[Clinical experience with collagenous wound dressing in severe traumatic soft tissue injuries]. / Klinische Erfahrungen mit einem kollagenhaltigen Wundverband bei schweren traumatisch bedingten Weichteilverletzungen.

We treated 34 patients during 1987-1990 with a collagen wound dressing. Eleven patients had traumatic soft tissue defects, 10 patients had 3 degrees-grade open fractures, 7 patients had infected soft tissue wounds and 6 patients had deep 2 degrees and 3 degrees-degree burns. Our clinical experience confirmed the excellent clinical experimental results of collagen wound dressings. In all cases after 4 until 6 days of treatment good granulation and vascularisation of the wound bed was obtained, so that a skin transplant could be performed, which in all cases healed primarily. Moreover, the wound dressing had a good antibacterial effect and integrated actively in the wound healing process.

[Postoperative nuclear magnetic resonance tomography of the talocrural joint after external syndesmorrhaphy]. / Postoperative kernspintomographische Untersuchung des oberen Spruggelenks nach Aussenbandnaht.

20 patients with acute traumatic rupture of the anterior talofibular ligament and ligamental suture were studied postoperatively by MRI. MR results were correlated with stress x-ray studies. We found a normal anterior talofibular ligament in eight cases. However, stress x-ray images showed normal stability of the ankle joint in eighteen cases. In six patients the anterior talofibular ligament was thickened, in another six cases it could not be separated from scar tissue. Therefore MR imaging of ankle ligaments did not allow a diagnosis of their function. Nevertheless, sequelae of the ankle trauma such as osteochondrosis, exudation into the ankle joint and tendovaginitis of the flexor muscles were sensitively visualised by MR.

[Perforation of a duodenal stress ulcer in a 7-year-old polytraumatized boy]. / Perforation eines Duodenal-Stressulkus bei einem siebenjährigen polytraumatisierten Jungen.

This is a report of a seven-year-old polytraumatised boy with perforation of a duodenal stress-ulcer. Aspects of the etiology and pathogenesis were discussed. The main therapeutical efforts by stress-ulcer risk patients consist in an early sufficient shock therapy and adequate stress-ulcer prophylaxis to prevent the origin of stress-ulcers and their complications like bleeding and perforation.

[Pathological fractures in childhood and adolescence in benign and semi-malignant bone tumors and tumorous and inflammatory bone changes]. / Pathologische Frakturen im Kindes- und jugendlichen Alter bei benignen, semimalignen Knochentumoren und tumorähnlichen sowie entzündlichen Knochenveränderungen.

The article reports on etiology, clinics and treatment of pathological fractures caused by benign, semimalign bone tumors as well as tumorlike lesions and inflammatory bone alterations in childhood. Our patients treated between the years of 1972 and 1986 were reexamined and the results reconsidered thoroughly. Of 47 children with pathological fractures 38 were treated surgically. The treatment consisted of tumor excision or milling out respectively, perforation of the excavation and its subsequent filling with autologous spongiosa combined with additional stabilization by osteosynthesis. With this surgical therapy 3 recurrent cysts were observed of which one resulted in a refracture. With the majority of the children the pathological fracture lead to the discovery of the tumor.

[Kidney carbuncle in a 9-year-old boy]. / Nierenkarbunkel bei einem 9-jährigen Jungen.

Report on a 9-year-old boy with right-sided renal carbuncle. The symptoms, diagnosis and treatment of the renal carbuncle are described. The possibility of maintaining the function and reconstructing the kidney through fibrin adhesive is discussed.

[Indications for various treatment procedures in the therapy of supracondylar humeral fractures in childhood]. / Indikationsbereiche der verschiedenen Behandlungsverfahren zur Therapie der suprakondylären Humerusfrakturen im Kindesalter.

In the time from 1972 through 1985 173 children with supracondylar fractures of the humerus were treated according to the fracture type with two upper arm plaster splints, nail extension from von Ekesparre and in special cases with open reduction and fixation with Kirschner wires-osteosynthese. As primary complications due to accidents we discovered 4% lesions of the arm nerves and in 1.5% disturbance of the blood circulation, of which 0.5% were due to vessel lesions. All nerve lesions could be treated conservatively, however, one child had to be operated because of ischemia of the lower arm and hand. Through reconstruction of the Arteria brachialis the disturbance of the blood circulation could be remedied. Two children with varus- und torsions deformity had to undergo a correcting osteotomy. From the methods used by us for the treating of dislocated fracture of supracondylar humerus in childhood, the nail extension from von Ekesparre found priority. An open reduction was then indicated when the fracture could neither through the conservative treatment nor the nail extension be held in a good reduction position. Further indications for surgery were if circulation remains disturbed or if paralysis persists.

