Die Schädelbasisfraktur Und Ihre Akuten Komplikationen: Erfahrungen an 571 Fällen
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Über 20 Jahre sind seit K. H. BAUERs5 Referat über die Schädel- basisfraktur (Sch.boIr.) auf dem Deutschen Chirurgenkongre 1939 ver- gangen. Durch die Arbeiten zahlreicher Forscher konnte seither die Dia- gnostik der Schädel-Hirn verletzungen weiter verfeinert und die Therapie verbessert werden. Überall ist eine rapide Zunahme der schweren Kopf- 184 verletzungen durch Verkehrsunfälle zu beobachten. Nach MARCUS be- trafen im Krankengut der 1. Unfallstation in Wien in den Jahren 1949 bis 1954 36 % aller bei Verkehrsunfällen erlittenen Verletzungen den Kopf. Da bei schweren Schädeltraumen die Behandlung sehr dringlich ist, müssen die Verunglückten in das nächstgelegene Krankenhaus ge- bracht werden 34. Ein langer Transport in eine SpezialkIinik wird einem tief bewu tlosen, röchelnden Patienten meist mehr schaden als nü zen. Die Ma nahmen bei akuten Verletzungsfolgen müssen daher jedem Chir- urgen geläufig sein 122. In der vorliegenden Arbeit sollen alle mit der Sch.boIr. verknüpften Probleme an Hand der Literatur und des gro en Krankengutes der 1. Unfallstation in Wien dargestellt werden. Während in den Jahren 1909-1919 an dieser Station 129 Sch.boIrn. und in den Jahren 1931-1934 175 Sch.boIrn. behandelt wurden 29, 149, umfa t das Krankengut der Jahre 1948-1957 bereits 571 Fälle, welche die Grund- lage dieser Ausführungen bilden. 11. Alter und Geschlecht der Verletzten Von unseren 571 Patienten waren 401 männlich (70%) und nur 170 weiblich (30%). Tabelle 1 zeigt die Verteilung auf die einzelnen Jahre.
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