Pub Date : 2013-03-14DOI: 10.1024/1023-9332.7.6.243
Scheunemann, Hosch, Kutup, Izbicki
Die Einfuhrung von immunhisto-/zytochemischen und molekularbiologischen bzw. zytogenetischen Methoden in der onkologische Forschung hat trotz vieler nach wie vor bestehender offener Fragen insgesamt zu einem besseren Verstandnis der genetischen Ursachen der Tumorentstehung gefuhrt. Daruber hinaus ergaben sich in verschiedenen Studien Hinweise fur eine prognostische Relevanz von bestimmten (zyto)genetischen Veranderungen bzw. residualen Tumorzellen in Lymphknoten oder Knochenmark. Bevor diese Untersuchungen jedoch in den klinischen Alltag Einzug halten und therapeutische Konsequenzen abgeleitet werden konnen, sind weitere prospektive Studien mit groaen Patientenfallzahlen sowie vereinheitlichte und methodologisch praktikable Untersuchungstechniken zu fordern.
{"title":"Molecular Markers for Colorectal Cancer","authors":"Scheunemann, Hosch, Kutup, Izbicki","doi":"10.1024/1023-9332.7.6.243","DOIUrl":"https://doi.org/10.1024/1023-9332.7.6.243","url":null,"abstract":"Die Einfuhrung von immunhisto-/zytochemischen und molekularbiologischen bzw. zytogenetischen Methoden in der onkologische Forschung hat trotz vieler nach wie vor bestehender offener Fragen insgesamt zu einem besseren Verstandnis der genetischen Ursachen der Tumorentstehung gefuhrt. Daruber hinaus ergaben sich in verschiedenen Studien Hinweise fur eine prognostische Relevanz von bestimmten (zyto)genetischen Veranderungen bzw. residualen Tumorzellen in Lymphknoten oder Knochenmark. Bevor diese Untersuchungen jedoch in den klinischen Alltag Einzug halten und therapeutische Konsequenzen abgeleitet werden konnen, sind weitere prospektive Studien mit groaen Patientenfallzahlen sowie vereinheitlichte und methodologisch praktikable Untersuchungstechniken zu fordern.","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57220094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-07DOI: 10.1024/1023-9332.7.3.141
E. Gygax, P. Berdat, T. Carrel
We report on a patient suffering from Budd-Chiari disease who developed heparin-induced thrombocytopenia preoperatively. Dorsocranial liver resection and hepatoatrial anastomosis were performed with the extracorporeal circulation and perioperative anticoagulation was achieved with r-hirudin. Surprisingly, thrombus formation was observed in the venous reservoir although intraoperative anticoagulation values were within the targeted level. An additional bolus of hirudin and rinsing the reservoir allowed unproblematic discontinuation of the cardiopulmonary bypass.
{"title":"[Challenging perioperative anticoagulation in a patient with Budd-Chiari syndrome and heparin-induced thrombocytopenia].","authors":"E. Gygax, P. Berdat, T. Carrel","doi":"10.1024/1023-9332.7.3.141","DOIUrl":"https://doi.org/10.1024/1023-9332.7.3.141","url":null,"abstract":"We report on a patient suffering from Budd-Chiari disease who developed heparin-induced thrombocytopenia preoperatively. Dorsocranial liver resection and hepatoatrial anastomosis were performed with the extracorporeal circulation and perioperative anticoagulation was achieved with r-hirudin. Surprisingly, thrombus formation was observed in the venous reservoir although intraoperative anticoagulation values were within the targeted level. An additional bolus of hirudin and rinsing the reservoir allowed unproblematic discontinuation of the cardiopulmonary bypass.","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"22 1","pages":"141-4"},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86057676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-07DOI: 10.1024/1023-9332.7.5.225
Rosenthal, Vogelbach
Pankreaspseudozysten sind selten im Kindesalter. Sie sind in 80% der Falle traumatisch bedingt. Anhand eines Fallberichtes diskutieren wir die Therapie von Pankreasverletzungen und der daraus resultierenden Pseudozysten beim Kind.
