[Dislocation fractures of the upper ankle joint. Classification--treatment--results]. / Verrenkungsbrüche des oberen Sprunggelenkes. Klassifizierung--Behandlung--Ergebnisse.

Between 1959 and 1989 a total of 1,387 ankle fractures were analysed under different aspects. For several reasons the authors prefer the classification by Lauge-Hansen schematized by Maatz. After the period of change from conservative to surgical treatment the actual state of operative approach is described. Early complications and late results are presented via smaller groups of patients. Evidently SE fractures have the worst prognosis independent of the success of the operation.

[Menstruation and postoperative complications. A review of the literature]. / Menstruation und postoperative Komplikationen. Eine Literaturübersicht.

Because of a Toxic Shock Syndrome following an urgent knee operation during the premenstrual period we reviewed the available literature. There is no indication that the physiological process in woundhealing is influenced by menstruation. Increased woundinfection after operations during the perimenstruum were--except for inner female genitals--not observed. But more and more TSS is described after any kind of operation, so traumatologists should be well acquainted with the symptoms.

[Results of functional aftercare following surgically treated ruptures of the outer ligaments. A comparative study of aftercare by a lower leg walking cast or the Dr. Spring special shoe]. / Funktionelle Nachbehandlungsergebnisse nach operativ versorgten Aussenbandrupturen. Eine vergleichende Studie der Nachbehandlung durch Unterschenkelgehgips oder Spezialschuh nach Dr. Spring.

There is no doubt that primary suturing of the ruptured ankle ligament gives the best results regarding joint stability. However, there are differing views concerning the follow-up treatment. In particular, there are controversial opinions about the value of a special shoe by Dr. Spring during the rehabilitation phase. During the period April 1984 to July 1985 100 patients with rupture of the fibular ligament were treated operatively, 50 of whom were treated post-operatively with 14-day lying plaster of Paris followed by a further 14 days with the special shoe from Dr. Spring and 50 with a lower leg walking plaster of Paris. The results were compared over a period of 8 weeks, using objective criteria. The subjective impressions followed after at least 6 months. After 8 weeks the mobility of the joint in dorsalflexion and pronation is similar in both groups; in plantar flexion and supination better mobility was seen after the plaster of Paris treatment. There was no significant difference in the duration of unfitness for work. Subjectively, there was a reduced tendency to swelling after the plaster of Paris treatment.

[Experimental animal studies of spring osteosynthesis]. / Tierexperimentelle Untersuchungen zur Federosteosynthese.

Clinical experiences from spring osteosynthesis suggest that more stability and possibly earlier neogenesis of the bone in the fracture area can be achieved by suitable springs for osteosynthesis. This stronger stability of fixation could be proved in experiments on cadaveric bones. In 13 experiments on dogs the biologic occurrences at spring osteosynthesis were compared to those at inflexible osteosynthesis. Observation was carried out by means of x-ray films, Tc-scintigraphy, and histologic examination; used were the methods of applying an autologous graft and of transverse osteotomy of the femora of the dogs. The question initially asked could not be answered definitely. Basing on the reported experiences, however, an experimental procedure is proposed which might yield results with clinical relevance.

[Report on 938 bimalleolar luxation fractures. 2. Late results in operated cases and consequences for the surgical technic]. / Bericht über 938 bimalleoläre Luxationsfrakturen. 2. Teil: Spätergebnisse bei operierten Fällen und Konsequenzen für die operative Technik.

In the first part of this paper the authors reported on the treatment of 938 bimalleolar luxation fractures. 256 of these patients underwent operative treatment. 109 of these were examined clinically and by X-ray 3-13 years after the operation. The analysis of late results allowed conclusions about complaints and function in connection with the new development of arthrosis deformans posttraumatica. Owing to these conclusions the operative method was partly changed. There are no new aspects regarding postoperative treatment.

The application of the Maatz-spreading-nail in operative treatment of distal tibial fractures.

The treatment of fractures located in the distal two fifths of the tibia offers some difficulties for anatomic and physiologic reasons. For operative treatment the conical form of the medullary cavity requires a special form of nail. Maatz developed a spreading-nail in 1943, which was applied in 107 cases between 1956 and 1974 by the present authors. Retrospective analysis of 64 cases showed advantages and limitations of this nail. If applied with proper indications very satisfactory results were seen. The operative technique described is simple.