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

Authors have followed 754 patients with hip fracture and have found that about 60 per cent of them are alive after one year; their functional state further improved between 4 months and 1 year, it cannot be however considered as satisfactory even after one year. Analysing the operations performed in femoral neck and trochanteric fractures it should be stated that the operative indications are generally adequate and the conditions of further improvement are defined. More significant improvement of the lasting results can be expected from a well organized rehabilitation.

Author reports on a case of ectopic bone formation in the Achilles-tendons and reviews the literature. The pathologic change was caused probably by the chronic mechanical irritation suffered during the conservative treatment of the club feet. The continuity of the ossified mass was interrupted similarly to a fracture; the function was restored after an "osteosynthesis".

Authors report on the substitution of in consequence of complete talus luxation, missing talus. It succeeded with the transplantation of a free vascular pedicled bone block, gained from the crista ilei to retain the length of the extremity and to secure the gait of the patient without aid, finally to make the return to the former active life possible. The use of the method in similar cases was found to be unknown after a review of the literature. This case is an example demonstrating the growing significance of microsurgery in the traumatology.

Author recalls the nearly four decades education activity of the National Institute of Traumatology and the Chair of Traumatology of the Postgraduate University of Medicine. The importance of the high standard therapeutical activity is stressed. Similarly the education based on scientific activity is also thought indispensable. He describes the technical conditions and the data of the more important courses.

Authors have compared two kind of exposures of the flexor tendons. The results were assessed by measuring the flexion oft the given finger on pulling, by light and electron microscopic examination. It was found that in fingers where the tendon sheat was detached from the subcutis the scarring was greater and its effect, limiting the motion has its maximum on the fourth postoperative week. It is raised that the role of the tendon sheat in respect of the success of the flexor tendon reconstruction is mainly mechanic and most effective if its highly integrated connection with its surrounding is not disturbed.

The extent of correction achievable by inclined subcapital osteotomy of the metatarsus I. was studied in 100 cases of the deformation. The different angular values and dimensions were compared in the X-ray plates taken pre- and postoperatively and the clinical changes of the patients were evaluated on the basis of subjective complaints and objective symptoms. The angular limit values of the performability of osteotomy were determined. In deformations larger than the limit values wedge and half-wedge osteotomy, basisosteotomy, respectively, are the expedient methods.

Authors report on the successful operative treatment, 15 years after the development of a pseudarthrosis, following the fracture of the lateral femoral condyle and causing knee instability. In this case the refreshing of the avascular pseudarthrosis gap reduction and screw osteosynthesis were performed. The basic principles of the distribution and treatment of pseudarthrosis are reviewed. Attention is called to the importance of exact reduction and stable fixation and to the fact that reconstruction can be carried out even long after the injury.

The review of the occurrence, etiopathology, classification and diagnosis of the aseptic necrosis of the femoral head is followed by the description of the method of transplantation of the vascular pedicled bone graft. During 5 years implantation of 12 vascular pedicled bone grafts in 10 young patients with severe and of major extension necrosis of the femoral head was carried out. The early result was in every case the quick and significant decrease of pains and that the necrosis did not progress. In the early stage the severe consequence of the necrosis the collapse can be prevented with core decompression. In a later stage the vascular pedicled revascularization of the femoral head may retain in young patients, beside adequate hip movements, the gait and the working capacity. This, though it is not a final solution, will give chance by gaining time to perform prosthesis operations later.

Authors described the development of the construction of fixateur externes supported by historical facts, analyse the biomechanical problems of the fixateur osteosyntheses, illustrated by drawings. They propose mountings, of modern montage proving its rightness. Finally a collection of synonyms is given to clear the nomenclature of the several montages.

Authors describe the cases of two patients, suffering from the rare, however frequently not diagnosed real writing spasm. In these patients surgery brought healing or significant improvement. After a review of the literature the symptoms, the possibilities of diagnosis and therapy are described. With their paper they want to call attention to this not well known disease.