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At least 163 records · Page 9Linked to original sources
PubMed1989

[Experiences with a combined sciatic and femoral block in surgery of injuries of the lower leg].

Besides various methods of general anaesthesia, regional anaesthetic procedures are well suited for the surgical care of traumatological patients. For operations on patients with lesions of the lower leg, we have been using for 3 years a combination of dorsolateral blockade of the sciatic nerve according to Winnie with a "3 in 1-block". Our experiences with 80 patients show that a complete anaesthesia of the operation field holds for about 100 minutes with a blockade using 1.5% lidocaine with adrenaline. Main indications of this method are operations on lesions of the fibular ligament, leg fractures, ankle joint fractures, removal of osteosynthesis metal and other operations on the leg or foot. Partial or complete failures were registered in 12% of the cases. Severe complications did not occur.

Adolescent↗
PubMed1981

[Large surgical flaps in the reconstruction of soft tissues after complicated injuries of the lower leg].

Experiences and results with a so called extended flap transfer including the fascia of the donor leg are discussed. Six patients suffering from complete open fractures of the lower legs underwent this procedure. All patients gained a functional and useful lower extremity. Also late reconstructive operations to cure bony problems did not affect detrimentally the healed flaps.

Fracture Fixation, Internal↗
PubMedDate not supplied

[Principles of management of high-energy injuries of the leg].

INTRODUCTION: High-energy traumas are open or closed injuries caused by force (missile, traffic injuries, crush or blust injuries, falling from heights), affecting the body surface and transferring high amount of kinetic energy inducing great damage to the tissue. Management of such lower extremity injuries has evolved over past several decades, but still remains a difficult task for every surgical team. Specific anatomic and functional characteristics combined with extensive injuries demands specific treatment protocols. MULTIPLE INJURIES: In a multiple injured patient the first priority is management of life-threatening trauma. Despite other injuries, surgical treatment of limb-threatening injuries must start as soon as life-threatening condition has been managed. TREATMENT ALGORITHMS: Algorithms are especially beneficial in management of severely injured, but salvageable extremities and in making decision on amputation. Insight into mechanisms of injury, as well as systematic examination of the affected limb, should help us understand the extensiveness of trauma and make an adequate management plan. PREVENTION OF INFECTION AND SURGICAL APPROACH: Prevention of wound infection and surgical approach to high-energy limb trauma, which includes wound extension, wound excision, skeletal stabilization and if necessary muscle compartment release, should be done in the first 6 hours after injury. METHODS OF SOFT TISSUE RECONSTRUCTION: Commonly used methods for soft tissue defects must provide wound coverage in less than five days following injury. REHABILITATION: Early passive and active mobilization and verticalization of patients is very important for successful treatment. CONCLUSION: Good and timely evaluation of the injured and collaboration between plastic and orthopaedic surgeons from the beginning of treatment, are crucial for final outcome.

Amputation, Surgical↗
PubMed1986

Reconstruction of foot injuries.

Foot injuries constitute a spectrum of problems that can be classified by severity. The development of successful techniques for the treatment of lower leg injuries has made the severity of a concomitant foot injury a key factor in determining the overall salvageability of the leg. A more complete classification of foot injuries is therefore needed and has been proposed. Preoperative assessment of foot injuries differs in the acute versus the delayed presentation. The acute case requires evaluation of wound conditions, exposed structures, and associated proximal injuries. The chronic injury requires gait analysis, study of weight-bearing patterns by Harris mat prints, skeletal evaluation, mapping of plantar sensation, and, in some cases, angiography. Thorough knowledge of foot anatomy is essential for developing a rational plan for treatment. The significance and course of the medial calcaneal nerve and the anatomy of the plantar nerves have not been fully appreciated in most reports on the treatment of foot injuries. The recognition of the proximal plantar subcutaneous plexus blood supply has modified the understanding of plantar flap design. It has simplified and improved the safety of dissection of sensate plantar flaps. A plethora of both local and distant flap options exist for the treatment of foot injuries. The foot is divided into four major areas based on different requirements for reconstruction and the types of flaps available. These areas are the proximal plantar area; the malleoli, Achilles tendon, and posterior (non-weight-bearing) heel area; the distal plantar area; and the dorsum. The options for coverage have been discussed in detail, and a summary of the reconstructive strategy by area has been presented in Table 3. Complex (type III) injuries are special injuries owing to their severity and multiple components. They require a careful initial evaluation for both feasibility and advisability of extremity salvage. Treatment of these injuries consists of bony stabilization and soft-tissue debridement followed by flap coverage.

Debridement↗
PubMedDate not supplied

Effect of environmental change on injuries of udder and legs in dairy cows.

Injuries of udder and legs of dairy cows in a changed production environment were studied in two herds. The frequency of injuries of udder and teat skin decreased in the renovated tying stall. The stall length and also the cubicle length was too short for large cows in old cowsheds which caused lesions on the skin of udder and legs. The new concrete on floors was rough and kept the wearing of hooves moderate. The yoke tying and the low level of manger worsened the fore leg conditions in the renovated tying stall. In the new loose house the incidence of injuries did not change markedly.

Animals↗
PubMed1990

Foot reach under guard rails on agricultural machinery.

Foot and leg injuries of workers using agricultural field machines frequently occur when contact is made with rotating components. This paper presents the results of a study carried out to determine how far people can reach under barriers. The results show that even at a low barrier height of 200 mm above the ground some short people can get their lower leg well under the barrier and reach considerable distances. Guarding of machines to minimise leg and foot injuries is therefore likely to be a compromise between desirable standards and practical considerations.

Journal Article↗
PubMed1991

[Snowboarding accidents in the Alps. Assessment of risk, analysis of the accidents and injury profile].

It is a common belief that snowboarding might carry a higher risk of accident than alpine skiing. In order to prove this suspicion but also to figure out a basic knowledge to develop special security precautions for snowboarding 204 snowboarding-accidents in the Alps have been registered and analysed. The major purpose of this study was to find out the crucial points of risks of this new way of performing winter sports and to compare these risks with the risk-profile of alpine skiing. These have been the main results: More than two thirds of all accidents happen on icy or hard courses. Few more than the half of all injuries affect the lower extremity, one third the upper extremity whereby injuries of the ankle, knee, shoulder and hand emphasize. Strains and fractures are placed in the foreground. Two thirds of all injuries of the lower extremity affect the front of the leg, whereby nearly two thirds of all leg-injuries result from a mechanism which is a combination between bending forward and torsions. Depending on the different types of boot characteristic crucial points have been shown with injuries of either the ankle or the knee. As a principal demand for better safety at least for beginners a functional safety-binding should be developed. Regarding to the most common critics that snowboarding will increase the incidence of collisions (on-course) and avalanche-accidents (off-course), this study could fortunately not prove these suspicions.

Adult↗