Der Unfallchirurg via MedWorm.com 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. Wed, 17 Mar 2010 15:08:58 +0100 [Arthrodesis of the elbow joint : Indications, surgical technique and clinical results.] http://www.medworm.com/index.php?rid=3363996&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%3D20224987%26dopt%3DAbstract Authors: Moghaddam-Alvandi A, Dremel E, Güven F, Heppert V, Wagner C, Studier-Fischer S, Grützner PA, Biglari B Arthrodesis of the elbow joint (EA) is a rare salvage procedure which is disliked by both surgeons and patients. The aim of this study was to analyze the indications, the operation techniques and the outcome of EA in patients treated at our clinic. Between January 1997 and December 2005 a total of 20 patients with a mean age of 55 years (range 27-85 years) were treated with EA at our clinic. In 18 patients a compression plate was used as surgical technique. In 18 out of the 20 patients the operation was performed post-traumatically after infection, bone and tissue defects and painful loss of motion. Of these patients, 16 could be followed up for an average time of 6... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3363996 Sat, 13 Mar 2010 00:00:00 +0100 3363996 [Herniation of the middle lobe of the right lung due to a coarsely dislocated sternum fracture.] http://www.medworm.com/index.php?rid=3359662&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%3D20221577%26dopt%3DAbstract Authors: Zeuner M, Schweigkofler U, Hoffmann R In cases of multiple trauma in patients with an injury severity score (ISS) >/=16 chest injuries, abbreviated injury scale (AIS) >/=3, are also sustained in 57.2% of all patients. Life-threatening complications may occur with lung contusions and rib fractures also in combination with hemothorax/pneumothorax being the most common diagnoses. In addition the lungs can also be functionally impaired by ruptures of the great thoracic vessels or in isolated cases by herniation of lung tissue following tears in the wall of the thorax. A case of multiple trauma in a 44-year-old male (ISS 29) with blunt thoracic trauma resulting in herniation of the middle lobe of the right lung into the subcutaneous tissue due to a coarsely dislocated fractur... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3359662 Fri, 12 Mar 2010 00:00:00 +0100 3359662 [Non-union of the clavicle after intramedullary nailing with a steel Kirschner wire.] http://www.medworm.com/index.php?rid=3359661&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%3D20221578%26dopt%3DAbstract Authors: Faymonville C, Jubel A, Schiffer G Elastically stable intramedullary nailing is a safe surgical procedure used to treat mid-shaft clavicular fractures of types A and B according to the Orthopaedic Trauma Association (OTA) classification. In the case reported intramedullary fixation with a Kirschner wire and an incorrectly performed surgical technique led to pseudoarthrosis (non-union). After revision surgery with an elastically stable titanium nail and a correct surgical technique, fracture healing was achieved. PMID: 20221578 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3359661 Fri, 12 Mar 2010 00:00:00 +0100 3359661 [Generation 2000 plus: at the end of the day I count(?).] http://www.medworm.com/index.php?rid=3359660&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%3D20221821%26dopt%3DAbstract This article attempts to demonstrate the background for this change and its influence on the upheaval in the health system. PMID: 20221821 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3359660 Fri, 12 Mar 2010 00:00:00 +0100 3359660 [The surgeon as a patient.] http://www.medworm.com/index.php?rid=3326363&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%3D20195839%26dopt%3DAbstract Authors: Krettek C PMID: 20195839 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3326363 Wed, 03 Mar 2010 00:00:00 +0100 3326363 [Fractures of the acetabulum. Diagnostic and therapeutic strategies.] http://www.medworm.com/index.php?rid=3326362&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%3D20195840%26dopt%3DAbstract Authors: Schmidt-Rohlfing B, Reilmann H, Pape HC Fractures of the acetabulum are a challenge in terms of orientation and the surgical skills of the orthopedic trauma surgeon. Due to the surrounding soft tissues and because of the indirect reduction control, operative treatment of acetabular fractures can be very demanding. This review includes the anatomical and clinical features, the radiological diagnostic approach, the classification systems, and, in particular, the surgical approaches and treatment principles. The work houses for surgical approaches are the ilioinguinal and the posterior (Kocher-Langenbeck) approach. In view of the high complication rate, the extended approaches are of less relevance. The therapeutic relevance of recent developments including navigation is discusse... