MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Der Unfallchirurg' source. Thu, 09 Feb 2012 00:02:27 +0100 http://www.medworm.com/index.php?rid=5665402&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22294422%26dopt%3DAbstract CONCLUSION: Especially the treatment of multiply injured patients is a challenge for young medical professionals. However, there is a high motivation to learn and train in emergency medicine. The students long for a practical trauma course compared to the advanced medical CPR course provided by the Department of Anaesthesiology of the University of Heidelberg. Those algorithm-based trauma courses do exist with PHTLS® and ATLS®. Based on these courses we developed the PHTLS® TEAM course. PMID: 22294422 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5665402 Thu, 02 Feb 2012 05:00:00 +0100 5665402 http://www.medworm.com/index.php?rid=5610025&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22258311%26dopt%3DAbstract CONCLUSION: The DTR technique provides lower CC distance compared to the STR technique, without a significant difference of CC distance and scores. PMID: 22258311 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5610025 Fri, 20 Jan 2012 05:00:00 +0100 5610025 http://www.medworm.com/index.php?rid=5520676&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22170326%26dopt%3DAbstract CONCLUSION: Anamnestic risk factors correlate with pathological BMD more than bone-specific laboratory values. The LOS Questionnaire used in this study would therefore function as a cost-effective primary diagnostic instrument for identification of osteoporosis patients. PMID: 22170326 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520676 Thu, 15 Dec 2011 05:00:00 +0100 5520676 http://www.medworm.com/index.php?rid=5520681&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22159529%26dopt%3DAbstract We present a patient history of an unusual case of an irreducible avulsion fracture with intra-articular dislocation including the surgical management and a review of the literature. PMID: 22159529 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520681 Sat, 10 Dec 2011 05:00:00 +0100 5520681 http://www.medworm.com/index.php?rid=5520684&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22159502%26dopt%3DAbstract Authors: Zwipp H, Ernstberger A, Groschupf V, Günther KP, Haase M, Haasper C, Hagemeister C, Hannawald L, Juhra C, Leser H, Lob G, Maier R, Seeck A, Winkler R, Otte D Abstract During a 1-day workshop organized by the German Society of Orthopaedics and Traumatology (DGOU) 15 German accident researchers used different approaches to improve the effectiveness of accident prevention for pedestrians and bicyclists on German roads. The main results of this analysis show: Fatal injuries of pedestrians have been significantly reduced by 82% between 1970 (n=6.056) and 2007 (n=695). Similarly, fatalities of bicyclists have been reduced during the same time period from 1,835 to 425 which amount to almost 80%. However, the total number of injured cyclists increased almost twice, i.e. from 40,5... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520684 Fri, 09 Dec 2011 05:00:00 +0100 5520684 http://www.medworm.com/index.php?rid=5520683&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22159503%26dopt%3DAbstract Authors: PMID: 22159503 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520683 Fri, 09 Dec 2011 05:00:00 +0100 5520683 http://www.medworm.com/index.php?rid=5520682&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22159504%26dopt%3DAbstract [A new reduction technique for posterior locked shoulder dislocation : Case report and technique description.] Unfallchirurg. 2011 Dec 9; Authors: Godry H, Citak M, Königshausen M, Schildhauer TA, Seybold D Abstract The case of a 61-year-old male with posterior dislocation of the right shoulder joint is presented and a new technique for closed reduction of posterior locked shoulder dislocation is described. The technique involves four steps: in step 1 a constant traction is applied on the injured arm, in step 2 the arm is internally rotated and in steps 3 and 4 the second arm of the physician is used as a lever arm to lateralize and ventralize the shoulder. Lateralization and ventralization of the humeral head are essential to engage the humeral head and to pass it around ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520682 Fri, 09 Dec 2011 05:00:00 +0100 5520682 http://www.medworm.com/index.php?rid=5520695&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22108769%26dopt%3DAbstract [Proximal humerus fracture : New aspects in epidemiology, fracture morphology, and diagnostics]. Unfallchirurg. 2011 Dec;114(12):1051-8 Authors: Hirzinger C, Tauber M, Resch H Abstract The incidence of proximal humerus fractures is rising and they constitute the third most frequent fracture in the elderly after femoral fractures in the hip area and radius fractures. They are caused by the age-related increase in osteoporosis. In contrast to young people, low-energy trauma involved in simple falls represents the mechanism that leads to the injury in older people. Numerous authors have introduced systems for the classification of proximal humerus fractures.After a thorough clinical examination of the affected extremity including assessment of circulation, motor function, and ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520695 Thu, 01 Dec 2011 05:00:00 +0100 5520695 http://www.medworm.com/index.php?rid=5520694&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22108770%26dopt%3DAbstract Authors: Jaeger M, Maier D, Izadpanah K, Strohm P, Südkamp NP Abstract Fractures of the proximal humerus are common, particularly seen in elderly, female patients. Using open reduction and internal fixation good clinical results can be achieved in general. But even today not every problem has been solved in the treatment of proximal humeral fractures. Varus displaced fractures are particularly challenging, especially when the medial column is destroyed. Anatomical reduction of the humeral head and medial bone contact are crucial for a good surgical outcome. Otherwise a secondary varus collapse and/or an implant failure are predictable. Further challenges are the intra-articular fracture patterns, as well as fractures with an initial ischemic humeral head. The indications for prost... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520694 Thu, 01 Dec 2011 05:00:00 +0100 5520694 http://www.medworm.com/index.php?rid=5520693&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22108771%26dopt%3DAbstract Authors: Scheibel M Abstract During the past decade the evaluation of the rotator cuff in the management of proximal humeral fractures has received increasing attention. Different studies have investigated the pathomorphology, prevalence and impact of rotator cuff lesions on the outcome of non-operative or surgical treatment of proximal humeral fractures. Tendon defects, either chronic or trauma related, are observed mainly in the anterosuperior or posterosuperior aspect of the rotator cuff and present as partial- or full-thickness tears. Structural changes of the rotator cuff muscles including atrophy and fatty infiltration in the context of proximal humeral fractures have been inadequately investigated. The prevalence of coexisting rotator cuff pathology varies between 5 and grea... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520693 Thu, 01 Dec 2011 05:00:00 +0100 5520693 http://www.medworm.com/index.php?rid=5520692&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22108772%26dopt%3DAbstract Authors: Voigt C, Lill H Abstract Proximal humeral fractures are always a relevant topic in routine clinical practice. Modern surgical techniques and implants do not resolve all problems. So, this fracture remains the focus of current research. As a consequence, some innovative approaches have arisen. The following recent trends can be observed and analyzed in detail: (1) Arthroscopically assisted fracture treatment and therapy of concomitant injuries/fracture sequelae, (2) locking plates: results and complication rates of recent implants, relevance of polyaxiality, impact of osteoporotic bone structure, (3) debate: what is "minimally invasive?", (4) "medial support", (5) Arthroplasty in fracture situations - the reversed shoulder arthroplasty as primary fracture prosthesis in the ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520692 Thu, 01 Dec 2011 05:00:00 +0100 5520692 http://www.medworm.com/index.php?rid=5520690&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22139056%26dopt%3DAbstract Authors: PMID: 22139056 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520690 Thu, 01 Dec 2011 05:00:00 +0100 5520690 http://www.medworm.com/index.php?rid=5520689&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22139057%26dopt%3DAbstract Authors: Lill H, Krettek C PMID: 22139057 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520689 Thu, 01 Dec 2011 05:00:00 +0100 5520689 http://www.medworm.com/index.php?rid=5520688&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22139058%26dopt%3DAbstract [Proximal humerus fracture : Is fixed-angle plate osteosynthesis superior to conservative treatment?]. Unfallchirurg. 2011 Dec;114(12):1059-67 Authors: Krettek C, Wiebking U Abstract KEYWORDS: Despite the fact that proximal humerus fractures represent one of the most frequent types of all fractures, the quality of evidence is poor although it has improved in recent years. It is widely agreed in the literature that nondisplaced fractures can be treated conservatively with good outcome. Two recent prospective randomized studies have shown that this also applies to displaced three- and four-part fractures.The results of fixed-angle plate osteosynthesis are also not superior to conservative management in complex displaced fractures in the elderly and in many aspects are even wo... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520688 Thu, 01 Dec 2011 05:00:00 +0100 5520688 http://www.medworm.com/index.php?rid=5520687&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22139059%26dopt%3DAbstract Authors: PMID: 22139059 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520687 Thu, 01 Dec 2011 05:00:00 +0100 5520687 http://www.medworm.com/index.php?rid=5520686&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22139060%26dopt%3DAbstract [Network "cirsmedical.de" and what is the benefit for trauma surgeons?]. Unfallchirurg. 2011 Dec;114(12):1120-1 Authors: Rohe J, Thomeczek C PMID: 22139060 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520686 Thu, 01 Dec 2011 05:00:00 +0100 5520686 http://www.medworm.com/index.php?rid=5520685&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22139061%26dopt%3DAbstract Authors: PMID: 22139061 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520685 Thu, 01 Dec 2011 05:00:00 +0100 5520685 http://www.medworm.com/index.php?rid=5520691&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22116585%26dopt%3DAbstract [Quality assurance with the aid of routine data : Is the quality of results henceforth measurable?] Unfallchirurg. 2011 Nov 26; Authors: PMID: 22116585 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520691 Sat, 26 Nov 2011 05:00:00 +0100 5520691 http://www.medworm.com/index.php?rid=5520696&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22101779%26dopt%3DAbstract We report the case of a long-lasting cutaneous side effect after inappropriate use of Octenisept® solution (containing octenidine and phenoxyethanol). Following lavage of an abscess in the inguinal region, a painful erythematous induration mimicking cellulitis persisted for several months. Manual lymphatic drainage considerably improved the symptoms. Octenisept® shows considerable tissue toxicity in vivo including - but not restricted to - blood vessel damage. Deterioration of endothelial cells followed by oedema and continued tissue damage can be seen histologically. Despite the fact that there is a circular letter issued by the manufacturer as well as a boxed warning on the bottles, the awareness to avoid this misuse of Octenisept® is still lacking. PMID: 22101779 [PubMed - as sup... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520696 Sun, 20 Nov 2011 05:00:00 +0100 5520696 http://www.medworm.com/index.php?rid=5520699&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22101776%26dopt%3DAbstract [Adherence to compression therapy : Psychoeducation and strengthening of resources as factors promoting adherence.] Unfallchirurg. 2011 Nov 18; Authors: Zschaler S Abstract Pressure garment therapy shows dropout rates between 30% and 59%. It is not the patient's health-related beliefs which lead to abandonment of therapy but the amount of negative side effects accompanying pressure garment therapy. Moreover, patients report a lack of information dealing with the garments, anxiety of damaging the skin and feelings of shame in contact with other people. The disabilities and restraints cannot be dispersed but only moderated. The two basic variables of an adherence promoting model are psychoeducation and strengthening of resources within a participative relationship between the... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520699 Fri, 18 Nov 2011 05:00:00 +0100 5520699 http://www.medworm.com/index.php?rid=5520698&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22101777%26dopt%3DAbstract CONCLUSIONS: Most fractures of the thoracic and lumbar spine heal fast and without any sequelae. Unstable fractures of type B and C (exclusively occurring as a result of traffic accidents) need operative stabilization as in adults. PMID: 22101777 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520698 Fri, 18 Nov 2011 05:00:00 +0100 5520698 http://www.medworm.com/index.php?rid=5520697&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22101778%26dopt%3DAbstract CONCLUSION: Performing the double bundle technique for ACL reconstruction in a university hospital setting, significant cost reductions are needed to achieve the revenue generated by the single bundle technique. Additional changes of the relative weighting in the DRG are also necessary. PMID: 22101778 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5520697 Fri, 18 Nov 2011 05:00:00 +0100 5520697 http://www.medworm.com/index.php?rid=5430313&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22083227%26dopt%3DAbstract [Pertrochanteric fractures : What impact do surgical timing and implant choice have on the outcome?] Unfallchirurg. 2011 Nov 16; Authors: Kostuj T, Smektala R, Schulze-Raestrup U, Müller-Mai C Abstract Pertrochanteric fractures are grouped together with femoral neck fractures to represent the most frequent femur fractures in the region of the hip joint and usually occur in elderly people with preexisting conditions. Analysis of the data from the 2004/2005 quality assurance program of North Rhine-Westphalia shows, just as is the case for medial femoral neck fractures, that not only does delayed management increase risk-adjusted general and surgical complications but also mortality. PMID: 22083227 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5430313 Wed, 16 Nov 2011 05:00:00 +0100 5430313 http://www.medworm.com/index.php?rid=5430312&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22083228%26dopt%3DAbstract CONCLUSION: Of all severely injured patients in trauma centres, 5% suffered their injuries as a consequence of a suicidal attempt. In women who survived initially, jumping from a height was the most frequently chosen method. In elderly men the use of firearms dominated. The significant increase of mortality in elderly patients, preexisting depressive conditions and the expected increase in the number of these patients as a consequence of the changed age pyramid should lead to more intensive recognition and treatment of this disease and possibly improved suicide prevention. PMID: 22083228 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5430312 Wed, 16 Nov 2011 05:00:00 +0100 5430312 http://www.medworm.com/index.php?rid=5430314&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22072058%26dopt%3DAbstract CONCLUSION: The failure mechanism in volar plating of distal radius fractures depended on the number of screws and their configuration. Using two more screws increases construct stiffness and angular stability under dynamic loading. However, increased stiffness also promoted screw penetration mainly in osteoporotic bone. Compared to screw penetration, loss of reposition and inclination of the distal fragment observed in the 4SC configuration is more likely to result in clinical complications. PMID: 22072058 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5430314 Fri, 11 Nov 2011 05:00:00 +0100 5430314 http://www.medworm.com/index.php?rid=5385289&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22048450%26dopt%3DAbstract Authors: Ney L, Mutschler W PMID: 22048450 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5385289 Fri, 04 Nov 2011 04:00:00 +0100 5385289 http://www.medworm.com/index.php?rid=5385288&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22048451%26dopt%3DAbstract [Nutritional management of severely injured patients : Treatment between guidelines and reality.] Unfallchirurg. 2011 Nov 4; Authors: Ney L, Annecke T Abstract Severe trauma triggers endocrine and inflammatory responses, leading to hyperglycaemia, insulin resistance and protein catabolism. Pharmacological and nutritional interventions cannot counteract these metabolic disturbances. However, adequate supply of energy and proteins may reduce excessive catabolism.Available guidelines recommend early use of enteral nutrition with energetic supply of about 25 kcal/kg and additional protein supply of 1.5 g/kg/day. These aims will be missed frequently by solely providing enteral nutrition in severely injured patients. Early supplemental parenteral nutrition should be used in these... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5385288 Fri, 04 Nov 2011 04:00:00 +0100 5385288 http://www.medworm.com/index.php?rid=5385292&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22033564%26dopt%3DAbstract Authors: Felbinger TW, Sachs M, Richter HP Abstract Immunonutrition may be superior to standard clinical nutrition in specific clinical situations. After severe trauma, an enteral immuno-enhancing diet, enriched with arginine, omega-3 fatty acids, and nucleotides, decreases infectious complications. During acute respiratory distress syndrome, a continuous enteral diet with high-dose omega-3 fatty acids, gamma-linolenic acid, and antioxidants improved clinical outcome. Glutamine should be administered enterally or parenterally whenever total parenteral nutrition is indicated. PMID: 22033564 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5385292 Fri, 28 Oct 2011 04:00:00 +0100 5385292 http://www.medworm.com/index.php?rid=5385291&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22033565%26dopt%3DAbstract Authors: Hoffmann M, Rueger JM Abstract Polytrauma mortality rates are continuously decreasing over the last years. Due to rising prevalence of obesity, patients with overweight and obesity are rising in numbers within the polytrauma collective. The body mass index (BMI) provides information about the nutritional status. Varying results have been reported concerning the effect of BMI on polytrauma outcome. Both obesity and underweight are independent risk factors for increased polytrauma mortality. While underweight is associated with early polytrauma mortality, obesity shows higher rates of multi organ failure and sepsis and is associated with late polytrauma mortality. PMID: 22033565 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5385291 Fri, 28 Oct 2011 04:00:00 +0100 5385291 http://www.medworm.com/index.php?rid=5385290&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22038236%26dopt%3DAbstract We report about the first hip arthroscopies of extracapsular neglected hip dislocations with concomitant injuries in two children (2 and 4 years old). The major problem of traumatic hip dislocation is avascular necrosis. Further problems are possible concomitant injuries. It is important not to cause further damage by therapeutic procedures. In a 4-year-old child the hip could be reduced under visualization and in a 2-year-old child with epiphyseal fracture the extent of the operation could be reduced. In both children large avulsion injuries of the ligamentum capitis femoris could be resected via hip arthroscopy. Hip arthroscopy can reduce surgical morbidity considerably and can possibly contribute to prevention of the feared avascular necrosis of the femoral head. PMID: 22038236 [Pub... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5385290 Wed, 26 Oct 2011 04:00:00 +0100 5385290 http://www.medworm.com/index.php?rid=5385293&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22009043%26dopt%3DAbstract [Open pertrochanteric fracture of the femur and post-traumatic osteitis in a child : Interposition of a pedicled vascularized fibula to preserve the femoral head in a child after.] Unfallchirurg. 2011 Oct 20; Authors: Hußmann B, Taeger G, Hierner R, Nast-Kolb D, Lendemans S Abstract The free microvascular fibula diaphysis transplant as femoral neck replacement with preservation of the patient's own femoral head due to a severe infection situation represents a rare indication in the treatment of young patients. In the current literature, such surgical methods do not exist. In the case described here, the free microvascular fibula transplant serves as femoral neck replacement with preservation of the patient's own femoral head without any postoperative mobility restrictions.... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5385293 Thu, 20 Oct 2011 04:00:00 +0100 5385293 http://www.medworm.com/index.php?rid=5385294&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21993535%26dopt%3DAbstract CONCLUSION: It has to be verified if logistic conclusions of these results can lead to more efficiency in a hospital. The underlying analysis is applicable for every hospital and poses a valid controlling tool. PMID: 21993535 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5385294 Fri, 14 Oct 2011 04:00:00 +0100 5385294 http://www.medworm.com/index.php?rid=5303423&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21979887%26dopt%3DAbstract Authors: PMID: 21979887 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5303423 Sat, 01 Oct 2011 04:00:00 +0100 5303423 http://www.medworm.com/index.php?rid=5303422&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21979888%26dopt%3DAbstract This article details the Hawkins classification, operative treatment and indications, and complications of fractures of the neck of the talus. It also discusses the treatment of fractures of the body of the talus and talar head. An English full text version of this article is available at SpringerLink as supplemental. PMID: 21979888 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5303422 Sat, 01 Oct 2011 04:00:00 +0100 5303422 http://www.medworm.com/index.php?rid=5303421&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21979889%26dopt%3DAbstract Authors: Clare MP, Sanders RW Abstract Fractures of the calcaneus generally occur in the setting of high-energy trauma, resulting in complex, three-dimensionally oriented fracture patterns. Surgical treatment is typically indicated for displaced intra-articular fractures, permitting restoration of calcaneal height, width and overall morphology, in addition to the posterior facet articular surface where possible, and enabling late in situ arthrodesis as a means of salvage in the event of post-traumatic arthritis. The present article briefly discusses our preferred methods for the management of calcaneal fractures. An English full text version of this article is available at SpringerLink as supplemental. PMID: 21979889 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5303421 Sat, 01 Oct 2011 04:00:00 +0100 5303421 http://www.medworm.com/index.php?rid=5303420&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21979890%26dopt%3DAbstract This article illustrates the causes of preventable mistakes and points out options to increase clinical outcome. PMID: 21979890 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5303420 Sat, 01 Oct 2011 04:00:00 +0100 5303420 http://www.medworm.com/index.php?rid=5303419&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21979891%26dopt%3DAbstract CONCLUSION: The web-based care capacity proof system introduced in 2010 does justice to the demand for optimum resource use on-line. Integration of this allocation system into the developing trauma networks can optimize the process for a quick and high quality care of severely injured patients. It opens new approaches to improve allocation of high numbers of casualties in disaster medicine. PMID: 21979891 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5303419 Sat, 01 Oct 2011 04:00:00 +0100 5303419 http://www.medworm.com/index.php?rid=5223599&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21909733%26dopt%3DAbstract Authors: Prokop A, König B, Schultheiss M, Andresen R Abstract Kyphoplasty is an established procedure for the treatment of osteoporotic vertebral compression fractures. Developments in instrumentation and techniques have facilitated its use also for other localizations. In the hands of experienced practitioners smaller working cannulas and balloons have made successful treatment of high thoracic and cervical fractures and metastases possible. Balloon kyphoplasty performed for sacral insufficiency fractures in older patients plagued by chronic pain leads to marked pain reduction as well as faster weight-bearing. There are also early research results regarding the repair of tibial head defects and reinforcement with resorbable cement. These new procedures, which are currently appli... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5223599 Sun, 11 Sep 2011 04:00:00 +0100 5223599 http://www.medworm.com/index.php?rid=5223598&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21909734%26dopt%3DAbstract CONCLUSION: The concept of small volume resuscitation provides early and effective hemodynamic control. Clinical side-effects associated with bolus infusion of hypertonic-hyperoncotic solutions are rare. PMID: 21909734 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5223598 Sun, 11 Sep 2011 04:00:00 +0100 5223598 http://www.medworm.com/index.php?rid=5223597&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21909735%26dopt%3DAbstract Authors: Letta C, Schmied M, Haller A, Rindlisbacher A Abstract Combined forearm fractures are identified according to their location as Galeazzi, Monteggia or Essex-Lopresti injuries. The feature common to these three forms is the combination of a forearm fracture with instability of the distal or proximal radio-ulnar joint. The combination of Galeazzi and Monteggia fractures in the same extremity is an exceedingly rare occurrence. It has been reported in eight cases including two pediatric patients worldwide. In this case report the rare occurrence of the combination of these injuries and the possibility of pitfalls in the operative treatment are presented. PMID: 21909735 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5223597 Sun, 11 Sep 2011 04:00:00 +0100 5223597 http://www.medworm.com/index.php?rid=5223596&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21909736%26dopt%3DAbstract CONCLUSIONS: Thromboprophylaxis with enoxaparin is well tolerated under clinical conditions as well as under out-patient treatment and severe bleeding complications are rare. PMID: 21909736 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5223596 Sun, 11 Sep 2011 04:00:00 +0100 5223596 http://www.medworm.com/index.php?rid=5223595&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21909737%26dopt%3DAbstract Authors: Hinkelbein J, Spelten O, Wetsch WA Abstract Up to 32.2% of patients in a burn center suffer from electrical injuries. Of these patients, 2-4% present with lightning injuries. In Germany, approximately 50 people per year are injured by a lightning strike and 3-7 fatally. Typically, people involved in outdoor activities are endangered and affected. A lightning strike usually produces significantly higher energy doses as compared to those in common electrical injuries. Therefore, injury patterns vary significantly. Especially in high voltage injuries and lightning injuries, internal injuries are of special importance. Mortality ranges between 10 and 30% after a lightning strike. Emergency medical treatment is similar to common electrical injuries. Patients with lightning inju... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5223595 Sun, 11 Sep 2011 04:00:00 +0100 5223595 http://www.medworm.com/index.php?rid=5223594&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21909738%26dopt%3DAbstract Authors: Gille J, Kienast B, Voigt C, Oheim R, Schulz AP, Grosser V Abstract BACKGROUND: Anterior cruciate ligament tears are one of the most common human ligament ruptures. The assessment of such ruptures is partic-ularly difficult because most ACL injuries involve minimal to no contact. The steps of the assessment are pre-sented with the necessary requirements. METHOD: Criteria for determining the cause of anterior cruciate ligament ruptures are discussed against the background of our experience and the literature. Different definitions of causality apply to German statutory accident insurance (workers' compensation) on the one hand and to private accident insurance on the other. RESULTS: The assessment of disability within the scope of workers' compensation in most cases results... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5223594 Sun, 11 Sep 2011 04:00:00 +0100 5223594 http://www.medworm.com/index.php?rid=5223593&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21909739%26dopt%3DAbstract CONCLUSION: The treatment of comminuted shaft fractures of the clavicle by means of a multidimensional locking plate is a safe treatment option that includes early functional postoperative care with free range of motion. PMID: 21909739 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5223593 Sun, 11 Sep 2011 04:00:00 +0100 5223593 http://www.medworm.com/index.php?rid=5223592&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21909740%26dopt%3DAbstract Authors: Baschera D, Sebunya J, Zellweger R Abstract The fact that many inferior vena cava filters (IVCF) in trauma patients are not being removed has been described numerous times in the literature, but nobody really gives a reason why. This case presents a young patient who prophylactically received an optional IVCF after sustaining severe multitrauma. He had a failed retrieval 8 weeks post insertion and consequently was lost to follow-up before a second removal attempt was performed. Institutions inserting IVCF should establish guidelines for following up patients receiving prophylactic IVCF. PMID: 21909740 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5223592 Sun, 11 Sep 2011 04:00:00 +0100 5223592 http://www.medworm.com/index.php?rid=5223591&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21909741%26dopt%3DAbstract Authors: Mittlmeier T Abstract Acute posttraumatic compartment syndrome of the foot is generally the consequence of a severe foot trauma. If the compartment syndrome is left unrecognized and untreated foot deformities and a variety of different functional impairments will follow, making secondary surgical interventions necessary. At present 9 or 10 clinically relevant compartments can be defined anatomically. The early diagnosis particularly in the unconscious patient is based essentially on measurement of the tissue pressure in the corresponding compartments. An effective compartment release depending on the extent of injury and involvement of the specific compartments needs knowledge of three different approaches. A complex foot trauma represents a clearly defined term (Zwipp sco... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5223591 Sun, 11 Sep 2011 04:00:00 +0100 5223591 http://www.medworm.com/index.php?rid=5199274&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21887538%26dopt%3DAbstract CONCLUSIONS: Both interference screw and a press-fit fixation lead to a high number of good or very good outcomes after ACL reconstruction. Tibial press-fit fixation decreases the amount of proximal bone tunnel enlargement. Press-fit fixation decreases the amount of proximal bone tunnel enlargement and improves bone to tendon contact. PMID: 21887538 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5199274 Sat, 03 Sep 2011 04:00:00 +0100 5199274 http://www.medworm.com/index.php?rid=5182451&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21879301%26dopt%3DAbstract Authors: Brand S, Teebken OE, Bolzen P, Hildebrand F, Wilhelmi M, Krettek C, Probst C Abstract Injuries of internal carotid arteries caused by high energy trauma are rare but often combined with poor outcome. Blunt trauma to the head and neck as well as the use of newer motorcycle helmets together with crash circumstances should promptly lead to a differentiated polytrauma management with expansion of radiologic diagnostics. This could lead to a reduction of overlooked dissections and an increase in promptly and correctly treated injuries. PMID: 21879301 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5182451 Wed, 31 Aug 2011 23:00:00 +0100 5182451 http://www.medworm.com/index.php?rid=5182450&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21879302%26dopt%3DAbstract CONCLUSION: The analyzed data support the rating of femoral neck fracture as requiring the intervention of urgent early surgery, as stated in the guideline. Percutaneous screw fixation can be considered for immobile and multimorbid patients with undislocated fractures. Advantages of total hip replacement compared to hemiarthroplasty cannot be supported by the QS-NRW data. PMID: 21879302 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5182450 Wed, 31 Aug 2011 23:00:00 +0100 5182450 http://www.medworm.com/index.php?rid=5182449&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21879303%26dopt%3DAbstract Authors: Lessing C, Siebert H PMID: 21879303 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5182449 Wed, 31 Aug 2011 23:00:00 +0100 5182449 http://www.medworm.com/index.php?rid=5182448&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21879304%26dopt%3DAbstract Authors: Ochman S, Evers J, Raschke MJ Abstract Injuries of the midfoot are often missed and therefore underestimated. The diagnosis and primary treatment are crucial for the outcome. An accurately made diagnosis and therapy initially can anticipate the extent of post-traumatic malpositioning, arthrosis and the number of subsequent surgeries.Diagnostics should liberally include computed tomography with multiplanar reconstructions; clinically a compartment syndrome should be treated at an early stage. Surgery includes anatomical reconstruction of the relevant joints and ligamentous structures and restoration of axes and lengths of the columns of the foot. Innovations comprise intraoperative 3-D imaging and computer-assisted surgery for quality control. New methods for ligamentous in... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5182448 Wed, 31 Aug 2011 23:00:00 +0100 5182448 http://www.medworm.com/index.php?rid=5182452&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21877221%26dopt%3DAbstract Authors: Panzica M, Krettek C, Cartes M Abstract The probability that an inpatient will be harmed by a medical procedure is at least 3% of all patients. As a consequence, hospital risk management has become a central management task in the health care sector. The critical incident reporting system (CIRS) as a voluntary instrument for reporting (near) incidents plays a key role in the implementation of a risk management system. The goal of the CIRS is to register system errors without assigning guilt or meting out punishment and at the same time increasing the number of voluntary reports. PMID: 21877221 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5182452 Tue, 30 Aug 2011 23:00:00 +0100 5182452 http://www.medworm.com/index.php?rid=5167567&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21870132%26dopt%3DAbstract Authors: Dietz SO, Nowak TE, Burkhart KJ, Müller LP, Rommens PM Abstract The intraarticular fracture of the distal humerus in an elderly patient remains a challenge for trauma surgeons. In case of severe co-morbidities and/or osteoporosis stable fixation with screws and plates is difficult and in some cases can be impossible. Even if osteosynthesis is feasible the clinical outcome is still incalculable due to delayed or non-union of the fracture fragments. Endoprosthetic replacement of the elbow joint for comminuted distal humerus fractures has been used for almost 20 years. The clinical results are predominantly excellent or good and better predictable than those of osteosynthesis. There still is no guideline when a prosthesis for the elbow joint should be used. We reviewed the ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5167567 Fri, 26 Aug 2011 23:00:00 +0100 5167567 http://www.medworm.com/index.php?rid=5167566&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21870133%26dopt%3DAbstract Authors: Kirschner S, Hamann C, Handreka S, Günther KP, Hartmann A Abstract Implementation of total hip arthroplasty is a successful and reliable treatment for end-stage osteoarthritis. The biomechanics and components as well as the fixation were selected with the aid of templating. Based on a cohort of 114 patients the quality of digital X-rays and the operative results were determined. There was a slight leg lengthening and a good offset reconstruction in these patients. For the patients with replacement of the second hip the leg lengthening was smaller. The cup inclination was at 43° and 44° within the desired range. The prediction of the exact component size used was 40% for the cup and 29% for the stem.Through variation in scaling of the digital X-ray a diminishing predicti... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5167566 Fri, 26 Aug 2011 23:00:00 +0100 5167566 http://www.medworm.com/index.php?rid=5167565&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21870134%26dopt%3DAbstract Authors: Passauer-Baierl S, Hofinger G Abstract The treatment of patients in the trauma room places extraordinary demands on the multidisciplinary and multiprofessional team with regard to expert qualifications and teamwork. The present study triangulates data extracted from observation, interviews and questionnaires. In general, team climate and teamwork are good, yet some problems could be identified. Not all team members-especially younger physicians and nurses-feel free to express their doubts and uncertainties. Furthermore, the treatment plan is not always clear for all team members. Absent or unclear leadership is seen as a main problem when a treatment proceeds negatively. The establishment of a team leader is therefore recommended. PMID: 21870134 [PubMed - as supplied b... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5167565 Fri, 26 Aug 2011 23:00:00 +0100 5167565 http://www.medworm.com/index.php?rid=5167568&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21863384%26dopt%3DAbstract CONCLUSION: Knowledge and reflection on the experience of the 2010 Love Parade optimizes local emergency guidelines and planning for similar events. A coordinated cooperation of all involved is essential. PMID: 21863384 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5167568 Wed, 24 Aug 2011 23:00:00 +0100 5167568 http://www.medworm.com/index.php?rid=5167569&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21858469%26dopt%3DAbstract Authors: Siebert H, Stockheim M, Kienapfel H, Blömer W Abstract Incidents involving implants, whether there is a break in the osteosynthesis plate or a synthetic inlay of an endoprosthesis, are incidents with mostly severe repercussions for the patient with immediate and delayed effects for the clinic involved and the manufacturer. PMID: 21858469 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5167569 Sat, 20 Aug 2011 23:00:00 +0100 5167569 http://www.medworm.com/index.php?rid=5126164&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21826493%26dopt%3DAbstract CONCLUSION: The allocation of common cases with a standardized treatment pattern appears to be appropriate and the reimbursement adequate. For the less common and more complex cases the 2011 G-DRG system still shows need for further modification (e.g. polytraumata, joint replacement, spine surgery). The proper integration of the modified OPS classification for foot surgery to the appropriate G-DRGs will be essential to maintain the high quality of the reimbursement structure for the future. PMID: 21826493 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5126164 Tue, 09 Aug 2011 23:00:00 +0100 5126164 http://www.medworm.com/index.php?rid=5126163&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21826494%26dopt%3DAbstract Authors: Huber-Lang M, Flohé SB, Marzi I A first meeting of the recently founded "Trauma Research Net" of the German Society for Orthopaedics and Trauma Surgery (DGOU e.V.) took place at the Reisensburg Castle, Günzburg, from 24 to 26 February 2011. Numerous representatives of trauma-related Research Institutes and University Hospitals in Germany demonstrated their main research foci. There was also an open discussion of current problems in trauma research, especially the lack of junior researchers and nationwide collaborations as well as limited information about the research topics of individual research groups. The overall research efforts of the "Trauma Research Net" apparently focus on fracture, multiple injury and inflammation on an organ and cellular level. Furthermore, an up-... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5126163 Tue, 09 Aug 2011 23:00:00 +0100 5126163 http://www.medworm.com/index.php?rid=5126162&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21826495%26dopt%3DAbstract CONCLUSION: Reimbursement of the top 15 diagnoses in hand surgery in Austria is 8% higher than in Germany. Except for one case, mean values as well as upper and lower thresholds of length of stay are considerably shorter in Austria. Comparison of international data to refine a national compensation system is advocated. PMID: 21826495 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5126162 Tue, 09 Aug 2011 23:00:00 +0100 5126162 http://www.medworm.com/index.php?rid=5126161&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21826496%26dopt%3DAbstract Authors: Scheld SM, Schmidt-Horlohé K, Fuchs S, Kemmerer M, Walter G, Hoffmann R Salmonella enterica serotype Enteritidis was detected in a 34-year-old, previously healthy patient who suffered from osteomyelitis of the costae. Radical surgical debridement and antibiotic therapy were able to stop the infection. An abdominal flap and a thoracic flap were used to cover the soft tissue defect. PMID: 21826496 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5126161 Tue, 09 Aug 2011 23:00:00 +0100 5126161 http://www.medworm.com/index.php?rid=5126168&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21800135%26dopt%3DAbstract Authors: Stange R, Raschke MJ, Fuchs T Demographic changes and rising numbers of implanted prostheses accompanied by increasing demands on mobility and activities of the elderly will lead to an increasing number of periprosthetic fractures in the future. Poor bone quality, geriatric comorbidities and multiple prostheses result in an increased risk for this type of fracture in the old patient. Management of these patients is challenging and demanding and needs an interdisciplinary approach.The present work describes the different aspects of periprosthetic fractures in the geriatric patient with regard to epidemiology, risk factors, prevention and treatment options. PMID: 21800135 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5126168 Sun, 31 Jul 2011 23:00:00 +0100 5126168 http://www.medworm.com/index.php?rid=5126167&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21800136%26dopt%3DAbstract Authors: Tosounidis G, Culemann U, Bauer M, Holstein JH, Garcia P, Kurowski R, Pizanis A, Aghayev E, Pohlemann T The aim of this study was to analyze the clinical outcome and incidence of hip arthritis in elderly patients with acetabular fractures. Because of poor bone quality in the elderly, even a low-energy trauma may lead to an acetabular fracture. An anatomical reconstruction of the acetabulum is necessary to achieve sufficient stability also for a potential hip arthroplasty. So far, there is very limited information on the outcome of acetabular fractures in the elderly.During a period of 6 years (2001-2006), 48 patients older than 60 years were admitted to our department with an acetabular fracture. Thirty-nine patients were treated operatively and nine patients non-operatively. ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5126167 Sun, 31 Jul 2011 23:00:00 +0100 5126167 http://www.medworm.com/index.php?rid=5126166&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21800137%26dopt%3DAbstract Authors: Fuchs T, Rottbeck U, Hofbauer V, Raschke M, Stange R The incidence of pelvic fractures at 0.3-8% is low compared to all fractures. Nevertheless, the number of pelvic fractures in the elderly is increasing. Due to the increased age of the patient differences in trauma mechanism, fracture pattern and therapy occur. Most pelvic fractures in the elderly are caused by low-energy trauma. This makes it difficult to find the right diagnosis especially in insufficiency fracture of the pelvis. The time until the right treatment is started is prolonged significantly. Elderly patients who suffer from a high-energy fracture have a significantly higher risk of haemorrhage. At the same time emergency stabilisation of the pelvis using a C-clamp is dangerous due to the special fracture morphol... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5126166 Sun, 31 Jul 2011 23:00:00 +0100 5126166 http://www.medworm.com/index.php?rid=5126165&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21809095%26dopt%3DAbstract Authors: von Dercks N, Schmidt C, Josten C The G-DRG-System is complex, mistakes in accounting are common. Therefore diagnosis with CCL-value are important because of the possibility of increasing revenues. Also procedures may lead to DRGs with a higher cost weight. So their acquisition is mandatory. The exact medical documentation is essential. High revenues have to be understood according to unvoidable expenditures. PMID: 21809095 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5126165 Sun, 31 Jul 2011 23:00:00 +0100 5126165 http://www.medworm.com/index.php?rid=5126159&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21826619%26dopt%3DAbstract Authors: Raschke MJ PMID: 21826619 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5126159 Sun, 31 Jul 2011 23:00:00 +0100 5126159 http://www.medworm.com/index.php?rid=5126158&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21826620%26dopt%3DAbstract Authors: Pichl J, Hoffmann R There has been a significant increase in the incidence and severity of ankle fractures in the elderly population in the last few decades. Classification and diagnostic procedures in the elderly are not different from standards in younger patients. We provide an overview of the characteristic features of treatment of ankle fractures in the elderly. An algorithm for therapy of ankle fractures in the elderly is presented. PMID: 21826620 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5126158 Sun, 31 Jul 2011 23:00:00 +0100 5126158 http://www.medworm.com/index.php?rid=5126157&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21826621%26dopt%3DAbstract Authors: Beynon C, Unterberg AW Traumatic brain injury is a leading cause of morbidity and mortality, especially under 45 years of age. The primary brain injury occurs at the moment of trauma and is defined by the direct damage to tissue. In contrast, secondary brain injury develops over time and is accessible to therapeutic interventions. Patients with severe traumatic brain injury have to be transferred to a specialized trauma centre in order to perform appropriate diagnostic and therapeutic procedures. These include surgical management of lesions (e.g. haematoma evacuation) as well as specific neurointensive care. Neurointensive care medicine principles such as treatment of increased intracranial pressure and advanced invasive neuromonitoring of brain tissue have to be followed. ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5126157 Sun, 31 Jul 2011 23:00:00 +0100 5126157 http://www.medworm.com/index.php?rid=5077436&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21785965%26dopt%3DAbstract Authors: PMID: 21785965 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5077436 Sat, 23 Jul 2011 23:00:00 +0100 5077436 http://www.medworm.com/index.php?rid=5077439&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21779899%26dopt%3DAbstract CONCLUSION: IT-based clinical pathways are applicable for routine use in trauma departments. For certain surgical procedures they are a suitable management device, even in a tertiary care facility. Clinical pathways lead to an improved operational structure of medical treatment and moreover to a complete and continuous documentation through the electronic file. PMID: 21779899 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5077439 Fri, 22 Jul 2011 23:00:00 +0100 5077439 http://www.medworm.com/index.php?rid=5077441&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21779897%26dopt%3DAbstract CONCLUSION: The surgical treatment of isolated ankle fractures as an outpatient procedure represents a safe and resource-efficient concept which is not associated with an increased complication rate. Cultural differences in the domestic environment of individual patients may have to be taken into consideration. PMID: 21779897 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5077441 Thu, 21 Jul 2011 23:00:00 +0100 5077441 http://www.medworm.com/index.php?rid=5077440&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21779898%26dopt%3DAbstract This article critically discusses the current literature and reports on first experiences with a new surgical concept in six geriatric patients aged 82-91 years: the combination of an anterior minimally invasive approach for open reduction and internal fixation of the acetabulum combined with an anterior minimally invasive (AMIS®) approach to the hip for total hip arthroplasty with promising short-term results. PMID: 21779898 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5077440 Thu, 21 Jul 2011 23:00:00 +0100 5077440 http://www.medworm.com/index.php?rid=5077438&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21779900%26dopt%3DAbstract Authors: Rammelt S, Heim D, Hofbauer LC, Grass R, Zwipp H Ankle fractures are the most frequent injuries of a load-bearing joint. Their treatment belongs to the daily routine in trauma surgery. However, despite an increased understanding of the mechanism of injury and relatively straightforward fixation techniques, the medium- to long-term results are often less than satisfactory. The following article therefore explicitly focusses on unsolved problems and controversies in the treatment of ankle fractures in the light of the current literature. These include the therapeutic and prognostic relevance of frequently used classification systems, criteria for the indication for surgery, frequent hazards in internal fixation, the question of whether and how to fix the posterior malleolus, and... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5077438 Thu, 21 Jul 2011 23:00:00 +0100 5077438 http://www.medworm.com/index.php?rid=5077437&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21779901%26dopt%3DAbstract Authors: Richter M PMID: 21779901 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5077437 Thu, 21 Jul 2011 23:00:00 +0100 5077437 http://www.medworm.com/index.php?rid=5077443&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21766203%26dopt%3DAbstract CONCLUSION: Following arthroscopic AC joint stabilization using the double TightRope™ technique, despite partial recurrent instability, favorable clinical results can be expected. PMID: 21766203 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5077443 Sat, 16 Jul 2011 23:00:00 +0100 5077443 http://www.medworm.com/index.php?rid=5077442&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21766204%26dopt%3DAbstract Authors: Herbort M, Raschke MJ There is an increasing incidence of ligament ruptures of the lower extremities in older patients. This higher incidence is caused by the typical current demographic changes in the population and the higher level of activity and athletic motivation of the older people in our society. In this review we address the most important ligament ruptures of the lower extremity in the old patient. Quadriceps tendon and Achilles tendon ruptures are mostly the result of degenerative and abrasion changes. The ACL rupture on the other hand occurs spontaneously after adequate trauma and without former degenerative changes especially in highly active patients.For a differentiated treatment of the older patient with tendon ruptures, secondary diseases, an increased risk an... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5077442 Sat, 16 Jul 2011 23:00:00 +0100 5077442 http://www.medworm.com/index.php?rid=5028715&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21748339%26dopt%3DAbstract Authors: Schmidt I, Schmieder A, Kilian O Exposed bradytrophic tissue in regions with high mechanical loading is an indication for defect coverage with (myo-, adipo-) fasciocutaneous flaps. In this case, distally based sural flaps were used for bilateral coverage of defects in weight-bearing areas of feet after fourth-degree frostbite. Residual defects can be covered with a split skin mesh graft. The definitive prosthetic supply of the foot assumes a stabilized plantar soft tissue situation. Among its advantages in comparison to free microvascular flaps, the locally based fasciocutaneous flap can be harvested with less donor site morbidity after elevation and does not require secondary debulking. It has been shown that the reduced stability at the border zone between flap and mesh graf... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5028715 Tue, 12 Jul 2011 23:00:00 +0100 5028715 http://www.medworm.com/index.php?rid=5028844&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21739355%26dopt%3DAbstract Unfallchirurg. 2011 Jul;114(7):556-557 Authors: PMID: 21739355 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5028844 Thu, 30 Jun 2011 23:00:00 +0100 5028844 http://www.medworm.com/index.php?rid=5028735&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21739356%26dopt%3DAbstract Authors: Maier D, Jaeger M, Izadpanah K, Bornebusch L, Südkamp NP Traumatic injuries of the sternoclavicular joint occur rarely and are mainly caused by an indirect trauma mechanism with high kinetic energy. Anterior dislocation is much more common than posterior dislocation, which may be associated with life-threatening injuries. The CT scan is the diagnostic tool of choice for accurate assessment of the injury and coexisting pathologies. The primary goal in anterior and posterior dislocations is an early closed reduction. In cases of redislocation after closed reduction of an anterior dislocation we recommend primary joint reconstruction on the basis of an individual therapeutic concept. Posterior dislocations often cannot be reduced by closed means. Then open reconstruction and sta... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5028735 Thu, 30 Jun 2011 23:00:00 +0100 5028735 http://www.medworm.com/index.php?rid=5028734&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21739357%26dopt%3DAbstract Authors: Maier D, Jaeger M, Izadpanah K, Bornebusch L, Südkamp N PMID: 21739357 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=5028734 Thu, 30 Jun 2011 23:00:00 +0100 5028734 http://www.medworm.com/index.php?rid=4928817&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21660510%26dopt%3DAbstract Authors: Vogel D, Lotter O, Stahl S, Pfau M, Schaller HE PMID: 21660510 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4928817 Fri, 10 Jun 2011 23:00:00 +0100 4928817 http://www.medworm.com/index.php?rid=4928816&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21660511%26dopt%3DAbstract Authors: Lotter O, Vogel D, Stahl S, Pfau M, Schaller HE Complicated flexor tendon injuries are classified into lacerations, avulsions, ruptures, and defects. They are often a challenge for hand surgeons and frequently they present unsatisfactory functional results postoperatively. Lacerations and avulsions are usually treated by pull-out sutures and suture anchors. In ruptures, the causality should be sought. Tendon-linking, transposition and tenodesis/arthrodesis are the domain of rheumatoid arthritis. The primary transplantation of tendons is rarely indicated, ideally in non-contaminated flexor tendon defects in zones III-V with an uninjured surrounding soft tissue situation. Postoperative rehabilitation programs are very the same as in normal flexor tendon injuries. PMID: 21660... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4928816 Fri, 10 Jun 2011 23:00:00 +0100 4928816 http://www.medworm.com/index.php?rid=4928815&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21660512%26dopt%3DAbstract Authors: Füchtmeier B, Gebhard F, Lenich A Fractures at the coxal end of the femur have an incidence of almost 100.000 p.a. in Germany. Pertrochanteric femur fractures make up almost half of this collective. The highest incidence of 1.32% is seen in patients over the age of 85. Osteosynthesis is the treatment of choice. The options include extramedullary nail/screw systems or intramedullary nail systems. Study findings to date do not show a clear advantage of one procedure over another. The published complication rates remain high. The main complication is secondary reduction loss with cutout of the hip screw. Other complications include femoral neck shortening and lateralization of the hip screw with local irritation at the iliotibial tract. Functional outcomes after osteosynthesis a... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4928815 Fri, 10 Jun 2011 23:00:00 +0100 4928815 http://www.medworm.com/index.php?rid=4928818&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21656037%26dopt%3DAbstract The objective of any surgical care of a trochanteric femoral fracture should be the achievement of a stable osteosynthesis that allows early full weight-bearing mobilisation of the patient, because long-term immobilisation soon becomes a vital threat to the affected patients who are usually elderly with correlating comorbidities. The anatomical references of the proximal femur and the structure of the hip joint contain some specifics that play an essential role in the incurrence of a trochanteric femoral fracture and the planning of the osteosynthesis as well. With reposition and fracture stabilisation particular importance must be attached to the collo-diaphyseal and the antetorsion angle so that they do not interfere with the functional interaction of the hip and knee joint. Uncomplex tr... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4928818 Wed, 08 Jun 2011 23:00:00 +0100 4928818 http://www.medworm.com/index.php?rid=4884775&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21626197%26dopt%3DAbstract Authors: Kraus M, Krischak G, Wiedmann K, Riepl C, Gebhard F, Jöckel JA, Scola A The incidence of trochanteric fractures is increasing in Europe, and the economic impact and mortality is high. The aim of the study was to evaluate the PFNA® (proximal femoral nail antirotation) with respect to its clinical use and mechanical complications.All patients with a trochanteric fracture who had been treated with a PFNA® between 12/2004 and 12/2007 were identified and analysed regarding complications and radiological findings. The study included 195 patients; 61.2% of the patients were classified as Singh I und II. The mean duration of surgery was 57 min. In ten cases (5.1%) the blade migrated, four cases (2.1%) showed blade cut out and in one case the nail broke (0.5%). The mean TAD was 26.... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884775 Sat, 28 May 2011 23:00:00 +0100 4884775 http://www.medworm.com/index.php?rid=4884789&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604026%26dopt%3DAbstract Authors: Weber-Endress S, Nothaas R The main condition that has to be met for reimbursement is the medical implication of the chosen method. This issue is discussed based on the case of a 72-year-old patient suffering from osteoporotic fractures of the spine. Drug treatment of osteoporosis was observed with a high-resolution peripheral CT (HR-pQCT/XtremeCT). A German court came to the conclusion that there is no added value of the procedure in comparison with the well-established DXA. Judges rejected the need for reimbursement in that particular case and ruled in favor of the insurance company, which had originally refused the refund.  PMID: 21604026 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884789 Sat, 21 May 2011 23:00:00 +0100 4884789 http://www.medworm.com/index.php?rid=4884788&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604027%26dopt%3DAbstract CONCLUSION: The present survey showed considerable practice variation in several important aspects of the NOM of splenic injuries. Not performing further CT scans in patients with suspected splenic injuries and not intervening in cases of a contrast extravasation were the most important discrepancies to the current literature. Standardization of the NOM of splenic injuries may be of great benefit for both surgeons and patients. PMID: 21604027 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884788 Sat, 21 May 2011 23:00:00 +0100 4884788 http://www.medworm.com/index.php?rid=4884787&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604028%26dopt%3DAbstract Authors: Vodička J, Spidlen V, Bierhanzlová J, Kuntscher V, Kastner J, Svoboda K The authors present a case of a 40-year-old man who intentionally stabbed himself several times in the trachea and larynx during a suicide attempt, and also inflicted other penetrating injuries of the stomach and liver upon himself. The preoperative examination using fiber-optic tracheoscopy and CT revealed only transection of the ligamentum cricothyroideum; the remaining two defects were discovered later, during the surgical revision. All three injuries were successfully treated with sutures, in one case using the transtracheal approach. PMID: 21604028 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884787 Sat, 21 May 2011 23:00:00 +0100 4884787 http://www.medworm.com/index.php?rid=4884786&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604029%26dopt%3DAbstract CONCLUSION: We could not substantiate that reducing the time between accident and neurosurgical decompression could decrease mortality. It rather seems that the initial magnitude of brain damage determines prognosis and outcome after sTBI. The interval between the appearance of neurological symptoms (e.g. anisocoria) and neurosurgical intervention plays an important role and should be kept as short as possible. PMID: 21604029 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884786 Sat, 21 May 2011 23:00:00 +0100 4884786 http://www.medworm.com/index.php?rid=4884785&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604030%26dopt%3DAbstract Authors: Kernt B, Neu J A 72-year-old man suffering from carpal tunnel syndrome had undergone minimally invasive decompression by using a SafeGuard® Mini-Open Carpal Tunnel Release System. After the operation the patient presented with a paraesthesia in the median nerve distribution. Two months later an operative revision was performed in another hospital. A partial transection of the median nerve and an incomplete release was seen. The surgeon of the first operation stated that detailed informed consent including the risk of iatrogenic nerve injury had been obtained. Furthermore he referred to the operative report, which mentioned the accuracy of the procedure without any problems or complications during surgery. The Arbitration Board stated that the operative report could not exculp... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884785 Sat, 21 May 2011 23:00:00 +0100 4884785 http://www.medworm.com/index.php?rid=4884784&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604031%26dopt%3DAbstract CONCLUSION: As only 53.3% of physicians in hospitals know their disaster control plan and only 33.9% of hospitals have participated in a disaster training scenario we conclude that more action is needed to increase awareness of the problem. Furthermore standardized training programs are needed to disseminate knowledge and skills in order to enable health care providers to face the occurrence of terroristic attacks in Germany. PMID: 21604031 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884784 Sat, 21 May 2011 23:00:00 +0100 4884784 http://www.medworm.com/index.php?rid=4884783&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604032%26dopt%3DAbstract Authors: Weber O, Müller M, Fischer P, Kabir K, Windemuth M, Pennekamp P, Pflugmacher R, Goost H, Burger C, Schädel-Höpfner M In contrast to the common intra- or extra-articular fractures of the distal radius, radiocarpal fracture dislocations are rare injuries. Concerning this issue, only a small number of publications can be found. Nevertheless, it is important to be informed about this injury since prompt operative treatment is often required and immobilization alone will not be sufficient. Sometimes, radiocarpal fracture dislocations are combined with carpal injuries. In such cases, both the radiocarpal dislocation and carpal injury have to be treated. Diagnostic difficulties can lead to misinterpretation or underdiagnosis. Insufficient reduction and fixation may result in joint... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884783 Sat, 21 May 2011 23:00:00 +0100 4884783 http://www.medworm.com/index.php?rid=4884782&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604033%26dopt%3DAbstract Authors: Biewener A, Rammelt S, Heineck J, Grass R, Zwipp H, Pyrc J Current recommendations on surgical management of unstable pelvic fracture with hemorrhagic shock include reduction and fixation, i.e., with a C-clamp and external fixator, angiographic embolization of injured pelvic arteries, and preferably extraperitoneal packing to control diffuse bleeding from the venous plexus and fracture site. However, the recently reported lethality at 40-60% remains seriously high. One possible reason could be the unsatisfactory efficiency of extraperitoneal packing in the case of a traumatically or surgically opened retroperitoneal compartment. In this paper, a new approach, so-called compression plate packing, is proposed to control diffuse bleeding. In this technique, the essential pressure... