[Spongioplasty in chronic post-traumatic bone defects with adequate soft tissue cover].
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Biomedical subjects
Publications and source records attributed to L Schweiberer.
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A so-called atraumatic operative technique is required to prevent post-traumatic wound infection. Especially in open fractures, closing a wound can lead to infection despite tension at the wound edges. Postoperative hematomas may also lead to infection, whereupon a further operation is necessary. Palliative treatment of the acute stages of infection consists in immediate evacuation, drainage and careful débridement. The wound must be closed without dead space remaining, but this proves impossible the dead space may be filled with a vascularized pedicle graft from adjacent muscle. The treatment of chronic infection, often accompanied by loss of skin and bone substance, has been improved by microsurgical techniques that allow the combination of autogenous bone grafting with vascularized musculocutaneous flap transplantation. Acute empyema requires early synovectomy.
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Under both normal and pathophysiological conditions the relationship between bony histology and the regionally associated vascular pattern was studied. Three independent methods of research were employed (microangiography, fuchsin stained ground sections, polychrome sequential labeling) and, thus, the limitations inherent in each method were minimized. Animals of different ages and different species were found to have relatively different amounts of primary and secondary bone. In all instances primary bone was associated with a network vascular pattern emanating from the periosteal surface and secondary bone was associated with an arborial vascular pattern arising from the endosteal circulation. Adult dogs, unlike sheep, were found to have a significant complement of secondary bone and, therefore, in consideration of human bony regeneration, the dog is a superior experimental model.
Crush injuries and abnormal pronation and supination are the most common reasons for typical ligament tears in this region. Most of them should be treated conservatively by plaster of Paris and early weight-bearing after exact clinical and X-ray diagnosis. At upper ankle joint, suture of ruptured fibular collateral ligaments should be favoured. For dislocations and fracture dislocations of the Lisfranc type operative reposition and K-wiring is recommended. Our treatment results with fibular collateral ruptures and fracture dislocations of the Lisfranc type are presented.