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3326362 Wed, 03 Mar 2010 00:00:00 +0100 3326362 [Early functional treatment and full weight-bearing of surgically treated isolated ankle fractures in the elderly.] http://www.medworm.com/index.php?rid=3326361&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%3D20195841%26dopt%3DAbstract CONCLUSION: This treatment concept can be recommended because patient comfort is increased and the risk of immobilization is excluded. PMID: 20195841 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3326361 Wed, 03 Mar 2010 00:00:00 +0100 3326361 [Current concepts of patient safety : Rapid response system.] http://www.medworm.com/index.php?rid=3299098&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%3D20174916%26dopt%3DAbstract Authors: Stahel PF, Fakler JK, Flierl MA, Moldenhauer K, Mehler PS The "100,000 lives campaign" initiated a wide-spread implementation of rapid response teams in the United States. A standardized rapid response system (RRS) is designed to reduce the preventable mortality of hospitalized patients who frequently have progressive signs of physiological deterioration minutes to hours before cardiac arrest. The implementation and maturation of a team-based RRS has been shown to significantly reduce the incidence of "COR zero" calls and, in some studies, the in-hospital mortality rate. An alternative model to rapid response teams has been recently proposed which is based on defined clinical triggers to initiate a "rapid response escalation". This clinical triggers program overcomes the class... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3299098 Sun, 21 Feb 2010 00:00:00 +0100 3299098 [Operative treatment of pediatric open fractures of the lower limb using the Taylor spatial frame fixator.] http://www.medworm.com/index.php?rid=3299097&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%3D20174917%26dopt%3DAbstract Authors: Geßmann J, Baecker H, Graf M, Ozokyay L, Muhr G, Seybold D The operative management of open fractures of the lower limb requires a consistent treatment to avoid soft tissue complications. Acute angular shortening of the fracture enabling primary soft tissue closure is still an uncommon operative technique because of difficulties in correcting the secondary deformity. The case of a pediatric open fracture of the lower limb (Gustilo type IIIa) is described, which was treated with acute angular shortening followed by gradual correction using the Taylor spatial frame (TSF). PMID: 20174917 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3299097 Sun, 21 Feb 2010 00:00:00 +0100 3299097 [What can we learn from patients?] http://www.medworm.com/index.php?rid=3288869&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%3D20165827%26dopt%3DAbstract Authors: Hansis M, Heilmann S Quality management is only complete and sound when it comprehensively takes all comments from patients or staff into consideration, especially negative comments. In this manner, complaints, surveys and registered risks can be seen in a synoptic way. Every comment must be evaluated in relation to isolated cases as well as in the sense of pattern recognition. PMID: 20165827 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3288869 Fri, 19 Feb 2010 00:00:00 +0100 3288869 [Post-traumatic torticollis in a schoolchild : Fracture, congenital anomaly or age-appropriate radiological findings of the atlas?] http://www.medworm.com/index.php?rid=3267381&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%3D20148240%26dopt%3DAbstract We describe the case of a 6-year-old girl with post-traumatic torticollis after falling on her head. The suspected fractures of the dens axis and/or atlas were ruled out after performing CT and MRI examinations as well as dynamic fluoroscopy. Radiological findings showed no further instability but there was a congenital non-fusion of the posterior arch and an age-appropriate non-fused anterior arch of the atlas. In addition to discoligamental injuries and fractures, congenital anomalies and normal variants of the immature anatomy of the cervical spine should also be considered in the diagnosis of the pediatric cervical spine after trauma. PMID: 20148240 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3267381 Fri, 12 Feb 2010 00:00:00 +0100 3267381 [Operative corrections of posttraumatic deformities of the elbow joint in children.] http://www.medworm.com/index.php?rid=3240583&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%3D20127305%26dopt%3DAbstract Authors: Eberl R, Weinberg AM Posttraumatic deformities with need for surgical correction are rare and demanding in the pediatric population. The consequences of a bad outcome may last a life time. The best prevention of deformities around the elbow joint is proper initial treatment. The most common deformities are cubitus varus, cubitus valgus, chronic dislocation of the radial head and pseudarthrosis of the radial condyle. In contrast to the wide spread opinion to await the effect of the further growth, the deformity should be treated contemporarily to the underlying injury. This strategy will optimize the outcome. In special cases treatment with delay is justified. PMID: 20127305 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3240583 Thu, 04 Feb 2010 00:00:00 +0100 3240583 [Sponsoring of medical congresses : A unproblematic problem?] http://www.medworm.com/index.php?rid=3223585&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%3D20108083%26dopt%3DAbstract Authors: Melzer S PMID: 20108083 