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

Authors, based on the experience gained from the operative therapy of a 9 year old child with inveterated Monteggia injury, discuss the types, the diagnosis and the principles of treatment of this injury. They take the part of urgent treatment following early diagnosis as the results of the treatment of the non-fresh cases are generally less favourable.

In the Boitchev-Andreiev operation the tip of the coracoid with the muscles having their origin here, is chiselled and after a transduction under the subscapular muscle it is refixed to its original place. One relapse from 28 cases was found in a mean follow up time of 3 years, in 2 cases subluxation was found. The average limitation of lateral rotation was 6.4 degrees. In the total follow-up out of 28 cases 23 could be classified as good, 3 adequate and 2 poor.

Authors report on clinical experiences gained with the two stage flexor tendon transplantation described by Hunter. Their modifications are described and the results given in details. They touch also upon the indications of the procedure considering the preoperative evaluation. Other procedures are also offered for injuries with bad prognosis and the future trends of investigation, held to be important, are mentioned.

Authors describe briefly the history of the development of elbow arthroplasty. They report on their experiences with the silicone, cementless, unconstrained elbow prosthesis developed by them and implanted in 23 cases during 3 years. The prosthesis is described, the operative indication and the problems of the operative technique are reviewed. On the basis of their results and the low number of complications this method of operation is suggested first of all for the successful treatment of elbows with rheumatoid arthritis.

Authors suggest, in their paper, a new method in this country, the so called brace treatment for the functional treatment of the diaphyseal fractures of the humerus. A 2-4 fifth of the diaphyseal fractures of the humerus can be treated in the majority with this method. An other novelty of this treatment is the humerus brace developed and manufactured in Hungary. This fracture treatment has unequivocal advantages both for the health service and the patient for its shorter duration of healing and treatment.

The therapy of the diseases of the infected hand belongs to the most difficult tasks of the hand surgery. In the county Bács-Kiskun we have reached important results during the last two decades, described in this paper, together with the Hand Surgery Work Groups of the Accident Departments of Kecskemét (County Hospital), Baja and Kiskunhalas.

In 1981 through 1989 authors performed 160 complex reconstruction operations for instability of the knee joint according to the basic principles of W. Müller, striving to restore all structures injured. 92 patients with 378 operations were controlled. The assessment of the results was based on the physical examination, the measurement of ligament laxity with the K 1000 arthrometer, the opinion of the patients, the level of their activity and Lysholm's functional point system was used. The stability of the knee could be restored in 73 per cent of the cases. The patients have thought the knees, found more stable with the arthrometer, really more stable. There was however no unambiguous relation between the knee stability and the level of activity of the patients. The most frequent complaint was pain, increased synovial fluid and the hindrance of squatting. The results were better if the patient had no previous operation in an other department and in those who did not need menisectomy, who had less operations, less body weight and better muscular force.

Authors have found in a 1 year survey in the county Vas 7580 hand injuries. The major proportion of young men and adolescents in the material was conspicuous. The types of accidents were investigated together with the place of the accident and types of the injury. The material shows that in contrary to the accidents of the work in the recent past the number of the accidents at home has increased--and so their prophylaxis became the main point.

Authors report on the result of correction osteotomies in 31 cases of gonarthrosis, developed in consequence of valgus deformity. In 12 cases high tibial osteotomy, in 19 supracondylar femoral osteotomy were performed. The result was excellent in 15, good in 10 and poor in 6 patients. Decisive factors of the favourable result were partly the correction of the femorotibial valgus to around the physiological values, partly the horizontalization of the articular surface. In overcorrection the results deteriorate. The medial tilt of the tibial articular surface leads to the progression of the arthrosis. Supracondylar femoral osteotomy was found especially successful in the treatment of valgus gonarthrosis. High tibial osteotomy is suggested only in selective cases.