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884782 Sat, 21 May 2011 23:00:00 +0100 4884782 http://www.medworm.com/index.php?rid=4884781&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604034%26dopt%3DAbstract We describe a surgical technique according to Morrey in a case of a young girl with resection osteotomy of the proximal radius without excision of the synostosis. Different therapeutic options for post-traumatic proximal radioulnar synostosis are discussed on the basis of the current literature. PMID: 21604034 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884781 Sat, 21 May 2011 23:00:00 +0100 4884781 http://www.medworm.com/index.php?rid=4884780&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604035%26dopt%3DAbstract Authors: Biberthaler P, Mutschler W PMID: 21604035 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884780 Sat, 21 May 2011 23:00:00 +0100 4884780 http://www.medworm.com/index.php?rid=4884779&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604036%26dopt%3DAbstract Authors: Stein G, Skouras E, Faymonville C, Thelen U, Schiffer G After operative correction of a clavicle fracture using an elastic stable intramedullary nail the patient presented signs of delayed fracture healing after 2 months. During the sixth postoperative month the 28-year-old obviously pain-ridden female patient showed dystonia of the shoulder girdle and allodynia surrounding the operation field. Upon these findings, we decided - as a result of the complex regional pain syndrome that had not been previously described in this location - to treat the patient by administering bisphosphonates, multimodal analgetic therapy, physiotherapy and occupational therapy. Fourteen months after surgery, the patient showed no remaining symptoms, and the fracture had consolidated at that time. ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884779 Sat, 21 May 2011 23:00:00 +0100 4884779 http://www.medworm.com/index.php?rid=4884778&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604037%26dopt%3DAbstract Authors: Arbter D, Piatek S, Probst A, Holmenschlager F, Winckler S BACKGROUND: With regard to the treatment of non-reconstructable radial head fractures, both the resection and the implantation of a prosthesis are considered. Various studies have shown poor results concerning the resection of the radial head with accompanying osteoligamentous injuries. Due to these experiences, different types of prosthesis have been developed. However, the majority of them were not convincing. Judet developed a type of a bipolar prosthesis which had been modeled on the anatomy of the radial head. The aim of our retrospective study consists in examining the results of the Judet prosthesis. PATIENTS AND METHODS: Between 1995 and 2007, 50 patients were treated with an arthroplasty. These were, correspon... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884778 Sat, 21 May 2011 23:00:00 +0100 4884778 http://www.medworm.com/index.php?rid=4884777&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604038%26dopt%3DAbstract Authors: Richter M Fractures of the forefoot are common and comprise approximately two thirds of all foot fractures. Forefoot fractures are caused by direct impact or the effect of indirect force. The forces exerted can range from repetitive minor load (stress fractures) to massive destructive forces (complex trauma).The clinical course in forefoot fractures is typically more favourable than in fractures of the mid- and hindfoot. The incidence of complications like infection or pseudarthrosis is low. Exceptions are rare fractures of the proximal shaft of the fifth metatarsal and the sesamoids with higher pseudarthrosis rates. Malunited metatarsal fractures can cause painful conditions that should even be treated operatively. Differences in structure and function of the different forefo... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884777 Sat, 21 May 2011 23:00:00 +0100 4884777 http://www.medworm.com/index.php?rid=4884776&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21604039%26dopt%3DAbstract CONCLUSION: Arthroscopic implant removal offers all the advantages of minimally invasive surgery and first results comparable to open implant removal. The subjective and objective satisfaction of the patients is high. The technique can be applied and established by all skilled arthroscopic shoulder surgeons. PMID: 21604039 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4884776 Sat, 21 May 2011 23:00:00 +0100 4884776 http://www.medworm.com/index.php?rid=4830264&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21584703%26dopt%3DAbstract CONCLUSIONS: We reproduced supination external rotation lesions according to Lauge-Hansen in osteoporotic ankles. There is a certain discrepancy between the obligatory lesion of the inferior anterior tibiofibular syndesmosis at stage II according to Lauge-Hansen, as we observed an intact syndesmosis in 50% at stage II. Stage IV defining medial malleolar fractures were reproduced after Lauge-Hansen and Michelson et al. PMID: 21584703 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4830264 Tue, 17 May 2011 23:00:00 +0100 4830264 http://www.medworm.com/index.php?rid=4830263&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21584704%26dopt%3DAbstract We present for the first time the successful management of a 17-year-old multiply injured patient with coincidental tracheal rupture and ARDS (acute respiratory distress syndrome) after a fall. Besides the case report and pathogenesis the essential diagnostic and therapeutic measures are mentioned and discussed. The circumstances surrounding the accident have to be balanced with the severity of the trauma to also exclude rare injuries with certainty. Finally level 1 trauma centers specialized in ARDS provide the best clinical setting for successful treatment of these life-threatening injuries. PMID: 21584704 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4830263 Tue, 17 May 2011 23:00:00 +0100 4830263 http://www.medworm.com/index.php?rid=4830262&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21584705%26dopt%3DAbstract Authors: Krischak G, Dürselen L, Röderer G Biomechanical considerations are relevant in the treatment of peritrochanteric fractures. Concomitant diseases and osteoporosis place high demands on the primary stability of the operative treatment. In the situation of unstable fractures (AO/ASIF 31-A2 and A3), even normal activities of life can easily exceed the critical limits of stability, which can result in implant failure. Both intramedullary and extramedullary implants are used successfully in the treatment of even unstable fractures. Different variations in the implant design and anchorage of the load carrier of the femoral neck are available and may have different biomechanical characteristics. Biomechanical tests show that new developments of implants can increase stability. Never... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4830262 Tue, 17 May 2011 23:00:00 +0100 4830262 http://www.medworm.com/index.php?rid=4830269&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21553137%26dopt%3DAbstract Authors: Konieczny M, Müller EJ, Gaggl A, Bürger KH A 20-year-old woman sustained massive elbow trauma from a gunshot wound. After initial surgery soft tissue coverage, reconstruction of the proximal third of the ulna, of the ulnar collateral ligament and of the triceps tendon was performed by one multicomponent microvascular free flap. There were no complications, the elbow is stable and reached full weight bearing 11 months after trauma. Active range of motion for extension and flexion is 0-20°-80°. PMID: 21553137 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4830269 Sat, 07 May 2011 23:00:00 +0100 4830269 http://www.medworm.com/index.php?rid=4830268&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21560037%26dopt%3DAbstract Unfallchirurg. 2011 May;114(5):378-379 Authors: PMID: 21560037 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4830268 Sat, 30 Apr 2011 23:00:00 +0100 4830268 http://www.medworm.com/index.php?rid=4830267&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21560038%26dopt%3DAbstract Authors: Sommerfeldt DW, Dietz HG PMID: 21560038 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4830267 Sat, 30 Apr 2011 23:00:00 +0100 4830267 http://www.medworm.com/index.php?rid=4830266&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21560039%26dopt%3DAbstract Authors: Dietz HG, Schlickewei W Femoral shaft fractures in children represent 1.5% of all fractures in childhood. Up to the age of 4 years, conservative treatment in a hip spica or short-term overhead traction is the therapy of choice. Femoral shaft fractures between the age of 5 and 16 years should be treated surgically. In over 90% of these cases elastic stable intramedullary nailing (ESIN) is the premier treatment option. Additional end caps can be used for unstable fractures and in length discrepancy. The external fixator and the locking plate are reserved for fractures with severe soft tissue injuries, vascular problems and some specific situations mentioned later on. By adhering to these standards good results can be achieved with a low complication rate. PMID: 21560039 [Pu... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4830266 Sat, 30 Apr 2011 23:00:00 +0100 4830266 http://www.medworm.com/index.php?rid=4830265&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21560040%26dopt%3DAbstract Authors: Wirth T Dislocation of the patella represents a frequent knee problem in childhood and adolescence. There are traumatic, recurrent, habitual and chronic forms. Many anatomical variations, which promote patellar dislocation, are known. The first traumatic dislocation is primarily treated conservatively with the exception of concomitant osteochondral fragments or very large soft tissue damage which justify surgical interventions. Recurrent, habitual and chronic dislocations are best cured surgically by vastus medialis advancement, reconstruction of the medial patellofemoral ligament, strengthening of the medial retinaculum together with a lateral release and by fixation of the patella using tendon grafts or medialisation of the insertion of the patellar ligament. To improve the ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4830265 Sat, 30 Apr 2011 23:00:00 +0100 4830265 http://www.medworm.com/index.php?rid=4780149&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21528394%26dopt%3DAbstract Authors: Schneidmueller D, Gercek E, Lehnert M, Walcher F, Marzi I Only 1-4% of all long bone fractures in children involve the proximal tibia. To evaluate these fractures appropriately, it is mandatory to differentiate between articular fractures and metaphyseal fractures. Articular fractures of the proximal physis are rare and include Salter Harris type III and IV injuries. The reconstruction of the articular surface is the fundamental goal of therapy. Injuries of the anterior crucial ligament which typically appear as an avulsion of the tibial spine and the avulsion fracture of the tibial tubercle apophysis can involve the articular surface. Dislocated fractures should be reduced and stabilized. Extraarticular fractures include Salter Harris type I and II fractures. Other types of m... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780149 Fri, 29 Apr 2011 23:00:00 +0100 4780149 http://www.medworm.com/index.php?rid=4780148&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21528395%26dopt%3DAbstract Authors: Kraus R, Herbst U, Perler G, Schnettler R, Röder C Traumatic physeal separations (SH I/II) of the lower extremities are rare. Complications are reported in 2.2-39.6%. The current study is intended to provide recent data concerning epidemiology and treatment decisions in physeal separation of the distal tibia. All patients who suffered a physeal separation of the distal tibia in a 36-month period were included in a multicenter study. Age, gender, mechanism of injury, classification, therapeutic decision, and early complications were recorded online. There were 150 cases (64.6% male, 35.4% female, average age 11.8 years). The most frequent mechanism of injury was sportive activity (42%); 76% of cases needed reduction. Antecurvation was tolerated up to 10° (p=0.0021) and valgu... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780148 Fri, 29 Apr 2011 23:00:00 +0100 4780148 http://www.medworm.com/index.php?rid=4780147&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21528396%26dopt%3DAbstract We report two cases of transitional fractures combined with typical fracture patterns of adults due to a dorsomedial ossified physis in the distal tibia. PMID: 21528396 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780147 Thu, 28 Apr 2011 23:00:00 +0100 4780147 http://www.medworm.com/index.php?rid=4780150&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21505943%26dopt%3DAbstract Authors: Fitze G While complex regional pain syndrome (CRPS) is a well-established entity in adults, its occurrence in children was doubted for a long time. However, in the last few years several case reports and some comparative studies have described CRPS in children and adolescents.In contrast to adults most of the involved children are female, suffering from CRPS after an initial event that is typically a minor trauma. Furthermore, CRPS occurs more frequently in the lower extremity than in the upper extremity when compared to adults. Since neither radiological findings nor laboratory parameters are able to confirm CRPS, the diagnosis is made from a detailed description of the clinical signs and symptoms characterized by a remarkable intra- and inter-individual variability.The treat... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780150 Wed, 20 Apr 2011 23:00:00 +0100 4780150 http://www.medworm.com/index.php?rid=4780152&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21503801%26dopt%3DAbstract We present a case of a pregnant woman (32nd gestational week) that suffered from a chronic non-healing wound at the distal radius. Skeletal tuberculosis was finally diagnosed and treated successfully with staged surgical therapy combined with appropriate medication. One year after surgical treatment, the outcome of the mother was excellent and the baby did not suffer from any disease related to operative procedures or pharmacotherapy. Operative treatment of skeletal tuberculosis (especially osteoarticular and vertebral tuberculosis) in combination with tuberculostatic therapy during pregnancy and lactation seem to be the appropriate treatment with minimal risk for the child and excellent outcome for the mother. PMID: 21503801 [PubMed - as supplied by publisher] (Source: Der Unfallchiru... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780152 Tue, 19 Apr 2011 23:00:00 +0100 4780152 http://www.medworm.com/index.php?rid=4780151&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21503802%26dopt%3DAbstract CONCLUSION: The sural flap remains a reliable solution for soft tissue defects. Under inappropriate circumstances (small pedicle or severe torque of pedicle) venous congestion or even thrombosis is possible. A two-stage approach with conditioning of venous drainage can have a positive effect on these problems. PMID: 21503802 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780151 Tue, 19 Apr 2011 23:00:00 +0100 4780151 http://www.medworm.com/index.php?rid=4780153&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21494814%26dopt%3DAbstract Authors: Schmidt-Rohlfing B, Reilmann H, Pfeifer R, Kobbe P, Pape HC The indications, technical principals, and results after vertebroplasty and kyphoplasty are presented in detail. We focus on the complications of both procedures. The benefit of vertebroplasty has been fundamentally questioned by two papers which have recently been published in the New England Journal of Medicine. Our paper discusses the present knowledge and policy about indication. The contradictory results from different studies are presented. In general, there is a lack of randomized clinical trials. Therefore, a final judgement of these two techniques is not possible. New procedures like stent-kyphoplasty or lordoplasty are briefly described. However, at present an assessment of these new techniques is impossible... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780153 Fri, 15 Apr 2011 23:00:00 +0100 4780153 http://www.medworm.com/index.php?rid=4780154&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21484402%26dopt%3DAbstract CONCLUSION: Those patients who need operative therapy require prompt diagnosis and therapy to minimize permanent damage. PMID: 21484402 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780154 Tue, 12 Apr 2011 23:00:00 +0100 4780154 http://www.medworm.com/index.php?rid=4780159&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21465239%26dopt%3DAbstract CONCLUSION: Using sophisticated treatment options, the prognosis of scaphoid nonunions is very good. PMID: 21465239 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780159 Tue, 05 Apr 2011 23:00:00 +0100 4780159 http://www.medworm.com/index.php?rid=4780160&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21461785%26dopt%3DAbstract Authors: Rickels E, von Wild K, Wenzlaff P The relationship between severe, moderate and mild traumatic brain injury (TBI) as well as the course of treatment and quality management, were studied in a 1-year prospective study in regions of Hannover and Münster Germany. A total of 6,783 patients were documented at the initial examination (58.4% male, 28.1% children <16 years old) and 63.5% participated in the follow-up survey 1 year after the accident. Of these TBI patients 5,220 (73%) were admitted to hospital for clinical treatment but only 258 (<4%) received inpatient rehabilitation. The incidence of TBI was 332/100,000 inhabitants and according to the Glasgow Coma Scale (GCS) brain injury was mild in 90.9%, severe in 5.2% and moderate in 3.9%. The main cause of injury was a fa... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780160 Sat, 02 Apr 2011 23:00:00 +0100 4780160 http://www.medworm.com/index.php?rid=4780158&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21465415%26dopt%3DAbstract Unfallchirurg. 2011 Apr;114(4):282-283 Authors: PMID: 21465415 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780158 Thu, 31 Mar 2011 23:00:00 +0100 4780158 http://www.medworm.com/index.php?rid=4780157&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21465416%26dopt%3DAbstract Authors: Sommerfeldt DW, Dietz HG PMID: 21465416 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780157 Thu, 31 Mar 2011 23:00:00 +0100 4780157 http://www.medworm.com/index.php?rid=4780156&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21465417%26dopt%3DAbstract Authors: Slongo T, Fernandez FF Although the so-called Monteggia-injury, defined as an isolated fracture of the Ulna accompanying a sub- or complete dislocation of the radial head - is already known more than one hundred years - this injury is anyway often assessed completely wrong! Not the overlooked ulna fracture there is the problem but the not realized dislocation of the radial head. The prognosis of such an overlooked Monteggia-lesion is depending of different factors: age of the patient, duration of the dislocation, the amount of the morphological alteration in the elbow joint.The presented article describes the essential criteria with which is necessary for a correct assessment. Due to these criteria the individual therapies are described. This in relation to the existing time o... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780156 Thu, 31 Mar 2011 23:00:00 +0100 4780156 http://www.medworm.com/index.php?rid=4780155&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21465418%26dopt%3DAbstract Authors: Oestern S, Varoga D, Lippross S, Kaschwich M, Finn J, Buddrus B, Seekamp A The patella dislocation is defined as a non-recurring or recurrent dislocation of the patella from the patella surface of the femur. In general the patella dislocates in the lateral direction. Patella dislocations are subdivided in congenital, habitual or traumatic dislocations. Furthermore patella dislocations are differentiated in recurrent and chronic dislocations. Etiology of patella dislocations is not consistent and can be due to genu valgum, patella dysplasia or patella alta etc. Frequently the patella reposes spontaneously after dislocation. Besides examination of the knee, x-ray and magnetic resonance tomography belong to clinical diagnostics of the knee joint. Decision between conservative and... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4780155 Thu, 31 Mar 2011 23:00:00 +0100 4780155 http://www.medworm.com/index.php?rid=4672392&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21448676%26dopt%3DAbstract CONCLUSION: In osteoporotic distal radii cancellous bone density decrease occurs homogeneously in all regions and is least pronounced beneath the joint surface. Comparing the regional cancellous bone density (radial versus ulnar and palmar versus dorsal) significant differences were mainly found near the joint surface in both groups. PMID: 21448676 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4672392 Wed, 30 Mar 2011 23:00:00 +0100 4672392 http://www.medworm.com/index.php?rid=4672411&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21445649%26dopt%3DAbstract Authors: Strohm PC, Schmittenbecher PP Polytrauma is a rare diagnosis in childhood. Even after high-energy accidents isolated injuries of the skull and brain or extremities are more common. Injury is still the most frequent cause of death in childhood in industrialized countries. The lethality of polytraumatized children is about 19%. Injuries of the extremities do not play such an important role for the survival of polytraumatized children but for the definitive outcome. The diagnostic algorithm for polytraumatized children is related to adults and includes spiral computed tomography in the emergency room. Plain radiographs are still the gold standard for the diagnostic workup of fractures. Generally therapeutic approaches in the treatment of fractures in children are often conservati... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4672411 Tue, 29 Mar 2011 23:00:00 +0100 4672411 http://www.medworm.com/index.php?rid=4672408&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21445650%26dopt%3DAbstract This article reviews current knowledge about scaphoid fractures in children and adolescents, including the development of the scaphoid, its injuries and age-specific treatment for acute and late presenting fractures. The following recommendations are based on the literature, although scientific evidence to support treatment strategies is scarce. The diagnosis of scaphoid fractures is often missed on initial X-rays. Therefore all suspected fractures should be treated with a thumb spica cast for 2 weeks, followed by clinical examination and repeat X-ray if symptoms persist. In cases of negative X-ray findings an MRI or alternatively a CT scan are indicated. None or minimally displaced paediatric scaphoid fractures should be treated in a spica cast for at least 7 weeks until union is documen... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4672408 Tue, 29 Mar 2011 23:00:00 +0100 4672408 http://www.medworm.com/index.php?rid=4672400&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21445651%26dopt%3DAbstract Authors: Lieber J, Sommerfeldt DW The optimal treatment for fractures in the diametaphyseal transition zone of the forearm is still a matter of debate. Stable fractures should be immobilized or treated by closed reduction when non-tolerably displaced. Unstable and displaced fractures can be treated by various operative techniques, which are all characterized by technical impracticability or disadvantages for the patient.In younger patients transepiphyseal intramedullary K-wire fixation represents a minimally invasive, quick and technically easy treatment option but requires additional immobilisation. In adolescent patients volar locking plate osteosynthesis constitutes an immobilisation-free treatment option, but is combined with high invasiveness. Percutaneous K-wire fixation and elas... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4672400 Tue, 29 Mar 2011 23:00:00 +0100 4672400 http://www.medworm.com/index.php?rid=4672398&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21445652%26dopt%3DAbstract Authors: Seif El Nasr M, von Essen H, Teichmann K Clavicle fractures are most common in children. Due to the thick periosteum that provides appositional bone proliferation on the one hand and a high potential of the medial physis for longitudinal growth on the other hand the fractures have an enormous healing potential. Both factors are also responsible for good fracture remodeling. In adolescents, the periosteal tube gets thinner and fracture types correspond to fractures in adults. Most fractures heal with good results after conservative treatment. In this article clavicle fractures in children and adolescents and options for therapy including the rare surgical treatment depending on different fracture localizations and morphologies are discussed. PMID: 21445652 [PubMed - as supp... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4672398 Tue, 29 Mar 2011 23:00:00 +0100 4672398 http://www.medworm.com/index.php?rid=4672429&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21424429%26dopt%3DAbstract We present the case of such an injury in an adolescent judoka who was treated by open reduction and reconstructive surgery using the gracilis tendon graft technique. PMID: 21424429 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4672429 Sun, 20 Mar 2011 00:00:00 +0100 4672429 http://www.medworm.com/index.php?rid=4672414&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21424430%26dopt%3DAbstract CONCLUSION: Our data showed some differences to the literature. Pelvic fractures are predictors for high injury severity. Despite similar fracture pattern, in contrast to adults most injuries could be treated non-operatively. In unstable or dislocated fractures open reduction and stabilization must be performed. PMID: 21424430 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4672414 Sun, 20 Mar 2011 00:00:00 +0100 4672414 http://www.medworm.com/index.php?rid=4553997&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21373929%26dopt%3DAbstract Authors: Chaberny IF, Graf K Surgical site infections (SSI) are a severe complication following surgical or orthopaedic procedures and are associated with significant increases in hospital length of stay (LOS), additional costs, morbidity and mortality. Hence, the prevention of SSI is essential and poses a major challenge in the healthcare system. Strategies and key points are presented and discussed. Infection control measures such as active surveillance of SSI, implementation of a checklist, compliance observations and instruction/training of healthcare workers as well as Staphylococcus aureus/MRSA screening, clipping instead of shaving, adherence to perioperative antibiotic prophylaxis, maintaining intraoperative normothermia and blood glucose control are essential for a comprehensi... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4553997 Sat, 05 Mar 2011 00:00:00 +0100 4553997 http://www.medworm.com/index.php?rid=4553996&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21373930%26dopt%3DAbstract Authors: Herr M, Grabein B, Palm HG, Efinger K, Riesner HJ, Friemert B, Willy C Necrotizing fasciitis belongs to a group of complicated soft tissue infections that can be even life threatening. Despite growing knowledge about its etiology, predictors, and the clinical progression, the mortality remains at a high level with 20%. A relevant reduction can be achieved only by an early diagnosis followed by consistent therapy. The clinical findings in about 75% of the cases are pain out of proportion, edema and tenderness, blisters, and erythema. It is elementary to differentiate a necrotizing or a non-necrotizing soft tissue infection early. In uncertain cases it can be necessary to perform a surgical exploration to confirm the diagnosis. The histopathologic characteristics are the fascial... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4553996 Sat, 05 Mar 2011 00:00:00 +0100 4553996 http://www.medworm.com/index.php?rid=4553998&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21369864%26dopt%3DAbstract Authors: Kujath P, Shekarriz H Skin and soft tissue infections (SSTI) are amongst the most common bacterial infections in humans. SSTI have a broad range of aetiology, clinical manifestation and severity. The outcome may be spontaneous resolution or on the other end sepsis with lethal outcome. Useful classifications are those which differentiate SSTI according to urgency of surgical intervention. The definitive diagnosis should be made by the clinical picture of the lesion and the condition of the patient. The key to successful treatment of many severe necrotizing soft tissue infections is based on early detection and prompt surgical debridement. This procedure has to be followed by an optimal wound management. From the early beginning of treatment an adequately calculated antibiotic t... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4553998 Fri, 04 Mar 2011 00:00:00 +0100 4553998 http://www.medworm.com/index.php?rid=4554002&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21347696%26dopt%3DAbstract CONCLUSIONS: The long-term disability following run-over injuries is severe and requires a multidisciplinary approach. Treatment should therefore be conducted in appropriate trauma centres. PMID: 21347696 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4554002 Fri, 25 Feb 2011 00:00:00 +0100 4554002 http://www.medworm.com/index.php?rid=4554001&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21347697%26dopt%3DAbstract CONCLUSION: This study demonstrates that a tibial press-fit technique which uses an additional bone block has better maximum load to failure results compared to a simple interference screw fixation. PMID: 21347697 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4554001 Fri, 25 Feb 2011 00:00:00 +0100 4554001 http://www.medworm.com/index.php?rid=4554000&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21347698%26dopt%3DAbstract ["Happy shooting" injury of a German KFOR soldier in Kosovo.] Unfallchirurg. 2011 Feb 25; Authors: Sammito S, Hartmann V, Kerschowski J, Klein B In this case report we describe a 24-year-old German KFOR soldier who was injured in the night of New Year's Eve 2009/2010 during the Kosovo Mission by a falling bullet in the right shoulder. The falling bullet was a full metal jacket probably shot during a "happy shooting" by a civilian. PMID: 21347698 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4554000 Fri, 25 Feb 2011 00:00:00 +0100 4554000 http://www.medworm.com/index.php?rid=4553999&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21350855%26dopt%3DAbstract [Specialists for orthopedics and trauma surgery as "decathletes"] Unfallchirurg. 2011 Feb 25; Authors: PMID: 21350855 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4553999 Fri, 25 Feb 2011 00:00:00 +0100 4553999 http://www.medworm.com/index.php?rid=4554004&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21344309%26dopt%3DAbstract CONCLUSIONS: Serological protein S100B measurement may be helpful as a screening test to identify patients with higher risk of traumatic brain injury for further diagnostic assessment. PMID: 21344309 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4554004 Thu, 24 Feb 2011 00:00:00 +0100 4554004 http://www.medworm.com/index.php?rid=4554003&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21344310%26dopt%3DAbstract Authors: Kösters C, Schliemann B, Raschke MJ In contrast to younger patients, tibial head fractures of the elderly usually result from minor trauma. In these patients, fractures of the tibial plateau are frequently seen and classified according to the Tscherne classification. In addition to plain radiographs which consist of an a.p. and a lateral view, a CT-scan is an obligatory part of the preoperative diagnostic. The therapeutic management is strongly depending on the psychic and physical condition of the patient, the fracture morphology, the decreased bone mineralization and the soft tissue damage. Low bone density requires rigid implants to provide a stable osteosynthesis. Metaphyseal defects have to be augmented with synthetic bone substitutes to avoid secondary loss of reduction... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4554003 Thu, 24 Feb 2011 00:00:00 +0100 4554003 http://www.medworm.com/index.php?rid=4554005&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21336531%26dopt%3DAbstract DISCUSSION: The correction of malunited distal radius fractures led to an improvement in function with less pain. Our data indicate that under certain circumstances interposition of an autologous bone graft does not need to be performed. PMID: 21336531 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4554005 Sat, 19 Feb 2011 00:00:00 +0100 4554005 http://www.medworm.com/index.php?rid=4499000&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21331816%26dopt%3DAbstract CONCLUSIONS: Based on our results, the bovine bone graft as a transplant for spondylodesis is inadvisable. PMID: 21331816 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4499000 Sat, 19 Feb 2011 00:00:00 +0100 4499000 http://www.medworm.com/index.php?rid=4498999&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21331817%26dopt%3DAbstract We present the case of a 37-year-old, multiply injured man who sustained a bilateral perilunar fracture dislocation after a 6 m fall. The fracture dislocations were diagnosed by standard radiographs. The right side was initially treated by closed reduction and external fixation, the left side by closed reduction and splint immobilization. The patient received definite treatment 5 days after the initial injury by open reduction and internal fixation using suture anchors and temporary K-wire fixation which were removed after 6 weeks. The patient achieved almost a full range of motion in both hands and went back to his work as a roofer 5 months after surgery. PMID: 21331817 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4498999 Sat, 19 Feb 2011 00:00:00 +0100 4498999 http://www.medworm.com/index.php?rid=4499003&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21327809%26dopt%3DAbstract CONCLUSION: A revision of the G-DRG definition of polytrauma is necessary to ensure adequate reimbursement for management of patients with multiple injuries. The severity of a trauma has to be considered in the DRG system. PMID: 21327809 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4499003 Fri, 18 Feb 2011 00:00:00 +0100 4499003 http://www.medworm.com/index.php?rid=4499002&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21327810%26dopt%3DAbstract CONCLUSION: The addition of computer-assisted planning and surgical guidance supported by Zero-dose C-arm navigation can be useful for the fixation of medial femoral neck fractures with cannulated screws. Further studies with the goal of reducing the operation time are indispensable before integrating this navigation system into the clinical workflow. PMID: 21327810 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4499002 Fri, 18 Feb 2011 00:00:00 +0100 4499002 http://www.medworm.com/index.php?rid=4499004&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21327547%26dopt%3DAbstract CONCLUSION: The study suggests reorganization of work-flows and additional educational measures about the necessity of prophylactic procedures after needle stick injuries. PMID: 21327547 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4499004 Thu, 17 Feb 2011 00:00:00 +0100 4499004 http://www.medworm.com/index.php?rid=4499001&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21327811%26dopt%3DAbstract Authors: Oberhuber A, Thiere M, Simon F, Kramer M, Einsiedel T, Orend KH, Sunder-Plassmann L, Schelzig H Traumatic rupture of the descending aorta is an acute life-threatening event. The most common cause is deceleration trauma resulting in a sudden stretching of the aortic isthmus as for example in car and motorcycle accidents and falls from a great height. Exemplified by a case report of a multiply injured 57-year-old male the diagnostic pathways, therapy and postoperative complications are presented. PMID: 21327811 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4499001 Thu, 17 Feb 2011 00:00:00 +0100 4499001 http://www.medworm.com/index.php?rid=4440095&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21286905%26dopt%3DAbstract Authors: Ernstberger A, Koller M, Nerlich M In industry, especially in the automobile industry, improvements in efficiency could be demonstrated by quality management and quality circles. There is no doubt that in medicine, major trauma is also a very complex challenge.The German Association for Trauma Surgery published the White Paper on the Management of the Seriously Injured in 2006. The White Paper specifies the demand for quality of care, sets the level of structural requirements for trauma care and postulates the cooperation of regional hospitals within a network of dedicated trauma centres. The Trauma Network Eastern Bavaria (TNO) was the first certified trauma network in Germany. One of the reasons for this success is the fact that cooperation between trauma surgeons has alread... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4440095 Thu, 03 Feb 2011 00:00:00 +0100 4440095 http://www.medworm.com/index.php?rid=4440094&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21286906%26dopt%3DAbstract Authors: Koslowsky TC, Schadt R, Mader K, Pennig D Closed and open dislocations of the knee joint with vascular and nerve injuries are treated immediately and may present an indication for external fixation. In acute trauma definitive treatment and reconstruction of the complex capsule and ligamentous injuries are often impossible. The application of a medial transarticular external fixator with motion capacity combines the treatment of remaining joint instability with the benefit of early joint movement. Disadvantages of prolonged joint immobilisation until definitive stabilisation of the knee are reduced. PMID: 21286906 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4440094 Thu, 03 Feb 2011 00:00:00 +0100 4440094 http://www.medworm.com/index.php?rid=4440093&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21286907%26dopt%3DAbstract Authors: Gausepohl T The rising incidence of distal intra-articular humeral fracture in elderly patients associated with osteoporosis frequently leads to difficulties in acute reconstruction and may result in early failure of internal fixation. The biomechanics of the elbow joint and especially the flexor group as well as the brachioradialis muscle as part of the extensor group is analyzed. The complex motion pattern of the transarticular muscle groups increases the load on internal fixation and may affect the interface between implant and osteoporotic bone. An external fixator with motion capacity serves to protect the internal osteosynthesis and secures the fixation in osteoporotic bone. PMID: 21286907 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4440093 Thu, 03 Feb 2011 00:00:00 +0100 4440093 http://www.medworm.com/index.php?rid=4440092&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21286908%26dopt%3DAbstract Authors: Gausepohl T The use of external fixation in the upper limb requires detailed anatomical knowledge. The centre of rotation in the elbow joint has to be understood and the bony landmarks have to be identified. The joint mechanics and the mechanics of the external fixation device have to be collinear in a wide range of the natural motion capacity. Insertion of humeral and ulnar pins considering the specific anatomy is described and post-operative diagnostic aspects are illustrated. PMID: 21286908 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4440092 Thu, 03 Feb 2011 00:00:00 +0100 4440092 http://www.medworm.com/index.php?rid=4440091&cid=s_36210_31_f&fid=36210&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21286909%26dopt%3DAbstract Authors: Osmers I, Winter M, Krieger S Internal fixation of fractures is an integral part of health care. However this is a privilege of the developed world. For humanitarian aid internal fixation has always been considered as too prone to infection given the poor hygienic conditions, too specialized, too costly and the infrastructure of so-called developing countries too weak to perform internal fixation successfully. Due to the globally increasing density of road traffic an alarming increase in victims of road traffic accidents can be observed. The World Health Organization (WHO) estimates that in 2030 road traffic accidents will be responsible for twice as many deaths as caused by HIV/AIDS.Road traffic accidents are considered to be the new global epidemic. Since the victims are gen... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=4440091 Thu, 03 Feb 2011 00:00:00 +0100 4440091