[Distal radius fracture--indications for conservative, partial surgical and surgical therapy]. / Distale Radiusfraktur--Behandlungsergebnisse, Indikationen zur konservativen, halboperativen und operativen Therapie.

460 fractures of the distal radius including 91 which are treated surgically are investigated in a retrospective study. There were 260 fractures of the left and only 200 of the right radius. 66% of the patients were female, especially striking is the superior number of women older than 45 years. The evaluation of the final radiological results referring to anatomical joint angles and normal radius length shows a high correlation to the evaluation of the final functional results. 70% of the latter are valued as excellent or good, 19% as tolerable and 11% as poor. The classification according to Frykman shows a significantly better result for cases without violation of the distal ulna. The comparison between operative and non-operative treatment of dislocated fractures without infraction of the radiocarpal joint demonstrates good results of percutaneous wire fixation in those cases. The therapy of fractures with infraction of radiocarpal and radioulnar joint is difficult. In this group we could not find a superiority of operative against conservative treatment. Wire fixation lead to 19% poor results and cannot be recommended for all cases. Six patients treated by external fixation and five treated by osteosynthesis using metal plates had good or tolerable results. The indication for using these methods has to be considered.

[Clinical incidence of subclavian thromboses following pacemaker implantation]. / Klinische Inzidenz von Subclaviathrombosen nach Schrittmacherimplantation.

Although pacemaker (PM) implantation has developed into a standard therapy in appropriate rhythm disorders the procedure is not free of complications. One of the most common problems is thrombotic alteration in the region of the entry of the pacemaker electrode into the venous system. To obtain more details of the incidence and extent of these complications, we investigated a total of 97 patients in two groups, clinically, phlebographically and by Doppler-ultrasound technique. 56 (30 males, 26 females, mean age 73 years) were examined 1 week, and 41 (18 males, 23 females, mean age 72 years) 1 year after PM implantation. The thrombotic changes were quantified and correlated to various anamnestic and clinical parameters with the following results: 1 week after implantation 25% of patients show thrombi with collaterals, in 15% shorter than, and in 10% longer than 3 cm. One complete obturation of the implantation vessel was recognized. Thrombotic changes without collaterals were found in 36%, in 25% shorter than, and in 11% longer than 3 cm. One year after PM implantation there are organized thrombi in 71%, 41% of these patients show collaterals phlebographically. The others had no hemodynamic changes. Of all the anamnestic and clinical parameters, a significant correlation was found only between development of thrombi and material of electrodes. Polyurethane electrodes have a significantly higher rate of thrombosis than silicone electrodes (p less than or equal to 0.0066).(ABSTRACT TRUNCATED AT 250 WORDS)