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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Unfallchirurg 99 (1996), S. 616-627 
    ISSN: 1433-044X
    Keywords: Schlüsselwörter: Komplexes Knietrauma ; Distale Femurfraktur ; Proximale Tibiafraktur ; Kniegelenkluxation ; Key words: Complex knee injury ; Supracondylar femoral fracture ; Tibia plateau fracture ; Knee dislocation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-044X
    Keywords: Schlüsselwörter: Zielgerät zur distalen Verriegelung ; Unaufgebohrter Tibianagel ; Implantationsbedingte Nagelverformung ; Röntgenmorphometrische Untersuchung ; Key words: Aiming device for distal locking ; Unslotted tibial nail ; Implant deformation ; Radiographic ; Morphometric investigation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: n = 10; diameter 9 mm, n = 10) were inserted in paired human cadaver tibiae. The results showed lateral translations of –4.5±3.5 mm (mean and standard deviation, range 14.3 mm) and dorsal translations of –7.8±5.8 mm (mean and standard deviation, range 19.2 mm). Rotational deformations around the longitudinal axis of the nail were 0.3±0.7° (mean and standard deviation, range 2.4°). The results showed, that a simple aiming arm, mounted on the proximal nail end, alone or even in combination with a large working channel (e.g. 10 mm in diameter), was not adequate to the aiming process. A radiographic-morphometric analysis was subsequently performed in 40 tibiae after experimental (n = 20) or clinical (n = 20) implantation of nails 8 mm and 9 mm in diameter. These measurements showed a relatively constant distance between the upper distal transverse hole and the anterior aspect of the tibia (average 12.3 mm and only a narrow range (7.6 mm). These data were the basis for the development of an aiming technique that exploits the relatively constant distance between the distal nail hole and the anterior aspect of the tibia. This aiming device is set at a distance of 12.3 mm from the anterior cortex, and the fine tuning is finally resolved by the use of a `working channel' 10 mm in diameter.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Unaufgebohrter Tibianagel ; Distale Verriegelungsbohrung ; Röntgenbildverstärker ; Key words Unreamed tibia nail ; Distal locking ; Image intensification
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: An aiming technique for an unreamed tibial nail was developed, which uses the relatively constant distance between the first transverse distal nail hole and the anterior aspect of the tibia. This aiming device is set at a distance of 12.3 mm from the anterior cortex, and fine tuning is finally resolved by use of a ``working channel'' with a 10 mm diameter from the medial side. The aiming system was tested in 20 cases in a video-documented prospective study using the unreamed tibial nail (UTN, Synthes) between July 1993 and March 1995. In all cases (100%) distal locking could be performed without image intensification. With a high percetange (55%) of open fractures (3 O3B fractures) the total operation time was 108 min (median, range 60 – 180 min). The time for distal locking (always 3 bolts) was 15.5 min (median, range 8.0 – 39.0 min), while the time for proximal locking (average 1.6±0.7 bolts) was 4.5 min (median, range 3.0 – 15.0 min). There were no major intra- or postoperative complications related to the aiming system. The major advantages are that it is not necessary to have image intensification for distal locking, there is a reduction in radiation exposure for the surgeon, and the drill holes are very precise.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Der Unfallchirurg 99 (1996), S. 615-615 
    ISSN: 1433-044X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Der Unfallchirurg 99 (1996), S. 815-815 
    ISSN: 1433-044X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European spine journal 5 (1996), S. 63-70 
    ISSN: 1432-0932
    Keywords: Odontoid fracture in children ; Synchondrosis ; Operative treatment ; Follow-up ; Biomechanics ; Child seat restraint
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Odontoid “fractures” in young children typically involve the cartilaginous plate (synchondrosis) that separates the odontoid process from the body of the axis; 58 cases have been described in the literature. We report two cases in which 2-year-old children were involved as backseat passengers in head-on motor vehicle accidents, both were restrained by four-point child's seat harnesses. A biomechanical investigation was carried out using simulation in a real car crash test with a child dummy. This revealed that head-on collisions with a speed absorption of at least 40 km/h are the typical mechanism of injury in children under the age of 3 years involved in motor vehicle accidents. Shearing force is all that is necessary to explain the dens fracture. Both children were immediately symptomatic, and the diagnosis was obvious on radiographs. Neither child had neurological deficit, which correlates well with the literature, where neurological injuries were found only in conjunction with head injuries. After closed reduction, both cases were initially trated conservatively with halo and plaster vest for 12 weeks. In one case, in which the anterior dislocation was less than the diameter of the odontoid shaft, eventless healing occurred. In our second case, despite an anatomic reduction, the odontoid fracture failed to unite. After a temporary posterior fixation of C1/C2 we reamed the synchondrosis from anterior and performed autogenous bone grafting. The posterior fixation wire was removed after 5 months. In contrast to the literature, we do not recommend a permanent posterior fusion of C1/C2. Our two young patients were both followed-up for more than 3 years. Clinical and radiological examination at final follow-up was normal with no signs of atypical growth of the odontoid. In cases of major dislocation with greater instability we recommend primary open reduction and osteosynthesis with appropriate implants. This was done in a third case: a $$1{\raise0.5ex\hbox{$\scriptstyle 1$}\kern-0.1em/\kern-0.15em\lower0.25ex\hbox{$\scriptstyle 2$}}$$ -year-old boy who fell down the stairs and sustained a head injury and an unstable lesion of the odontoid with subtotal paraplegia. The odontoid was fixed with two screws.
    Type of Medium: Electronic Resource
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