A total of 28 Spiron prosthesis were implanted in 26 patients (15 men, 11 women, mean age 51 years [range 34-64 years], mean BMI 28 kg/m(2) [range 21-39 kg/m(2)]) from August 2009 to January 2012. Diagnoses: 13 cases of primary osteoarthritis, 8 cases of secondary osteoarthritis, 5 cases of femoral head necrosis, and 2 cases of posttraumatic osteoarthritis. The mean surgery length was 93 min (range 70-121 min), the mean hospital stay was 9 days (range 6-16 days). Blood transfusion was not necessary in any of the cases. There were no immediate complications such as deep vein thrombosis, surgery requiring secondary bleeding, wound infection, nerve palsy, or dislocation of the hip. Postoperative radiologic examinations showed an average leg lengthening of 3 mm (range -10-19 mm). No varus deviation of the prosthesis was observed. The Harris Hip Score improved from 55.4 points (range 33.5-76.9 points) preoperative to 90.5 points (range 75.7-99.9 points) 3 months postoperative. In 1 case with aseptic loosening, replacement surgery was performed without complications.
To improve outcome quality of rehabilitation, the German Social Accident Insurance implemented a rehabilitation management system. A rehabilitation manager operates as active supervisor of the rehabilitation process of severely injured persons beginning from the time when the accident happened. The sequence is recorded on a rehabilitation schedule by the physician, rehabilitation manager and patient together. The concept has not yet been fully accepted by all insurers. Furthermore there is no uniform approach in compiling the rehabilitation schedule which can lead to delays in the process and insecurity of patients. In the following article these aspects are illustrated and improvement suggestions are highlighted.
This is a case presentation of a 9-year-old boy who sustained a rare Salter-Harris type IV distal fibular fracture including an avulsion fracture of the anterior inferior tibiofibular ligament at the fibular attachment. Treatment consisted of open reduction and internal fixation by Kirschner wire and cerclage. Possible posttraumatic growth disturbances and the major implications are highlighted.
Isolated avulsions involving the tendon of the biceps femoris muscle are rare injuries. Injury patterns are similar to those of posterolateral knee injuries mostly due to hyperextension and external rotation. Functional loss is common regarding painful limited flexion of the knee. In the case described in this article there was complete avulsion of the biceps femoris tendon but low levels of pain and functional loss despite the proximity to the attachment.
Beschwerden im Bereich des H?ftgelenks sind ein h?ufiger Grund f?r die Vorstellung beim Orthop?den und Unfallchirurgen. Erst durch die gezielte Anamneseerhebung und k?rperliche Untersuchung kann das breite Spektrum m?glicher Differenzialdiagnosen eingegrenzt und in Richtung einer Verdachtsdiagnose gelenkt werden. Die bildgebende Diagnostik schlie?t sich an. Therapeutische Schl?sse k?nnen erst in Zusammenschau von klinischem und bildgebendem Befund gezogen werden.
Dieser Artikel thematisiert die strukturierte Anamneseerhebung und die klinische Untersuchung des H?ftgelenks.
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