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  • 1
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To find out whether retrograde nailing of distal femoral fractures is beneficial for the aged patient, we performed a prospective study of consecutive patients 65 years or older with distal femoral fracture treated with a retrograde femoral nail between 1 March 1993 and 30 April 1996 in our department. In total, 26 patients with unilateral distal femoral fractures had been treated in our department, and 24 patients had been followed up for more than 12 months. All fractures had healed. Six patients did not walk before the injury. According to the Neerscore we counted 10/18 excellent results (≥ 85 points), 6/18 good results (≥ 70 points), 2/18 fair results (≥ 55 points) and no failures (〈 55 points). Retrograde intramedullary nailing makes a biological osteosynthesis of distal femoral fractures possible. Even in our aged patients good functional results could be obtained. Poor hold of the distal interlocking screws and difficult proximal locking are the two major technical problems encountered with this implant. Early weight-bearing is not advisable.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 108 (1989), S. 238-242 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Etagenfraktur des Tibiaschaftes entsteht immer nach einem hochenergetischen und direkten Trauma. Sehr oft sind schwere Begleitverletzungen der Weichteile vorhanden und die Durchblutung des intermediären Knochensegmentes ist schwer gestört. Die postoperativen Probleme von 40 Patienten mit 41 Etagenfrakturen des Tibiaschaftes wurden nachgesehen. 23 Frakturen (56,1%) wurden mit einer Plattenosteosynthese, 18 (43,9%) mit einer äußeren Fixation versorgt. 37 Frakturen konnten bis zur Knochenheilung nachverfolgt werden. Frakturheilungsstörungen wurden in 29% gesehen, immer in der distalen Fraktur. Ein gutes funktionelles Ergebnis konnte in 78,4% erreicht werden. Die spezifischen Probleme jeder Stabilisierungsmethode werden besprochen. Die Durchblutung des intermediären Knochensegmentes darf durch das Osteosyntheseverfahren sicherlich nicht gefährdet werden.
    Notes: Summary Segmental fractures of the tibial shaft are always caused by a high-energy direct trauma. They are frequently associated with important soft tissue injuries, and the vascularization of the intermediate bone fragment is severely disturbed. The postoperative problems of 40 patients with 41 segmental tibial shaft fractures were reviewed. Twenty-three fractures (56.1%) were treated with a plate osteosynthesis, 18 (43.9%) with an external fixator. Thirty-seven fractures could be followed-up until bony consolidation. Bone-healing problems were seen in 29%, always in the distal fracture. A good functional result, could be obtained in 78.4%. The problems of each stabilization method are discussed. The vascularization of the intermediate segment may not be endangered secondarily by the stabilization procedure.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 111 (1992), S. 73-77 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Radiotherapy and chemotherapy will result in an increase in the number of pathological fractures that occur, principally as a consequence of metastatic disease. These lesions are painful, especially at the level of the femur, and are apt to make invalids of the patient. If surgical intervention is applied as quickly as possible, (compound double-plate osteosynthesis or endoprosthesis), preferably before the lesion becomes a real fracture, the patient still has a chance of keeping a good, painless and well-functioning limb. This report concerns 40 patients with 48 pathological femoral fractures. Seventy-five percent of the lesions were localised at the level of the proximal extremity (femoral head or neck, trochanteric region, subtrochanteric region). Twenty cases were treated with an endoprosthesis, 28 by osteosynthesis; 4 patients died within the 1st month after surgery. In two of them, the data when considered postfacto were judged to show that any surgery would be too risky. Forty-five percent of patients survived for more than 1 year after operation. The average survival time of the whole group was slightly over 10 months. One patient is still going strong more than 35 months after surgery. Survival time was essentially dependent on the primary underlying malignant process. The results obtained have been more than reasonable: in 67% recovery of walking capacity, in 75% an effective fight against the pain.
    Type of Medium: Electronic Resource
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