Treatment of ruptures of the symphysis and iliosacral joint in pediatric patients.

The three osseous parts of the human pelvis form a continuous structure because of the symphysis and both iliosacral joints that-owing to their mobility-make possible a shock-absorption of vertical forces. The goal in the treatment of ruptures of the symphysis and/or of the sacroiliac joints is the restoration of functioning joints. Especially in the adolescent, a stiffening of these joints has to be avoided. Therefore, we treat ruptures of the pelvic joints with an overbridging banding that preserves the function of shock absorption. Due to utilisation of a banding, made up of polydioxanone, another operation to remove internal fixation material is not necessary. Rupture of the symphysis or iliosacral joint in the pediatric patient is very rare. Only three among the 67 patients whom we operated on because of a rupture of the symphysis or iliosacral joints between 1984 and 1990 were children. These were an eleven-year-old girl and a nine-year-old boy, who had suffered a rupture of the symphysis, and an eight-year-old boy with a disrupted iliosacral joint. In these children a banding with PDS suture was performed. At a follow-up examination, the children were free from pain and did not feel restricted in their daily routine or their physical activities.

[Bridging tension band fixation in the reconstruction of ruptured amphiarthrosis of the pelvic girdle]. / Uberbrückungszuggurtungen zur Wiederherstellung rupturierter Amphiarthrosen am Beckenring.

Two different surgical techniques to treat rupture of the symphysis or the sacroiliac joint, which were introduced at the beginning of the seventies and were modified later, are presented in regards to their methodology and their results. In a lot of cases after surgery they enable a normal spring-suspension of the pelvis.

[Oropharyngo-spinal gunshot wounds]. / Oropharyngospinale Schussverletzungen.

Two cases of bullet injuries inflicted in suicidal intention are represented. In the first instant the barrel of a rifle in the second the barrel of a revolver was inserted to the oral cavity before the shot was fired.

[Reconstruction of an acetabulum by implantation of a reconstruction prosthesis]. / Wiederaufbau einer Hüftpfanne bei Implantation einer Rekonstruktionsprothese.

The problem of the "missing acetabulum" in central dislocation of the hip was solved in the case under report by means of a bone transplant from the ala of the ilium. After the bone had healed, a vital and solid acetabulum had been obtained, so that a repeated central dislocation is most unlikely--both as a result of this fact and because of the insertion of an Eichler ring.

[Rupture of the amphiarthrosis of the pelvic girdle]. / Die Rupturen der Amphiarthrosen am Beckenring.

So-called over-bridging tension band fixations are presented with special respect to their surgical procedures, development to technique, operative approaches, experimental findings gathered from 83 human pelves explanted post-mortally and clinical results. PDS band fixation has shown to guarantee approximately the same stability as comparable procedures offering in any case an immediate ease of bedside care and the possibility of physical exercise in bed. A slight postoperative elongation of the PDS band is sometimes seen on the X-ray as a small step in the outlines of the symphysis, but so far has been of no importance in our cases of treatment.

[Chondromatosis of the elbow joint--a single-joint arthropathy]. / Die Chondromatose des Ellenbogengelenkes--eine monoartikuläre Arthropathie.

The surgical treatment of a case of chondromatosis of the elbow is reported. The description of the course shows the clinical features, the diagnosis and the therapeutical approaches.

[Adamantinoma of the fibula--follow-up study]. / Ein Adamantinom der Fibula--Verlaufskontrolle.

A case of the adamantinom of the fibula has been reported. The tumor was resected six years ago. The yearly follow-up showed no sign of a relapse or metastases.