{"title":"Posttraumatic Pancreatic Pseudocyst in Children - Case Report and Discussion","authors":"Rosenthal, Vogelbach","doi":"10.1024/1023-9332.7.5.225","DOIUrl":"https://doi.org/10.1024/1023-9332.7.5.225","url":null,"abstract":"Pankreaspseudozysten sind selten im Kindesalter. Sie sind in 80% der Falle traumatisch bedingt. Anhand eines Fallberichtes diskutieren wir die Therapie von Pankreasverletzungen und der daraus resultierenden Pseudozysten beim Kind.","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57220074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-07DOI: 10.1024/1023-9332.7.1.32
M. Niedergethmann, R. Hildenbrand, M. Winkler
Liposarcomas comprise about 20% of soft tissue sarcomas and occur in 14% in the retroperitoneal space originating in one third from the perirenal fat. The case of a patient with an extraordinary huge, resectable, well-differentiated retroperitoneal liposarcoma is reported. The presenting symptoms were abdominal pain and distension as well as weight gain. Magneticresonance imaging revealed a huge retroperitoneal tumor suspected of well-differentiated liposarcoma. Curative resection of the tumor could be obtained. Only 50% of all tumors are excised without residual tumor and recurrence, occurring in 90% after 10 years, is the main therapeutic challenge. Since neoadjuvant and adjuvant therapy as well as intraoperative radiotherapy failed to prove prognostic value, curative resection remains the main treatment for primary and recurrent liposarcomas.
{"title":"[Monstrous, retroperitoneal liposarcoma--a case report].","authors":"M. Niedergethmann, R. Hildenbrand, M. Winkler","doi":"10.1024/1023-9332.7.1.32","DOIUrl":"https://doi.org/10.1024/1023-9332.7.1.32","url":null,"abstract":"Liposarcomas comprise about 20% of soft tissue sarcomas and occur in 14% in the retroperitoneal space originating in one third from the perirenal fat. The case of a patient with an extraordinary huge, resectable, well-differentiated retroperitoneal liposarcoma is reported. The presenting symptoms were abdominal pain and distension as well as weight gain. Magneticresonance imaging revealed a huge retroperitoneal tumor suspected of well-differentiated liposarcoma. Curative resection of the tumor could be obtained. Only 50% of all tumors are excised without residual tumor and recurrence, occurring in 90% after 10 years, is the main therapeutic challenge. Since neoadjuvant and adjuvant therapy as well as intraoperative radiotherapy failed to prove prognostic value, curative resection remains the main treatment for primary and recurrent liposarcomas.","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"6 1","pages":"32-5"},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72559670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
But du travail: La chirurgie de revascularisation myocardique minimale invasive est fondamentalement differente de la methode classique sous circulation extra-corporelle (CEC). Elle oblige a de nombreuses adaptations tant operatoire, qu'anesthesiologique et post-operatoire. Nous evaluons l'effet eventuel d'une phase d'apprentissage sur les resultats a court terme de cette nouvelle technique. Methode: Nous presentons notre experience de 20 patients ayant beneficies de cette approche de juillet 1997 a fevrier 1999, en comparant du point de vue chirurgical et post-operatoire, 2 collectifs successifs de 10 patients chacun (groupe 1: 8H2F; 59.6 +/- 13.8 ans) aux 10 derniers (groupe 2: 8H/2F; 63.2 +/- 6.1 ans). Discussion: La progression est remarquable du point de vue operatoire et post-operatoire: Le temps de clampage de l'IVA est passe de 28.5 +/- 2.4 min. a 22.2 +/- 1.8 min. (p < 0.05) et le temps operatoire est passe de 125 +/- 4 a 97 +/- 5 min. (p < 0.005). La morbidite post-operatoire a regresse avec un ...
