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Twenty acutely traumatised patients with a rupture of the anterior talofibular ligament were studied by MRI. The results of 3D-studies were correlated with conventional stress x-ray studies. The ruptured ligament was directly visualised in all cases as a thickened structure of high signal intensity. In case of complete ruptured ligaments free flowing ligamentous structures were seen in the signal intense exudation in the ankle joint. MRI can help to decide between surgery or conservative therapy.

We treated 34 patients during 1987-1990 with a collagen wound dressing. Eleven patients had traumatic soft tissue defects, 10 patients had 3 degrees-grade open fractures, 7 patients had infected soft tissue wounds and 6 patients had deep 2 degrees and 3 degrees-degree burns. Our clinical experience confirmed the excellent clinical experimental results of collagen wound dressings. In all cases after 4 until 6 days of treatment good granulation and vascularisation of the wound bed was obtained, so that a skin transplant could be performed, which in all cases healed primarily. Moreover, the wound dressing had a good antibacterial effect and integrated actively in the wound healing process.

This article describes the differential diagnosis between hereditary Madelung's deformity and acquired posttraumatic Pseudo-Madelung's deformity. Three cases of posttraumatic Pseudo-Madelung's deformity were reported. Aspects of aetiology, clinical radiological appearance of hereditary Madelung's deformity and acquired Pseudo-Madelung's deformity are discussed. Differential diagnostic criteria for the discrimination between both forms are also discussed. A rare case of acquired posttraumatic "reversed" Madelung's deformity is also reported.

This is a report of a seven-year-old polytraumatised boy with perforation of a duodenal stress-ulcer. Aspects of the etiology and pathogenesis were discussed. The main therapeutical efforts by stress-ulcer risk patients consist in an early sufficient shock therapy and adequate stress-ulcer prophylaxis to prevent the origin of stress-ulcers and their complications like bleeding and perforation.

116 supracondylar fractures of the humerus were treated from 1973 to 1979. A plaster cast was applied to 68 patients after repositioning of fractures of the type Baumann I and II. 34 children were given an extension according to v. Ekesparre (fractures according to Baumann type II, III), whereas 14 patients were given surgical treatment by fixation with Kirschner wires (type III) according to Baumann). The good results obtained encouraged us to consider the extension treatment according to v. Ekesparre as a good method. Surgery appears to be indicated only if good results cannot be expected with conservative treatment or extension, or if the circulation remains disturbed or if paralysis persists.

Clinical experiences with Fibrin-Nebacetin-bone marrow combination for the treatment of chronic bone infection and as local prophylaxis by operation of non-infected bone diseases. Since 1979 we have carried out 33 autologous bone graftings in children and used the Fibrin-Nebacetin-bone marrow combination. Nebacetin provides a most effective local antibiotic therapy as supplementary and consecutive treatment are surgical procedures executed in bone infection. The chronic bone infection of 15 children subsided completely. In 18 children with bone transplants no infections was observed and all the patients showed primary healing. The use of fibrin did not disturb the bone reconstruction. After 12 weeks the reconstruction of the bone was almost complete. In two cases only we had to make a reoperation, caused by a recurrent cyst. We could not observe any hepatitis in our patients. The operative technique and advantages of treatment were discussed.

Within 7 years 12 children with a intercondylar eminence fracture (Typ I 5, Typ II 3, Typ III 4 times) according to Meyers and McKeever were treated in the Department of Pediatric Surgery of the Rudolf-Virchow-Hospital in Berlin. 7 avulsed intercondylar eminences were treated operatively by means of transepiphysial compression screws and wires. Temporary, transepiphysial screwing or wiring for a period of maximal six weeks is recommended. The results were excellent in 11 children and good in one child.

Temporary implantation of Gentamycin PMMA beads and chains provides a most effective local antibiotic therapy as supplementary and consecutive treatment after surgical procedures executed in bone and soft tissue infections. Gentamycin beads and chains are used as an alternative to irrigation-suction drainage. From 1977 to 1979 70 patients were treated for chronic post-traumatic osteomyelitis and infection of the soft tissue. The chronic bone infections subsided completely in 90% of the patients, but 8.3% re-infections were observed within 3 to 24 months after termination of treatment. In 18 patients with gunshot wounds 66.6% of the patients got primary healing and 33.4% secondary healing.

The article reports on etiology, clinics and treatment of pathological fractures caused by benign, semimalign bone tumors as well as tumorlike lesions and inflammatory bone alterations in childhood. Our patients treated between the years of 1972 and 1986 were reexamined and the results reconsidered thoroughly. Of 47 children with pathological fractures 38 were treated surgically. The treatment consisted of tumor excision or milling out respectively, perforation of the excavation and its subsequent filling with autologous spongiosa combined with additional stabilization by osteosynthesis. With this surgical therapy 3 recurrent cysts were observed of which one resulted in a refracture. With the majority of the children the pathological fracture lead to the discovery of the tumor.

Segmentary resection of a traumatic ruptured spleen was carried out in two children. Bleeding of the resected area was prevented by stitching, and the resected space was sealed up by means of a layer of a collagen preparation and with fibrin adhesive. Furthermore, the parenchymal space was enveloped in a dexon net that was fastened under slight tension to the capsule of the residual spleen by means of fibrin adhesive. Postoperative progress of both children was without complications. Postoperatively a residual spleen was seen sonographically having approximately the size of an organ of substandard dimension.