[Segmental resection of the spleen as function-preserving therapy in pediatric rupture of the spleen. Sealing of the resected surface with fibrin glue, collagen fleece and dexon net]. / Segmentäre Resektion der Milz als funktionserhaltende Therapie der kindlichen Milzruptur. Mit Abdichtung der Resektionsfläche durch Fibrinkleber, Kollagenvlies und Dexonnetz.

Segmentary resection of a traumatic ruptured spleen was carried out in two children. Bleeding of the resected area was prevented by stitching, and the resected space was sealed up by means of a layer of a collagen preparation and with fibrin adhesive. Furthermore, the parenchymal space was enveloped in a dexon net that was fastened under slight tension to the capsule of the residual spleen by means of fibrin adhesive. Postoperative progress of both children was without complications. Postoperatively a residual spleen was seen sonographically having approximately the size of an organ of substandard dimension.

[Operative treatment of avulsion fractures of the intercondylar eminence in childhood]. / Zur operativen Behandlung von Abrissfrakturen der Eminentia intercondylica Kindesalter.

Within 7 years 12 children with a intercondylar eminence fracture (Typ I 5, Typ II 3, Typ III 4 times) according to Meyers and McKeever were treated in the Department of Pediatric Surgery of the Rudolf-Virchow-Hospital in Berlin. 7 avulsed intercondylar eminences were treated operatively by means of transepiphysial compression screws and wires. Temporary, transepiphysial screwing or wiring for a period of maximal six weeks is recommended. The results were excellent in 11 children and good in one child.

[Clinical experiences with a fibrin-nebacetin-spongy bone seal in the treatment of chronic bone infections and as local prophylaxis of infection in uninfected bones]. / Klinische Erfahrungen mit einer Fibrin-Nebacetin-Spongiosaplombe zur Behandlung der chronischen Knocheninfektionen und als lokale Infektionsprophylaxe bei nicht infiziertem Knochenherd.

Clinical experiences with Fibrin-Nebacetin-bone marrow combination for the treatment of chronic bone infection and as local prophylaxis by operation of non-infected bone diseases. Since 1979 we have carried out 33 autologous bone graftings in children and used the Fibrin-Nebacetin-bone marrow combination. Nebacetin provides a most effective local antibiotic therapy as supplementary and consecutive treatment are surgical procedures executed in bone infection. The chronic bone infection of 15 children subsided completely. In 18 children with bone transplants no infections was observed and all the patients showed primary healing. The use of fibrin did not disturb the bone reconstruction. After 12 weeks the reconstruction of the bone was almost complete. In two cases only we had to make a reoperation, caused by a recurrent cyst. We could not observe any hepatitis in our patients. The operative technique and advantages of treatment were discussed.

[Problematic, clinic and treatment of benign bone tumors in childhood and adolescence (author's transl)]. / Zur Problematik, Klinik und Therapie gutartiger Knochentumoren im Kindes- und jugendlichen Alter.

Bone tumors in children show a large variety in Kind. Often there is no clear distinction between benign and malignant tumors. So in between according to Zollinger there are semimalignant tumors with potential malignity. Adequate excision of these tumors or resection enbloc inhibit the tumor recurrence and give a good prognosis to semimalignant tumors. 31 children with benign bone tumors were operated between 1972 and 1979. They have been followed up medically and radiologically from 1 to 7 years. Up to now we could neither find a recurrence nor a sign of malignant degeneration.

[Treatment of chronic post-traumatic infections of the bone and soft tissue with gentamycin PMMA beads (PMMA = polymethylmethacrylate) (author's transl)]. / Zur Behandlung der posttraumatischen Knochen- und Weichteilinfektionen mit Gentamycin-PMMA-Ketten. Ein Erfahrungsbericht aus dem Iran.

Temporary implantation of Gentamycin PMMA beads and chains provides a most effective local antibiotic therapy as supplementary and consecutive treatment after surgical procedures executed in bone and soft tissue infections. Gentamycin beads and chains are used as an alternative to irrigation-suction drainage. From 1977 to 1979 70 patients were treated for chronic post-traumatic osteomyelitis and infection of the soft tissue. The chronic bone infections subsided completely in 90% of the patients, but 8.3% re-infections were observed within 3 to 24 months after termination of treatment. In 18 patients with gunshot wounds 66.6% of the patients got primary healing and 33.4% secondary healing.

[Treatment of supracondylar fractures of the humerus in children and adolescents (author's transl)]. / Die Behandlung der supracondylären Humerusfraktur bei Kindern und Jugendlichen.

116 supracondylar fractures of the humerus were treated from 1973 to 1979. A plaster cast was applied to 68 patients after repositioning of fractures of the type Baumann I and II. 34 children were given an extension according to v. Ekesparre (fractures according to Baumann type II, III), whereas 14 patients were given surgical treatment by fixation with Kirschner wires (type III) according to Baumann). The good results obtained encouraged us to consider the extension treatment according to v. Ekesparre as a good method. Surgery appears to be indicated only if good results cannot be expected with conservative treatment or extension, or if the circulation remains disturbed or if paralysis persists.