[Correlation between postoperative duration of Redon drainage and wound healing. A study of 150 patients with total endoprosthetic hip replacement]. / Zusammenhang zwischen postoperativer Liegedauer der Redon-Drainage und Wundheilung. Eine Untersuchung von 150 Patienten mit totalendoprothetischem Hüftgelenkersatz.

The influence of the residual application of postoperative wound suction drainage devices on wound healing was examined in 150 patients with total hip replacement. The duration of continuous wound-draining as well as their bacterial contamination were analysed and the possible correlation was evaluated. Another aim of the study was to observe if the bacteriologic result is a proper method to obtain evidence about the wound situation. The 150 patients were divided in 3 groups. Two groups (of 50 patients each) had total hip replacement at the same time period. One group had postoperative wound complications or infection that had to be reoperated. The other 50 patients had normal wound healing without any complication. The third group of 50 patients with a shorter draining period was analysed and compared with the others. As a control factor the indication for operation, the sex and the age of the patients were similar in each group. We could show an increasing number of bacteriological contamination in drainage tubes which had a longer suction period than 3 days. In the reoperated group we found a significantly higher number of contaminated tips (37.4%) than in the groups with uncomplicated wound healing (8% and 2.8%). The comparison of the bacteriological examination of the drainages with the smear of reoperated wounds showed the same constellation of germs in 64.3% of the cases. It seems to be a good method to get information about the bacterial wound conditions.

[The value of sonographic diagnosis of the injured knee joint in trauma-surgical practice]. / Die Wertigkeit der sonographischen Diagnostik des verletzten Kniegelenkes in der unfallchirurgischen Praxis.

In a period of two years (January 1990 to December 1991) 136 knee joints were examined by ultrasound and arthroscopy. 40 out of 42 arthroscopically proven lesions of the anterior cruciate ligament were detected by ultrasound. The sensitivity therefore was 95.24%. We found three cases of ruptures of the posterior cruciate ligament, which were not detected clinically. 16 cases of ruptured medial collateral ligaments and 27 cases of elongations of the same ligament were diagnosed. Ultrasound examination of the knee and especially of the cruciate ligaments showed to be an accurate tool in order to obtain additional information on an injured knee even if clinical examination is difficult or impossible. Sonography is able to exclude lesions of the cruciate ligaments precisely. Therefore it helps to restrict the necessity of acute or early arthroscopy of knee joints.

[Rare, bilateral posterior shoulder dislocation. A case report]. / Die seltene, doppelseitige hintere Schulterluxation. Ein kasuistischer Beitrag.

Posterior shoulder dislocation is a very rare injury, accounting for only 1-2% of all shoulder dislocations. It is very often misdiagnosed because its clinical symptoms are not characteristic and the X-ray pictures are often misinterpreted. In many cases this means delayed treatment and impaired shoulder function. The most common cause of posterior shoulder dislocation is an epileptic seizure. In approximately 50% of all cases a ventral impression fracture of the humeral head is diagnosed. This is known as the "reverse Hill-Sachs lesion". About 10% of all posterior shoulder dislocations are associated with fracture of the lesser tuberosity of the humerus. In this paper a case of bilateral posterior shoulder dislocation with bilateral fracture of the lesser tuberosity of the humerus is described. The luxations were caused by an epileptic seizure following chronic alcohol abuse. Following early commencement of an exercise programme excellent results were obtained, and no redislocations occurred.