[Limbus diagnosis by computerized tomography after initial traumatologic dislocation of the shoulder]. / Computertomographische Limbusdiagnostik nach traumatischer Erstluxation der Schulter.

This paper shows a retrospective analysis of 98 shoulder joint CT scans after traumatic primary anterior dislocation in the period of 1988 till December 1991. The intraoperative findings and the X-ray characteristics beside arthrographic and MRI examinations led us to a classification of four types by pathomorphologic aspects, the type of the tear correlated to the degree of instability. For anterior limbus tear and lesions, a CT scan gives a diagnostic sensitivity of more than 90% (own rate 94.6%). Concerning our patients, the total lesions rate of 77.6% following first traumatic dislocation justifies a progressive examination and evaluation of the joint structures, that enhance further dislocations. Hereby, inspite of its invasivity, joint CT scan have, in comparison to other diagnostic procedures, proved to be routinely useful.

[Bankart operation with the Mitek anchor system]. / Bankart-Operation mit dem Mitek-Anker-System.

We would like to introduce a new technique for the operation according to Bankart, incorporating a special system of refixation (Mitek-anchor-system). Up to now, Bankart's method is worldwide known as the operation method for correcting an anterior instability. The difficulties arising from the reinsertion of the capsula onto the glenoidal rim are responsible for the numerous modifications Bankart's method suffered. The Mitek-anchor-system makes a sufficient procedure available for the open refixation of the capsula. Stable reinsertion of the joint capsula onto the anterior glenoidal rim can be performed with considerably greater ease and simplicity than with the methods described by numerous other authors. The method is also excellently suited for the open suture of the limbus. We present our operation technique after 20 operations employing this method of refixation, and at the same time point out its indication, as well as its advantages over other conventional methods.

[Value and limits of shoulder ultrasonography]. / Stellenwert und Grenzen der Schultersonographie.

A report is given on our experiences with approximate 500 soft tissue sonographies of the shoulder. Since about 2 years, all clinically not defineable shoulder pain conditions are submitted to a sonographic examination. We employ a 7.5 MHz linear sonoemitter. The method of examination includes a static and dynamic technique of examination as well as a comparison of the contralateral side. All structures are visualised in two planes and documented on magnetic tape. In view of the intraoperative situs, we want to demonstrate, first, the possibility of a misinterpretation of the preoperative sonographic findings, second, the limits of this method of examination.

[The diagnostic value of double contrast CT in shoulder dislocation]. / Diagnostischer Stellenwert des Doppelkontrast-CT bei der Schulterluxation.

The article reports of the indication, technique and results of the shoulder joint double-contrast-computertomography. It discuss its diagnostic value in comparison to other examining methods. As alternative preoperative diagnostic procedures only arthroscopy, arthrography and MRI can be considered. Also discussed are the therapeutic consequences resulting from the nature of the pathological lesions (rupture of the limbus glenoidalis, Hill-Sachs-defect, reversed Hill-Sachs-defect). Especially for the first traumatic dislocations of the shoulder joint, we consider this investigational method an eminent enlargement of the diagnostic spectrum. Therefore, we are generous with its indication, attempting to prevent reluxations by primary diagnostic and therapeutic procedure.

[Fresh rupture of the Achilles tendon]. / Der frische Achillessehnenriss.

In the Unfallkrankenhaus Salzburg (Salzburg Trauma Hospital) 586 inpatients with a recent Achilles-tendon rupture (ATR) underwent treatment within the years 1967 to 1984. Sporting activities were the dominant cause of the lesion (75% of total cases). Due to the location of our hospital skiing injuries dominated within this group. Pathogenesis of the lesion is discussed according to type and mechanism of the injury. Surgical approach has clearly been the standard therapeutic procedure (475 patients), whereas conservative treatment (twelve patients) resulted in a distinctly higher rate of reruptures. Thus the latter approach should be chosen in patients only when local factors or general disease rule out surgery. Rerupture is the most serious long-term complication. Therefore those cases have been critically analyzed with special attention to the type of surgical approach. In two thirds of our patients we conducted a follow-up with a questionnaire. The average time post trauma in this group was 8.9 years. Results are presented considering comments of the patients as well as occurrence of complications in the various surgical procedures.

[Malunion and growth disorders following fractures of the condylus radialis humeri in children]. / Fehlheilungen und Wachstumsstörungen nach Frakturen des Condylus radialis humeri im Kindesalter.

Basing on the results of 46 fractures of the lateral humeral condyle in children possible mal-unions and disturbances of growth after conservative and operative treatment are shown. Varus-tendency of the elbow axis was observated in 23% after conservative treatment of undisplaced fractures and in 37.5% after open reduction and Kirschner wiring of displaced fractures. Fish-tail deformity was seen both after conservative treatment and fixation with Kirschner wires; only open reduction and osteosynthesis with small-fragment screws could avoid this two disturbances of growth. One non-union was seen after conservative treatment.

[Surgical treatment of forearm shaft fracture]. / Die operative Behandlung der Unterarmschaftfraktur.

Between 1977 and 1987 at trauma hospital in Salzburg 142 patients with shaft fractures in the middle third of forearm have been treated by open reduction (altogether 730 forearm fractures in the same period). Among other things post surgical complications are examined. Functional results and reported troubles of patients are demonstrated by 66 cases which have been reviewed.

[Comparative study of arthroscopic and open meniscus surgery]. / Vergleichende Untersuchung zwischen arthroskopischen und offenen Meniskusoperationen.

In this paper we compared two groups of 80 patients each with meniscal tears. One group was treated by Arthrotomie and partial meniscectomie and the other group by an arthroscopic procedure also with partial meniscectomie. All patients were seen at a follow up between six and 18 months postoperatively. According to the Gaudernak scale we found in both groups 98% of very good and good results. The duration of hospitalisation and sickleave was reduced by 50% after the arthroscopic operation, which showed a significant difference.

[A rare combination injury in Alpine skiing]. / Seltene Kombinationsverletzung beim alpinen Schilauf.

This is a report on the incidence of associated osseos lesions in Achilles tendon ruptures. From 1967 to 1984 630 patients underwent treatment for closed Achilles tendon ruptures. In 49 cases (7.7%) associated osseos injuries were discovered. In 42 cases (6.6%) fractures of the malleolus medialis were found. Two patients with a rare combination (primarily treatment of osseos lesions, with delayed diagnosis of tendon rupture) deserve special attention. Concerning fractures of the lower leg with associated tendon rupture. Chronology and pattern of the injury are analyzed.