[Results of rotation osteotomy in habitual shoulder dislocation].
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Biomedical subjects
Publications and source records attributed to J Rehn.
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The parenchymatous organs are mostly involved in blunt abdominal trauma. Besides the physical examinations, the additional peritoneal lavage is emphasized as a diagnostic tool of great importance. The special diagnostic and surgical proceedings in injuries of spleen, liver and pancreas are discussed in detail. In cases of spleen injuries -- even if there are only small lacerations -- the total exstirpation of the spleen is necessary. For sutures in hepatic injuries the application of "collagenous bands" is recommended. The different methods of treatment in pancreatic trauma reach from simple drainage to partial resection.
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The question whether metals implanted in tissue may induce heat damage is yet controversial. Due to physical laws an increased production of heat is to be expected around the metal parts directed towards the capacitor plates. This is due to a converging and shunting effect of the metal in the electric field. Model experiments show that the shunting effect is most significance for the production of heat damage close to the metal. No heat damage is to be expected under the four following conditions: 1. linear or 2-dimensional osteosynthesis implantats are in a rectangular position to the electric field, 2. the metal is covered with at least 10 mm of tissue, 3. the tissue between the capacitor plates is of a with at least 40 mm and 4. common used frequency generators or field intensities are applied. Reported results suggest to investigate whether the high frequent electrical field influences the fracture regeneration advantageously.
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Since April 1977 we have carried out more than 250 arthroscopies using a nitrous oxide insufflation device. Nitrous oxide is completely non-toxic to the tissues and is rapidly absorbed. Unlike carbon dioxide, which is the other commonly used insufflation gas, nitrous oxide does not combine with water to form an acid which can irritate the tissues. Furthermore, it is more rapidly absorbed than air. The normal insufflation pressure of 50 mm Hg is usually sufficient to expand the soft parts of the knee joint to the required degree. Interstitial nitrous oxide emphysema occurred in only 7 cases; it was of limited degree in each case and attributable to initial technical difficulties with the apparatus, selection of an excessive insufflation pressure, or additional stab incision. The nitrous oxide emphysema was always asymptomatic and, in some cases, was not even noticed by the patient. No infections of the knee joint or other serious complication followed insufflation with this device, which incorporated a bacterial filter.
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