{"title":"Coronary Bypass via a Mini-Thoracotomy: Advantages Become Evident with the Growing Experience of the Medical Team","authors":"Tevaearai, Mueller, Chastonay, Favre, Ravussin, Eckert, Vogt, Delabays, von Segesser, Stumpe","doi":"10.1024/1023-9332.7.1.16","DOIUrl":"https://doi.org/10.1024/1023-9332.7.1.16","url":null,"abstract":"But du travail: La chirurgie de revascularisation myocardique minimale invasive est fondamentalement differente de la methode classique sous circulation extra-corporelle (CEC). Elle oblige a de nombreuses adaptations tant operatoire, qu'anesthesiologique et post-operatoire. Nous evaluons l'effet eventuel d'une phase d'apprentissage sur les resultats a court terme de cette nouvelle technique. Methode: Nous presentons notre experience de 20 patients ayant beneficies de cette approche de juillet 1997 a fevrier 1999, en comparant du point de vue chirurgical et post-operatoire, 2 collectifs successifs de 10 patients chacun (groupe 1: 8H2F; 59.6 +/- 13.8 ans) aux 10 derniers (groupe 2: 8H/2F; 63.2 +/- 6.1 ans). Discussion: La progression est remarquable du point de vue operatoire et post-operatoire: Le temps de clampage de l'IVA est passe de 28.5 +/- 2.4 min. a 22.2 +/- 1.8 min. (p < 0.05) et le temps operatoire est passe de 125 +/- 4 a 97 +/- 5 min. (p < 0.005). La morbidite post-operatoire a regresse avec un ...","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57219359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-07DOI: 10.1024/1023-9332.8.1.31
Hetzer, Schäfer, Demartines, Clavien
Einleitung: Mit der Stapler-Hamorrhoidektomie (SH) ist ein neues Verfahren zur Behandlung der prolabierenden Hamorrhoiden entwickelt worden. Uber Lernkurve, Komplikationsrate und Langzeitverlauf gibt es bis heute nur wenige Berichte in der Literatur. Wir haben deshalb unsere Patienten prospektiv erfasst und ambulant nachkontrolliert. Methoden: Von Marz 1999 bis Mai 2001 wurde bei 61 Patienten mit Hamorrhoiden II (n = 18), Grad III (n = 38) und Grad IV (n = 5) nach schriftlicher Einwilligung eine SH durchgefuhrt. Operationszeit und perioperative Komplikationen wurden prospektiv erfasst und mit der Erfahrung des Operationsteams korreliert. Anhand der visual analogue scale (VAS) konnte die postoperative Schmerzintensitat gemessen werden. Mittels pra- und postoperativ erhobenen Inkontinenzscore nach Williams und der histologischen Untersuchung des Exzisates wurde nach Sphinkterlasionen gesucht. Ambulante Nachkontrollen erfolgten nach drei Wochen und drei Monaten. Ergebnisse: Operationsdauer und Komplikationsr...
{"title":"The Learning Curve and Clinical Safety of Stapled Haemorrhoidectomy: A Prospective Study of 61 Patients","authors":"Hetzer, Schäfer, Demartines, Clavien","doi":"10.1024/1023-9332.8.1.31","DOIUrl":"https://doi.org/10.1024/1023-9332.8.1.31","url":null,"abstract":"Einleitung: Mit der Stapler-Hamorrhoidektomie (SH) ist ein neues Verfahren zur Behandlung der prolabierenden Hamorrhoiden entwickelt worden. Uber Lernkurve, Komplikationsrate und Langzeitverlauf gibt es bis heute nur wenige Berichte in der Literatur. Wir haben deshalb unsere Patienten prospektiv erfasst und ambulant nachkontrolliert. Methoden: Von Marz 1999 bis Mai 2001 wurde bei 61 Patienten mit Hamorrhoiden II (n = 18), Grad III (n = 38) und Grad IV (n = 5) nach schriftlicher Einwilligung eine SH durchgefuhrt. Operationszeit und perioperative Komplikationen wurden prospektiv erfasst und mit der Erfahrung des Operationsteams korreliert. Anhand der visual analogue scale (VAS) konnte die postoperative Schmerzintensitat gemessen werden. Mittels pra- und postoperativ erhobenen Inkontinenzscore nach Williams und der histologischen Untersuchung des Exzisates wurde nach Sphinkterlasionen gesucht. Ambulante Nachkontrollen erfolgten nach drei Wochen und drei Monaten. Ergebnisse: Operationsdauer und Komplikationsr...","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57219746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-07DOI: 10.1024/1023-9332.7.2.82
A. Oesch, K. Küpfer, A. Bodoky
The intercostal nerve syndrome is caused by an impingement of the intercostals nerve at the level of the anterior rectus sheath. It may lead to acute or chronic abdominal pain, it should therefore be considered in the differential diagnosis of the acute or chronic abdomen. A positive Carnett-test and an effective local anaesthesia at the point of maximal tenderness allow the correct diagnosis. In our retrospective study 14 patients with 15 entrapment syndromes are described. If, sometimes after a few diagnostic and therapeutic detours, the diagnosis is established, surgical intervention with resection of the altered nerve at it's exit of the anterior rectus sheath can usually abolish the pain with little side effects.
