From 1984 to 1990 we treated 18 patients aged 5 to 15 1/2 years with solitary bone cysts of the humerus, the femur and the calcaneus. To fill the defect, tricalcium phosphate (TCP) instead of bone grafting was used. The clinical and radiological long-term results up to seven years postoperatively are reported. In 16 patients TCP was well incorporated without any adverse reaction to the synthetic material. Two patients with a recurrence of the bone cyst were successfully reoperated. We conclude that ceramics are a cheap and easy available substitute for bone grafts in the treatment of solitary bone cysts.
Every year about a hundred children with burns and scalds are hospitalised in the Burns Unit of the University Children's Hospital in Zürich. 15% of these patients are children between 1/2 to 4 years old with isolated burns and scalds of their hands. The experience gained in the treatment of 53 such children during 4 years is described. The burn healed spontaneously in 31 patients; in 22 cases Thiersch grafts had to be used. In the follow-up treatment compression suits and special splints to prevent secondary contractures were employed. The results of this treatment using splints and compression suits are discussed.
Beta-Tricalcium phosphate granulates (Ceros 82) implanted in femurs of the rat led to osteoconduction already one week after implantation. Compared to the problems of autologous implants, TCP presents many advantages: No operation on the donor site, no limitation of quantity, clinically negligible resorption, immediate osteoconduction. The results on femoral defects of 26 rats filled up by beta-TCP and our first clinical experiences on juvenile bone cysts are presented.
From 1982 to 1984 140 patients with fractures of the fingers were admitted to the department of surgery of the University Children's Hospital. Only 28 patients (21.5%) suffered from intraarticular fractures. Three 3/12 years later, 10 patients (35.7%) presented functional trouble or suffered from pain. Only 2 of the 15 conservatively treated patients had trouble. On the other hand, 8 children out of the 13 operatively treated patients presented an unsatisfactory result. Localisation, type of fracture and kind of treatment are analysed. We prefer as a rule conservative treatment excepting fractures of type Salter III and IV, osseous ruptures of the ulnar collateral ligament of the thumb and dislocated fractures. We suggest splinting with 0.6 mm K-wires.
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