[Reconstruction of the tibial plateau fracture with arthroscopic monitoring without arthrotomy]. / Reconstructie van de tibiaplateaufractuur onder artroscopische controle zonder artrotomie.

In the period from October 1986 to November 1988 in the Medisch Spectrum Twente of Enschede, 25 patients were treated for a tibial plateau fracture by means of arthroscopic surgery. The mean hospital stay was 18 days. Active movement of the leg was prescribed from the fifth day. The results were very good in 23 and poor in 2 patients. Complications such as wound infections and skin necrosis were not seen. Additional meniscal lesions could be diagnosed and treated better using this surgical technique. In addition, the limited incisions and consequently the avoidance of extensive arthrotomy allowed faster rehabilitation and a higher probability of healing the chondral tissue.

Selective low-dose thrombolysis in patients with an axillary-subclavian vein thrombosis.

The treatment of axillary-subclavian vein thrombosis is still controversial. Development of a post-phlebitic syndrome in patients treated conservatively occurs in many patients. Therefore more aggressive treatment is advocated. We report six patients treated with selective low-dose streptokinase infusion with excellent short-term results. Major complications did not occur. Recanalisation was observed in all patients. Long-term results are not yet available.

Carcinoma of the thyroglossal duct.

Based on the case histories of six patients with carcinoma of the thyroglossal duct, the literature on the origin and treatment of this disease was reviewed. As to the treatment of papillary adenocarcinoma there is some controversy, although in most cases treatment is limited to local excision as described by Sistrunk, provided that tumor growth is restricted to the cyst. The prognosis of this carcinoma seems favorable. Squamous cell carcinoma of the thyroglossal duct is rare; there is no uniform advice as to its treatment, and the prognosis is poor.

Two patients with recurrent pneumonias in one lung.

Case histories are described of two young patients, both known to have recurrent infections of one pulmonary lobe. Further investigations (especially aortography) disclosed the cause in both to be an intrapulmonary sequestration. Surgical intervention made both patients symptom-free. The aetiology, clinical and investigational findings as well as therapy are discussed. The need for further investigations in patients with recurring infections of one pulmonary lobe is stressed.