperative examinations were employed in order to enhance to safety of the procedures.

Authors introduce the different methods in the treatment of Achilles tendon injury, including the "ordinary" surgical technique and the new method, using Tissucol. They point out the importance of indication and proper rehabilitation. Concerning the results and the complications they give evaluation of 98 patients.

The author gives a report on the lateral supramalleolar fasciocutan flap, supplied by the a. peronea perforans, according to Maquelet and the Valenti's modification is introduced as well. The indications are discussed on the experience of two cases, treating calcaneal skin defect.

Experiences gained in 106 reoperations of 88 patients following 1968 total and 18 Wagner arthroplasties, performed in the Department of the authors between 30. 05. 1969. and 30. 06. 1991., are described. They think that after the THR yearly control and radiological examinations are necessary. Radiological signs in symptomless patients do not mean operative indication, in these cases regular control is thought to be even more important. Big loss of bone with loosening makes reoperation in symptomless patients necessary as with the progression of bone destruction the danger of fracture increases and the possibility of reimplantation becomes dubious. In dubious cases bone scintigraphy may be of help. The technical solutions used by them are described. At the planning of reoperation the age of the patient, the state of the acetabulum and femur are considered. Under 60 years of age and at loosening with big bone loss cementless prosthesis and bone transplantation are suggested. The most important is thought to be to reach stable fixation. Attention is called that the performance of reoperation needs good technical skills.

Authors describe the results of 10 patients operated for avascular necrosis of the femoral head. The first operation was performed in October 1987. The follow-up was in average 41.9 (24-54) months, minimally 2 years. 7 patients improved, 2 deteriorated, 1 was unchanged. The analysis of the results showed that this operation is indicated only in strictly stated conditions.

26 cases of calcanconavicular coalitions were treated by resection of the calcanconavicular bar. The endresults were markedly influenced by the age at surgery, while there was no difference between the "bone" and "cartilage" group. The coalition must be recognised if someone examinates a rigid flatfoot.

Authors report on the control examinations of 108 patients on a peduncular system, known since 1986 and applied successfully in the operative treatment of various diseases of the lumbosacral spine. The results of healing of 69 patients in whom the fusion of the lumbosacral spine was performed because of long standing low-back pains are analysed. They describe also other possibilities given by the peduncular system, among others the correction and stabilization of the lumbar kyphosis in Becterew's disease, the postlaminectomy kyphosis and the lumbar scoliosis of adults. Cases of trauma and tumor in which this method of stabilization was also successfully used are also mentioned.

Authors report on the results of treatment in 19 patients, operated for avascular necrosis of the femoral head. The first operation was performed in October, 1989. The average follow-up was 28 (24-42) months, the minimal follow-up 2 years. The state of one patient grew worse, one was unchanged, the rest improved. Operation in early cases is suggested if less than 50 per cent of the femoral head is attainted.

Authors describe the acute treatment and the reconstruction of the face in the severe, multiple combined fracture of the facial bones. After the primary definitive care further reconstructive operations were performed. After one and half year treatment the functional and esthetic results are good.

Authors analyse their 233 cases of Scheuermann's disease, treated 1980 through 1990 and followed in average until the age of 18.5 years. The material is classified according to the radiological appearance. The assessment of the results was based on the decrease of the dorsal kyphosis, the change of the complaints and of the Radiograms. The efficacity of the braces used in various radiological type. The brace, resting on 3 points, is in atypical form ineffective, in classical appearance success may be expected in 30 per cent from its application. In severe cases, or cases treated only late a brace, resting on 3 points is used for the day and a Milwauke brace in the night. Its efficacity could be increased by the physiotherapeutic ceasing of the flexion contracture of the hip and shoulder and of the ischiocrural tension.