[Is ice hockey a dangerous sport?].
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Biomedical subjects
Publications and source records attributed to E Hipp.
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Twenty-eight patients with necrosis in the hip joint, the femoral condyles and the talus were examined by MR tomography. This revealed various features whose frequency depended upon the various stages of the necrosis. Three patients who showed no, or only indefinite, changes on radiographs, displayed clear evidence of necrosis on MR. Staging of femoral head necrosis on the basis of MR criteria is suggested, as well as a suitable procedure for early diagnosis. Accurate localisation and knowledge of the extent of the necrosis by means of MR makes it possible to plan an osteotomy accurately.
CT of the foot often helps clarification of difficult problems where conventional radiology has proved inadequate. Sections in the coronary and transverse plane may demonstrate fractures, joint involvement and displacement of bone fragments. Ill-defined degenerative changes in the talo-calcaneal joint can be demonstrated. The extent and localisation of rare tumours of the foot can be shown and additional information may be obtained by densitometric studies.
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It is out of the question that alloarthroplasty of the upper angle joint must today belong to the therapeutic repertoire of the orthopedic surgeon. The anatomical situation of the upper ankle joint brings considerable problems for the total replacement and then also for the surface replacement. At the time being models are already available, which, seen on the whole, have already brought quite reliable results. Requirement for the success of the operation is the technically perfect insertion of the surface replacement or of the total joint and furthermore the insertion of the replacement under appropriate conditions, whereby the operation in an aseptive room ("Reinraum") has proven itself effective also on the upper ankle joint.
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Several thousand mountaineers a year from Germany alone visit high mountains (4000 to 7000 m) in non-european countries. This number si steadily increasing and it seems necessary to familiarize oneself with the medical situation in these countries. Compared to other countries we saw that in Bhutan rescue is possible within a short time, because of the rather short distances between trekking routes and the Thimphu General Hospital. Medical staff in this hospital is very cooperative, for instance if a patient with severe joint injuries should be transferred to Europe for treatment with all possibilities of bone and joint surgery. Generally, however, we recommend to establish special rescue stations in various places with wireless equipment in order to get help as soon as possible in case of emergency and to avoid delayed rescue or transportation under poor conditions (horse back).
Fractures of the vertebral column due to riding accidents are frequent. In most of the cases we observe compression fractures of a vertebral body without compression symptoms of the spinal cord. If fractures of the spine heal with a gibbus deformity degenerative changes of the vertebral joints with severe back pains may ensue. Therefore it seems necessary to treat fractures of the vertebral spine with immediate reposition (ventraler Durchhang) and following immobilisation with a plastic corset Lightcast, Hexcelite). Occasionally operative stabilisation is necessary, especially in fractures of the cervical spine.
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Symptoms and etiology of "Migraine cervicale" are discussed. Further more the treatment of the complaints is mentioned.
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