[Subtotal spinal cord dissection from a stab injury]. / Subtotale Rückenmarkdurchtrennung. Als Folge eines Messerstichs.

We report a stab-injury of the back with consecutive dissection of a thoracic vertebral arch and subtotal dissection of the spinal cord. The clinical findings and out-come of the patient--representing an incomplete Brown-Sequardsyndrome--are described. The diagnostic and therapeutic management of such rare entities is discussed.

[Treatment of fingertip defect injuries with a semi-occlusive dressing]. / Die Behandlung von Fingerkuppendefektverletzungen mit einem semiokklusiven Verband.

In the treatment of substance loss of fingertips it is crucial to maintain functional length and to restore adequate sensibility. By treating those injuries with a semiocclusive dressing according to Mennen and Wiese (1993), we were able to achieve both goals with excellent results, avoiding the necessity of local or regional flaps as well as shortening of bone to achieve primary closure. 82 patients with 85 injured digits were treated either conventionally (primary closure with or without shortening of bone, vaseline gauze dressings: 31 digits) or with semiocclusive dressings (54 digits). 42 digits of the latter group with complete protocols were evaluated at the end of treatment. 26 digits with defects of skin and subcutaneous tissue of less than 1 cm2 to more than 2 cm2 necessitated an average of 18 days until complete healing (minimum 6, maximum 46 days). Eight digits with loss of skin, subcutaneous tissues and nailbed healed within 10 to 32 days (average 22 days) and eight digits in which defects included bone loss averaged 49 days for complete healing (37 to 64 days). No complications, especially no infections have been observed. All healed finger-tips were well padded, painless, many without visible scar and with static two-point discrimination between 2 and 8 mm.

Interphalangeal dislocation of the fourth toe with avulsion-fracture in a child: report of a case.

Phalangeal dislocations of toes are extremely rare in childhood and usually can be treated by closed reduction. We present a proximal interphalangeal dislocation of the fourth toe with an irreducible avulsion fracture of the middle phalanx requiring open reduction. To our knowledge concomitant avulsion fractures in this condition have not been reported thus far in pediatric patients. The pathological mechanism of this injury is discussed, and the significance of the plantar plate for joint stability is emphasized.

[Surgical stabilization of thoracic wall fractures]. / Zur operativen Stabilisierung von Thoraxwandbrüchen.

We report our experience with 12 patients whose chest wall injuries were treated with stable internal fixation by means of rib plates. Of all patients with chest wall injuries requiring inpatient treatment, only 5.19% were operated for this diagnosis; that is to say this operation is seldom indicated. In 5 patients stabilization was done "on the retreat" when thoracotomy had to be performed for intrathoracic injury anyway; in another 5 patients inadequate recovery from respiratory insufficiency following conservative treatment led to the operation, and in 2 patients extreme dislocation of chest wall fractures with restricted chest volume was the reason for surgical intervention. The mean age of these patients was 58 years, the mean PTS score 28.5 (ranging from 18 to 56), mean duration of postoperative mechanical ventilation 6 days (median 5 days), mean duration of stay in the intensive care unit 18 days, and duration of stay in hospital was 42 days, reflecting the severity of associated trauma. The stability achieved in the chest wall permitted sufficiently painfree spontaneous ventilation 1-5 days after the operation in 50% of patients. Two aged patients died of non-trauma-related myocardial infarction and myocardial insufficiency, respectively, while in hospital. Complications attributable to the specific surgical intervention were superficial infection of the incision (2 cases) and postoperative haemorrhage from an intercostal artery (1 case). No late complications related to the specific operative procedure occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

[Neurogenic appendicopathy--long-term results following appendectomy]. / Die neurogene Appendicopathie--Langfristige Ergebnisse nach Appendektomie.

The neurogenic appendicopathy is a disease which is caused by proliferation of nerve fibres and hyperplasia of endocrine cells in the submucosa of the appendix. It is to be diagnosed surely only histologically. 28 patients in which appendectomy specimens solely changes of neurogenic appendicopathy type were present have been traced. Following statements can be made: 1. The disease is curable in 96% by simple appendectomy. 2. Concerning this diagnosis about 60% of so-called "negative" appendectomies will find a reasonable explication. 3. At the same time a facultative precurser disease of appendiceal carcinoid tumor is removed.

[Medium term results of treatment of post-traumatic osteitis and osteomyelitis with gentamycin-PMMA minichains]. / Mittelfristige Ergebnisse über die Behandlung der posttraumatischen Osteitis und Osteomyelitis mit Gentamycin-PMMA-Miniketten.

In 10 cases of posttraumatic osteitis or osteomyelitis gentamicin-PMMA minichains have been used for treatment after radical local debridement. In 8 cases infection could be controlled completely by this regimen, one case needed adjuvant systemic antibiotic treatment and only one case with proved primarily gentamicin-resistant beta-haemolytic-streptococcus could be controlled after removal of PMMA-minichain by systemic antibiotic treatment. 3 to 9 months after therapy all infections were still under control.