{"title":"[Intercostal nerve syndrome].","authors":"A. Oesch, K. Küpfer, A. Bodoky","doi":"10.1024/1023-9332.7.2.82","DOIUrl":"https://doi.org/10.1024/1023-9332.7.2.82","url":null,"abstract":"The intercostal nerve syndrome is caused by an impingement of the intercostals nerve at the level of the anterior rectus sheath. It may lead to acute or chronic abdominal pain, it should therefore be considered in the differential diagnosis of the acute or chronic abdomen. A positive Carnett-test and an effective local anaesthesia at the point of maximal tenderness allow the correct diagnosis. In our retrospective study 14 patients with 15 entrapment syndromes are described. If, sometimes after a few diagnostic and therapeutic detours, the diagnosis is established, surgical intervention with resection of the altered nerve at it's exit of the anterior rectus sheath can usually abolish the pain with little side effects.","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"8 1","pages":"82-5"},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78555100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stressfrakturen des Os cuboideum sind sehr selten. Meist werden diese Frakturen, wie in unserem vorliegenden Fall, bei ambitionierten Sportlern gesehen. Die geschilderten Symptome sind unspezifisch. Die Anamnese und die klinische Untersuchung, erganzt durch das konventionelle Rontgenbild, sollten einen Verdacht ergeben. Zur Diagnosesicherung konnen Knochenszintigraphie, Computertomogramm oder Magnetresonanz erforderlich werden. Therapeutisch steht die Ruhigstellung im Unterschenkelgehgips oder allenfalls mit konfektionierter Schiene im Vordergrund. Im vorliegenden Fall konnte auf konservativem Wege nach wenigen Wochen die Abheilung erzielt werden. Wichtig ist auch die Anpassung der weiteren sportlichen Aktivitaten, bei Bedarf erganzt durch fussorthopadische Massnahmen wie z.B. die Einlageversorgung, bzw. korrektes Schuhwerk. Besonders in Laufsportarten ist die Bedeutung der optimalen Schuhversorgung zur Behandlung oder Prophylaxe von Uberlastungsproblemen bekannt.
{"title":"Stress Fracture of the Cuboid Bone: A Rarity which Is Simple to Treat","authors":"Battaglia, Simmen, Meier","doi":"10.1024/1023-9332.8.1.3","DOIUrl":"https://doi.org/10.1024/1023-9332.8.1.3","url":null,"abstract":"Stressfrakturen des Os cuboideum sind sehr selten. Meist werden diese Frakturen, wie in unserem vorliegenden Fall, bei ambitionierten Sportlern gesehen. Die geschilderten Symptome sind unspezifisch. Die Anamnese und die klinische Untersuchung, erganzt durch das konventionelle Rontgenbild, sollten einen Verdacht ergeben. Zur Diagnosesicherung konnen Knochenszintigraphie, Computertomogramm oder Magnetresonanz erforderlich werden. Therapeutisch steht die Ruhigstellung im Unterschenkelgehgips oder allenfalls mit konfektionierter Schiene im Vordergrund. Im vorliegenden Fall konnte auf konservativem Wege nach wenigen Wochen die Abheilung erzielt werden. Wichtig ist auch die Anpassung der weiteren sportlichen Aktivitaten, bei Bedarf erganzt durch fussorthopadische Massnahmen wie z.B. die Einlageversorgung, bzw. korrektes Schuhwerk. Besonders in Laufsportarten ist die Bedeutung der optimalen Schuhversorgung zur Behandlung oder Prophylaxe von Uberlastungsproblemen bekannt.","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57219699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-07DOI: 10.1024/1023-9332.7.2.68
Ch. Sommer, L. Brendebach, R. Meier, A. Leutenegger
BACKGROUNDThe distal radius fracture is the most frequent fracture in the adult patient. The wide spectrum of different types of fracture and the coexisting factors make the choice for the optimal treatment difficult. As an interne quality control we retrospectively evaluated all patients with distal radius fractures treated in 1995 at our institution.METHODSThe study included 69 adult patients with 71 distal radius fractures. After on average 26 months 58 patients with 59 fractures were clinically and radiologically evaluated. The patients were asked to give supplementary information about their follow-up treatment as well as any remaining physical difficulties and limitations in the daily life. All x-rays of the broken radius were carefully analysed and compared with the opposite side. The final results were evaluated according to the "Demerit Point System".RESULTSPatients were treated with five different therapeutical methods. 76.3% of the patients showed a very good/good final result. In 56.7% of the cases secondary fracture dislocation occurred; the dislocation-rate of fractures treated with percutaneous k-wires was 93.3%! A clear correlation between secondary displacement and final results was found.CONCLUSIONA main factor for an optimal outcome is the anatomic restoration of length and axis of the distal radius as well as of joint congruency, also moderate angular deformities are well tolerated. Our collective showed an unexpected high rate of secondary displacement, especially in the k-wire group. The reasons for this unsatisfactory event are manifold: too optimistic indication, insufficient follow-up examination in the first four to six weeks, inconsequent change to a more stable fixation method in case of a secondary dislocation. The results of this retrospective evaluation had a major impact on our concept of treatment. The dorso-radial double-plate technique combined with bone graft will be more used in the future especially in younger patients. The new standardised concept is the base of a present prospective study.
