[First aid and transport in injuries of the spine]. / Erstversorgung und Transport bei Verletzungen der Wirbelsäule.

Prognosis of lesions of the spine and spinal cord has greatly improved in recent years. It depends significantly and decisively on early recognition of such lesions and can be improved further by on-target immediate or early measures. Especially after traffic accidents, every unconscious person must be assumed to have suffered an injury of the spine until definite proof to the contrary. Appropriate measures must therefore be taken during rescue and transportation.

[Acute post-traumatic cholecystitis. Caused by or following polytrauma?]. / Akute posttraumatische Cholecystitis. Infolge oder nach Polytrauma?

Traumatic acute cholecystitis is of secondary importance beside many other complications in the polytraumatised patient, since it is rarely diagnosed--possibly too rarely. Difficulties often arise because of a multitude of injuries, which are often life-threatening and which must be given top priority (3). Men are chiefly involved (4). In most cases, the condition is preceded by shock, but not necessarily by gallstones (10, 11). First pointers in literature were given by Mennenga (8). As early as 1939 he pointed out that blunt abdominal trauma may produce tears in the gallbladder and bile duct regions. Marre (7) described acute signs in the upper abdomen due to rupture of the bile duct. Genesis of post-traumatic acute cholecystitis is still unclarified. Apart from rupture or perforation of the gallbladder or bile ducts, it is mainly shock (4, 9, 12) which is considered to be an important causative factor.

[Roentgen diagnosis of statically-induced chronic fractures]. / Röntgendiagnostik statikbedingter Dauerfrakturen.

Three patients with statically conditioned non-traumatic permanent fractures are presented. X-ray morphology classification criteria and commonly used definitions are presented, basing on an extensive list of references. Different non-traumatic fracture types are demarcated according to roentgenological and aetiological criteria. Typical characteristics of permanent fractures are highlighted and illustrated by means of pictorial representations.

Osteoinduction. Part I: Test model and comparative long term observation of allogenic and xenogenic matrix implants.

In order to demonstrate osteoinductive activity of transplants and implants an experimental approach is presented in this study. Matrix induced osteogenesis following allogenic and xenogenic implantation is demonstrated morphologically, by induction of alkaline phosphatase, and by mineralisation of the newly formed matrix. Beginning on day 20 new bone formation can be found lasting up to 6 months in allogenic implants, whereas in xenogenic implants only inflammatory infiltrations are detectable. Osteoinduction is a matrix conducted phenomenon, as was confirmed by control experiments. Orthotopic allogenic implantation in diaphyseal defects of dogs demonstrates the ability of such implants to bridge a great defect by induced new bone formation and the property of the newly formed bone to adapt to physiologic stress.

[Animal experimental studies on "bone welding" by ultrasound (author's transl)]. / Tierexperimentelle Untersuchungen zum Thema "Knochenschweissen" mit Ultraschall.

This article deals with a method of osteosynthesis which was tried out in a model experiment on Wistar rats. In this method, which may be termed "bone welding with ultrasound", bone fragments are glued together, using ultrasound and n-butyl-2-cyanoacrylates. The load capacities of glued and welded bones were compared in an in-vitro trial. The course of the in-vivo trial was followed up clinically and roentgenologically, and the preparations obtained after termination of an observation period of 6 weeks were then subjected to histological processing.

[Controlled tension and tension adjustment of the external fixator using a dynamometer (author's transl)]. / Kontrollierte Spannung und Nachspannung des äusseren Festhalters mit Hilfe eines Dynamometers (Kraftringmessgerät).

Bone fractures treated with an external fixator tend to heal more slowly than with an internal fixator, since the tension of the fixator gradually relaxes and this decrease in pressure is not counteracted in any way. A dynamometer makes possible an exact measurement of effective compressive forces and an adjustment of the tension of the fixator. A special feature of the apparatus is an elastic metal ring. The apparatus is mounted on the free ends of both tubes of the fixator for measuring and adjusting the tension. This should be done once a week. Supported fractures are put under an axial compression of 50 kp. In the case of comminuted and defect fractures, and axial compression of 5 kp should be begun after 5 weeks, and this dosage should be increased every week.

[Suture of flexor tendons and substitution of flexor tendons in the "no-man's land" in children]. / Beugesehnennaht und Beugesehnenersatz im "Niemandsland" beim Kind.

From 1969 to 1976, there were 14 primary, 10 secondary one-stage, and 14 secondary two-stage repairs of injured flexor tendons in the so-called 'no-man's-land'. Functional results of these three operational methods are compared in this paper and show that, in children, flexor tendons in uncomplicated wounds can be sutured primarily, even in the 'no-man's-land'. Flexor tendons in complicated wounds also may be primarily sutured, but not as effectively. In the latter case, according to the results under review, secondary two-stage repair, not secondary one-stage repair, must be applied.

[The induction of new bone formation after transplantation (author's transl)]. / Die Induktion der Knochenneubildung nach Transplantation.

Bone induction by implantation of decalcified bone is described by many authors. This statement was proffed by implantation of decalcified pig bone in the abdominal wall muscle of rats. An enchondral osteogenesis was found following the implantation in a time intervall of 12 weeks according to the results of many other authors.

[Elimination of bone defects with the aid of a transplant (bone morphogenetic protein BMP) prepared according to Urist's method. Animal experimenst compared with Kieler spongiosa]. / Beseitigung von Knochendefekten unter Verwendung eines nach Urist zubereiteten Transplantates (Bone morphogenetic Protein BMP). Tierexperimentelle Untersuchungen im Vergeleich zur Kieler Spongiosa.

In two groups of six beagle dogs a standardized bone defect of 1 cm was replaced by a) "Kieler Spongiosa", and b) autologous bone material, prepared according to the formula of Urist. Instead of mechanical insufficiency an impressive osteogenetic potency and periosteosis was noticed in group b.

[Complications caused by the plastic material used in a 2-stage flexor tendon grafting operation]. / Materialbedingte Komplikationen nach Gleitlagerplastik für zweizeitige Beugesehnentransplantation.

After the use of the silicone-rod method for the two-stage flexor tendon grafting without complications in more than 120 cases, there were found -- although an identical technique was used -- some cases of inflammatory reaction compelling the earlier removal of the rods and leading to poorer results. Tests showed that there are silicone-rubber rods on the market which differ widely in their physical qualities and, therefore, also show differences in their compatibility with tissue.

[Indications for percutaneous fracture fixation in bone surgery]. / Indikationen für den äusseren Spanner (Fixateur extern) in der Knochenchirurgie.

Because of its technical improvement percutaneous pinfixation of bones is now a successful procedure of osteosynthesis. The indications of this method are: Open fractures of second and third degree, emergency treatment of polytraumatized persons with debris fractures, fractures in combination with vascular injuries or burns, elongating osteotomy, pseudarthrosis, osteomyelitis and arthrodesis. External pin-fixation offers the following advantages: High range of stability with the possibility of early exercises. In case of resorption of the bone fragments it is possible, to correct the axial compression. No lesion of the fragments periosteum or endosteum. The operative damage to cortical vascular supply is minimized. The danger of bone infection is reduced. Subsequent correction of the bone axis can be performed. Altogether the pin-fixation is a safe and satisfactory method of osteosynthesis without physical strain for the patient.