[Lesions of the symphysis and the sacroiliac joint].
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Biomedical subjects
Publications and source records attributed to T Tiling.
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This study deals with the problem of osteomyelitis by presenting 875 patients treated at Goettingen University, Department of Surgery between 1924 and 1978, with particular emphasis on methods of treatment, frequency of recurrences and change in pathogenic organisms which had become more apparent within the past decades. There was 555 haemotogenic cases, 320 of post-traumatic origin.
Bone defects and osteotomies of the rabbit tibia were stabilized by a mixture of ethyl cyanoacrylate and bone meal. Healing of osteotomy or new bone formations growing through the defect could not be observed.
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Extensor tendon injuries are mostly treated by younger general surgeons. Good follow-up results in the zone 2, 3, 4 and 6 of VERDAN are observed only 6 to 17 percent (fig. 1), which may be explained by: 1. the complicated anatomy of the extensor tendon in zone 2 to 4, 2. lack of attention to handsurgical principles, 3. infections in up to 40 per cent, which appear especially in connection with extensive soft tissue damage, 4. posttraumatic arthrosis (fig. 3) caused by lesions of the finger-joints or temporary KIRSCHNER wire fixation. The highest restriction of movement is found in the finger-joint distal to the injury (fig. 2.) The degree of flexion deficit in all finger-joints always exceeds the degree of extension deficit (fig. 4). The extension deficit alone is, therefore, not a satisfactory criterion in follow-up. The use of KIRSCHNER wire fixation by the inexperienced and the adoption of conservation therapy for zones 1 and 2 cannot be recommended.
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Our objective was to compare the effect of two methods of data collection on results in a functional knee score. Two Lysholm scores were obtained for 61 patients 1 year after anterior cruciate ligament surgery at the same clinic visit. First, the patients completed a self-administered questionnaire, and second, the Lysholm score form was completed by the investigator in the course of a patient interview. A comparison of the scores revealed that the mean score was significantly lower with self-administration (self, 89.3 +/- 10.6; interviewer, 92.2 +/- 7.4) (P = 0.0035, Wilcoxon rank sum test). The assignment to one of four categories (excellent, good, fair, poor) was also significantly altered by the manner of data collection. Nineteen patients (31%) were assigned to different categories based on the mode of data collection. We believe that the major reason for a better score result with an interview was the presence of interview bias. The more the investigator is involved in the treatment of the patient, the greater the influence of this bias may be. To avoid such potential bias we suggest that a standardized self-administered questionnaire be used as the method of choice for obtaining subjective data in clinical settings.
This retrospective study compares the results of different therapies for fibular ligament rupture in a homogenous group of professional athletes. The endpoint "competitive sports" was an outcome consideration. Subjects were examined by means of a standardized questionnaire and a structured interview. One hundred and seventy-nine of the questionnaires were completed and returned for evaluation. All of the basketball players with severe ankle sprain (supination trauma with swelling, pain, and inability to bear stress) were included. Those players with fractures of the foot, pronation trauma, or additional distal fibula or tibia fractures were excluded from this study. Of the 179 basketball players 160 (89%) had suffered severe ankle sprain. The treatment was divided into three groups: primary surgery (N = 35), plaster cast (N = 39), and functional treatment (N = 89). While simple ligament injuries (Grade I and II) were mostly treated functionally, complex ligament injuries (Grade III) were usually operated on. A total of 119 (74%) of the players reported no further pain. For pain reduction surgical and functional treatments showed advantages over plaster treatment. In the surgical group 63% of the players judged their regained stability to be equivalent to that of their healthy leg. Only 50% of the players in the plaster and functional groups believed their ankle joints to have regained the same stability as before their injuries. Despite the achievement of good results through surgery, there were clear differences in the players' assessments of their performance in competitive sports. Most subjects (92%) did not have any problems in everyday life regardless of which kind of therapy had been chosen.(ABSTRACT TRUNCATED AT 250 WORDS)