{"title":"[Distal radius fractures--retrospective quality control after conservative and operative therapy].","authors":"Ch. Sommer, L. Brendebach, R. Meier, A. Leutenegger","doi":"10.1024/1023-9332.7.2.68","DOIUrl":"https://doi.org/10.1024/1023-9332.7.2.68","url":null,"abstract":"BACKGROUND\u0000The distal radius fracture is the most frequent fracture in the adult patient. The wide spectrum of different types of fracture and the coexisting factors make the choice for the optimal treatment difficult. As an interne quality control we retrospectively evaluated all patients with distal radius fractures treated in 1995 at our institution.\u0000\u0000\u0000METHODS\u0000The study included 69 adult patients with 71 distal radius fractures. After on average 26 months 58 patients with 59 fractures were clinically and radiologically evaluated. The patients were asked to give supplementary information about their follow-up treatment as well as any remaining physical difficulties and limitations in the daily life. All x-rays of the broken radius were carefully analysed and compared with the opposite side. The final results were evaluated according to the \"Demerit Point System\".\u0000\u0000\u0000RESULTS\u0000Patients were treated with five different therapeutical methods. 76.3% of the patients showed a very good/good final result. In 56.7% of the cases secondary fracture dislocation occurred; the dislocation-rate of fractures treated with percutaneous k-wires was 93.3%! A clear correlation between secondary displacement and final results was found.\u0000\u0000\u0000CONCLUSION\u0000A main factor for an optimal outcome is the anatomic restoration of length and axis of the distal radius as well as of joint congruency, also moderate angular deformities are well tolerated. Our collective showed an unexpected high rate of secondary displacement, especially in the k-wire group. The reasons for this unsatisfactory event are manifold: too optimistic indication, insufficient follow-up examination in the first four to six weeks, inconsequent change to a more stable fixation method in case of a secondary dislocation. The results of this retrospective evaluation had a major impact on our concept of treatment. The dorso-radial double-plate technique combined with bone graft will be more used in the future especially in younger patients. The new standardised concept is the base of a present prospective study.","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"17 1","pages":"68-75"},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79079854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-07DOI: 10.1024/1023-9332.7.4.184
Csizy, Hintermann
Obgleich hinlanglich bekannt ist, dass Steroide das Rupturrisiko von Sehnen erhohen, werden zur Behandlung der Achillodynie lokal infiltrierte Steroide immer noch angewandt. In den drei beschriebenen Fallen zeigt sich ein inadaquater Rupturmechanismus sowie intraoperativ nekrotische Veranderungen der Sehnenstruktur, welche an intakten Sehnen nicht gesehen werden. Alle Patienten werden operativ mit einer Rekonstruktionstechnik versorgt, wobei gesundes, korpereigenes Material zur Uberbruckung von bestehenden Gewebedefekten verwendet wird. Obschon in einem Fall eine relevante lokale Heilungsstorung eintritt, zeigen alle ein Jahr postoperativ gunstige Resultate mit voller Belastbarkeit und Sportfahigkeit.
{"title":"Achilles Tendon Rupture After Local Steroid Injection","authors":"Csizy, Hintermann","doi":"10.1024/1023-9332.7.4.184","DOIUrl":"https://doi.org/10.1024/1023-9332.7.4.184","url":null,"abstract":"Obgleich hinlanglich bekannt ist, dass Steroide das Rupturrisiko von Sehnen erhohen, werden zur Behandlung der Achillodynie lokal infiltrierte Steroide immer noch angewandt. In den drei beschriebenen Fallen zeigt sich ein inadaquater Rupturmechanismus sowie intraoperativ nekrotische Veranderungen der Sehnenstruktur, welche an intakten Sehnen nicht gesehen werden. Alle Patienten werden operativ mit einer Rekonstruktionstechnik versorgt, wobei gesundes, korpereigenes Material zur Uberbruckung von bestehenden Gewebedefekten verwendet wird. Obschon in einem Fall eine relevante lokale Heilungsstorung eintritt, zeigen alle ein Jahr postoperativ gunstige Resultate mit voller Belastbarkeit und Sportfahigkeit.","PeriodicalId":79425,"journal":{"name":"Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57220020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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