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  • 1980-1984  (3)
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  • 1
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Problematik der residivierenden Schulterluxationen ist seit langem bekannt. Zu ihrer Behandlung sind bisher mehr als 100 verschiedene Operationen beschrieben worden. Dieser Überblick beschreibt 113 Patienten, die wegen rezidivierender Schulterluxationen ausnahmslos nach der Putti-Platt-Operationstechnik operiert wurden. Der signifikante Befund in der Vorgeschichte war eine mangelhafte Ruhigstellung des Gelenkes nach der ersten Luxation (bei 62% der Patienten). Nach dem operativen Eingriff wurden nur wenig Reluxationen (1%) aber eine relativ ausgeprāgte Bewegungseinschränkung beobachtet, die sich jedoch allmählich, bis zur annähernd vollen Beweglichkeit verbesserte.
    Notes: Summary Recurrent dislocation of the shoulder has long been recognized, and more than 100 techniques for repair of the injury are described. This survey describes 113 patients who suffered from recurrent anterior dislocation of the shoulder and were operated upon in accordance with the Putti Platt technique. The most significant preoperative finding was inadequate immobilization after the primary dislocation (62% of the patients). Postoperative recurrence was uncommon (1%) and a relative increased limitation of motion in the postoperative period improved gradually to almost a full range of movement.
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  • 2
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In der Zeit vom 1. Januar 1972 bis 31. Oktober 1982 erfolgte bei 7 Kniegelenken von 7 Patienten eine Bandrekonstruktion wegen Instabilität nach Implantation einer Kniegelenk-Totalprothese. Bei 6 Patienten bestand eine schwere Instabilität des medialen Längsbandes und bei einem Patienten eine schwere mediale Instabilität, kombiniert mit einer leichten lateralen Instabilität. Die operative Technik zur Wiederherstellung der Bandfestigkeit bestand in einer Versetzung des proximalen und distalen Ansatzes des medialen Längsbandes. In 5 der 7 Fälle wurden zusätzliche Weichteiloperationen mit der Anspannung des medialen Längsbandes kombiniert. Bedauerlicherweise hat die Rekonstruktion des Bandapparates bei der Wiederherstellung der Kniegelenkstabilität in allen 7 Fällen versagt. Bei 4 Patienten war eine Auswechslung der Knieprothese erforderlich. Die Knie-Instabilität erforderte die dauernde Versorgung mit einer Orthese, nur einer der 7 Patienten kam ohne eine Orthese mit der Instabilität zurecht. Eine Bandrekonstruktion ohne eine Auswechslung des Kunstgelenkes ist ein ungeeignetes Vorgehen bei der Behandlung einer instabilen Kniegelenk-Totalprothese.
    Notes: Summary During the period of January 1, 1972 through October 31, 1982 seven knees in seven patients had ligamentous reconstructions for instability following total knee arthroplasty. The type of ligamentous instability included severe medial instability in six and a combined severe medial and mild lateral instability in one patient. The surgical technique utilized to reconstruct the ligaments included proximal and distal advancement of the medial collateral ligament. In five of the seven, additional soft tissue surgery was combined with tightening of the medial collateral ligament. Unfortunately, ligamentous reconstruction failed to restore stability to the knee in any of the seven patients. Four patients required revision total knee arthroplasty. Instability of the knee necessitated full-time support with a brace and the seventh patient manages his instability without a brace. Ligamentous reconstruction without component revision is inappropriate in the treatment of the unstable knee following total knee arthroplasty.
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  • 3
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The therapeutic efficacy of ceftriaxone and gentamicin was investigated in a foreign body induced abscess model in the rat by implanting a dialysis tube contaminated withKlebsiella pneumoniae into the subcutaneous tissue. Animals were treated for four days with ceftriaxone, gentamicin, and their combination starting immediately following or 48 h after the implantation. Peak free ceftriaxone and gentamicin abscess fluid levels were 4.3 and 2.6 mcg/ml, which were 7.3% and 37.5% of peak blood levels respectively. Both agents persisted longer in abscess fluid than in blood. Ceftriaxone inhibited the development of abscess formation when administered shortly after the implantation of the contaminated foreign body whereas gentamicin alone was without beneficial effect. When administered after 48 h ceftriaxone was less effective than immediately after implantation and gentamicin was again without any therapeutic effect. The effect of the combination of ceftriaxone and gentamicin was slightly better than ceftriaxone alone. Low oxygen tension may be an explanation for the lack of bactericidal effect of gentamicin. Ceftriaxone may be more suitable for the therapy of closed space infections caused by susceptible microorganisms than gentamicin.
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