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

Author describes a case of calcification of the intervertebral disk in a child, observed simultaneously in two segments on the dorsal spine. During a long observation the signs of remission were observed. The case was thought worthy to be published because of the rare occurrence and the problematic differential diagnosis.

Authors have examined the optimal position of the wrist from the viewpoint of active motion during the postoperative care, after the suture of the flexor tendons of the hand. Based on clinical and cadaveric experiences a motion of the wrist (inverse) in contrary direction to the motion of the fingers is suggested i. e. flexion of the fingers in wrist extension and vice versa. The tendon injuries distally and proximally from the wrist are discussed separately.

Forty eight primary and 20 secondary chondrosarcomas were treated surgically 1975 through 1991. An evaluation of the data of the Bone Tumor Register of the Semmelweis Medical University proved that the incidence of the malignant transformation and development of secondary chondrosarcomas is 3% and 2.6% among solitary osteochondromas. The authors summarize the clinicopathological characteristics of the malignant transformation. A retrospective evaluation of the histological grade of the malignancy proved that 67% of tumors were classified as grade I; 18% as grade II and 15% as grade III. The survival of the patients was mainly determined by the grade of the malignancy. A 95% 5-years survival was found in the grade I group and a 10% survival only in the grade II and III groups. In the cases of highly malignant chondrosarcomas radical surgical intervention i.e. amputation is recommended, considering the most often extra-compartmental location of the tumors. Low malignant and intra-compartmental highly malignant chondrosarcomas should be treated, however, by limb saving surgery. In the cases of large inresecable but low malignant chondrosarcomas debulking surgery is also acceptable.

Since 1st January 1986 the authors have been using Zadravecz's method for the classification and treatment of intraarticular calcaneal fractures. Evaluation of 132 cases: Based on their good results, they propagate the use of this method for the treatment of calcaneal fractures. After reviewing results covering a period of more than five years, they neither found late bone-height loss nor other complications.

Author describes a new method, the intraosseal compression loop, unknown until now in this country for the treatment of intraarticular, osteochondral fractures. The advantages of the new method are analysed, attention is called however to the fact, that it can be used only in the therapy of certain types of fractures and it can be only one from the great variety of procedures for the treatment of osteochondrial fractures. It is demonstrated with a few examples that the method can be used to treat unstable diaphyseal fractures too.

Authors report in connection with two cases, operated on with an operative procedure rather rare in the practice in this country. The deltoid paralysis, developed following the injury of the axillary nerve, was successfully treated with the transposition of the bony insertion of the trapezius muscle to the proximal part of the humerus.

Authors made a follow-up of the pilon fractures treated in the National Institute of Traumatology during the five years period of 1983 through 1987. 43 of them could be controlled after 4-8 years personally. A radiological follow-up result of at least 1-2 years was nearly in all cases available. The surgical therapy in this period was almost exclusively stable osteosynthesis. Fixateur externe was used only exceptionally. On the basis of their results it is thought that in the treatment of pilon fractures the stable osteosynthesis with exposure should have an important role in the future too.

Authors report on the results achieved with Sugioka's osteotomy in 20 cases. In the stage III or less and if the damage of the femoral head was less than 100 degrees, the result of the operation was good or excellent. The operation performed with adequate indication proved to be effective.

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.