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3223585 Fri, 29 Jan 2010 00:00:00 +0100 3223585 [How much competence in emergency vascular surgery does a modern trauma surgeon need? : Experiences regarding deployment as a military surgeon.] http://www.medworm.com/index.php?rid=3223588&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%3D20107760%26dopt%3DAbstract Authors: Elias K, Willy C, Engelhardt M Management of combat-related major vascular injuries is a challenge to all surgeons and a vascular specialist will not always be available in a wartime setting; therefore, every surgeon deployed to a war setting must be able to cope with these life and limb-threatening injuries. Data obtained from searching Medline and Google on the localization and treatment of combat-related vascular injuries of the USA strike forces in Afghanistan and Iraq were analyzed and adjusted to the requirements of the German Armed Forces. A total of 5-7% of casualties sustained major vascular injuries. After initial treatment using damage control measures to control the bleeding and restore perfusion definitive repair with vascular reconstruction must be performed in a... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3223588 Thu, 28 Jan 2010 00:00:00 +0100 3223588 [The educational program for modern military surgeons.] http://www.medworm.com/index.php?rid=3223587&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%3D20107761%26dopt%3DAbstract Authors: Willy C, Gutcke A, Klein B, Rauhut F, Friemert B, Kollig EW, Weller N, Lieber A Casualties in military conflict produce patterns of injuries that are not seen in routine surgical practice at home. In an era of increasing surgical sub-specialization the deployed surgeon needs to acquire and maintain a wide range of skills from a variety of surgical specialties. Improvised explosive devices (IEDs) have become the modus operandi for terrorists and in the current global security situation these tactics can be equally employed against civilian targets. Therefore, knowledge and training in the management of these injuries are relevant to both military and civilian surgeons. To create this kind of military surgeon the so-called "DUO-plus" model for the training of surgical officers (... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3223587 Thu, 28 Jan 2010 00:00:00 +0100 3223587 [Role of trauma surgery in military actions and terrorist threat.] http://www.medworm.com/index.php?rid=3223586&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%3D20107762%26dopt%3DAbstract Authors: Willy C PMID: 20107762 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3223586 Thu, 28 Jan 2010 00:00:00 +0100 3223586 [Patterns and causes of injuries in a contemporary combat environment.] http://www.medworm.com/index.php?rid=3217097&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%3D20101383%26dopt%3DAbstract Authors: Lechner R, Achatz G, Hauer T, Palm HG, Lieber A, Willy C Epidemiological analyses of injury patterns and mechanisms help to identify the expertise military surgeons need in a combat setting and accordingly help to adjust infrastructure and training requirements. Therefore, a MEDLINE search (1949-2009), World Wide Web search (keywords "combat, casualties, war, military, wounded and neurosurgery") and an analysis of deaths among allied war casualties in Afghanistan and Iraq were performed. Up to 10th December 2009 there had been 4,688 allied military deaths in Iraq and 1,538 in Afghanistan. Of these 22% died in non-hostile action, 33% in direct combat situations and the majority of 45% in indirect combat actions. The leading causes of injury were explosive devices (70%) and guns... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3217097 Wed, 27 Jan 2010 00:00:00 +0100 3217097 [Spectrum of surgical procedures performed in German rescue centers and the field hospital in Afghanistan in 2008.] http://www.medworm.com/index.php?rid=3202211&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%3D20094698%26dopt%3DAbstract Authors: Güsgen C, Achatz G, Palm HG, Kollig E, Engelhardt M, Willy C, Lieber A From the military perspective detailed knowledge about the spectrum of operations undertaken abroad is of particular interest to provide indications of the skills that will be required by the surgeons. Therefore, all surgical reports produced in 2008 in the operation theatres of Mazar-e-Sharif, Feyzabad and Kunduz were reviewed. The overview shows that a total of 799 operations were performed equivalent to 0.4-1.6 operations/day. Most of the patients who underwent surgery were local civilians and most of these operations involved osteosynthesis, débridement and soft tissue procedures. Of the surgical procedures 11% involved patients who were German service personnel of which 85% were urgent or eme... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3202211 Sat, 23 Jan 2010 00:00:00 +0100 3202211 [German military surgeons in deployment abroad : Life and working conditions.] http://www.medworm.com/index.php?rid=3202210&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%3D20094699%26dopt%3DAbstract Authors: Hauer T, von Lübken F, Johann M, Schreyer C, Hartmann V, Kollig E, Willy C Since 1992 the German Bundeswehr has been deployed for securing peace and peacekeeping abroad. Since then 83 German soldiers have been killed and overall 129 wounded in action as of 07.12.2009. In Northern Afghanistan the German Bundeswehr runs a combat support hospital (role 3) in Mazar-e-Sharif providing a multidisciplinary capability profile. Furthermore, there are two role 2 medical treatment facilities for primary surgical trauma care located in Kunduz and Feyzabad. In these role 2 facilities life saving procedures and damage control operations are performed in order to enable rapid evacuation to a higher level of care. Thereby military surgeons are often confronted with various medical and lo... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3202210 Sat, 23 Jan 2010 00:00:00 +0100 3202210 [Trauma surgeon without X-ray competence? : An ominous sign.] http://www.medworm.com/index.php?rid=3168004&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%3D20066391%26dopt%3DAbstract Authors: Kalbe P PMID: 20066391 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3168004 Wed, 13 Jan 2010 00:00:00 +0100 3168004 [Can vertebroplasty still be responsibly used for treatment of osteoporotic vertebral fractures? : Results of two randomized placebo-controlled trials.] http://www.medworm.com/index.php?rid=3168003&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%3D20066392%26dopt%3DAbstract Authors: Böcker W, Schieker M, Stengel D, Birkenmaier C, Huber-Wagner S, Rueger J, Mutschler W PMID: 20066392 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3168003 Wed, 13 Jan 2010 00:00:00 +0100 3168003 [Perioperative management for endoprosthetic hip joint replacement : The functional interdisciplinary therapy (FIT) concept.] http://www.medworm.com/index.php?rid=3168002&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%3D20066393%26dopt%3DAbstract Authors: Jerosch J, Heisel J During the last decade there have been significant changes in the perioperative management of total hip replacement patients. This process begins in the preoperative phase. Many patients are much better informed and standardized preoperative patient programs improve patient outcome and optimize the clinical pathways. The techniques in perioperative pain management have also significantly improved. The surgeon should not only rely on the anesthesiologist but should also use the options available during surgery.Postoperative weight bearing is handled in a much more progressive way than previously. In a standard primary hip replacement pain-adapted full weight bearing is possible if there are no patient-specific problems. There has also been a shift in the pos... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3168002 Wed, 13 Jan 2010 00:00:00 +0100 3168002 [Phlegmon of the palm of the hand as initial manifestation of the Lemierre syndrome.] http://www.medworm.com/index.php?rid=3111918&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%3D20024523%26dopt%3DAbstract We report the case of a 19-year-old male patient who presented initially with a phlegmon of the right palm and beginning septic shock. During the clinical course a subcutaneous abscess of the left shoulder, multiple lesions of the lungs and a pericardial abscess were identified and Lemierre's syndrome was diagnosed. In this case, positron emission tomography (PET) was revealed to be an appropriate instrument to determine the extent of the disease in a one step procedure. PMID: 20024523 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3111918 Sun, 20 Dec 2009 00:00:00 +0100 3111918 [Chronic osteitis of the lower extremities : An interdisciplinary treatment concept.] http://www.medworm.com/index.php?rid=3111917&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%3D20024524%26dopt%3DAbstract CONCLUSION: According to the results of this study the quality of life of patients with chronic osteitis of the lower leg is in general satisfying. In order to improve quality management and cost reduction in public health an interdisciplinary treatment concept of plastic and orthopedic surgeons should be established for complex fracture management as this is the most effective tool in treating chronic osteitis. PMID: 20024524 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3111917 Sun, 20 Dec 2009 00:00:00 +0100 3111917 [Biomechanical investigation of fixed-angle plate osteosynthesis of the proximal humerus.] http://www.medworm.com/index.php?rid=3111916&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%3D20024525%26dopt%3DAbstract CONCLUSION: The NCB-PH plate provides superior interfragmentary stability when used in the locked mode in a human cadaveric proximal humerus fracture model. Therefore, we recommend that all screws should be inserted in the locked mode. The results suggest that the NCB-PH plate in the locked mode provides higher primary postoperative stability thus permitting early functional treatment of the patient. PMID: 20024525 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3111916 Sun, 20 Dec 2009 00:00:00 +0100 3111916 [Perioperative management of interventions on the musculoskeletal system.] http://www.medworm.com/index.php?rid=3106984&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%3D20020093%26dopt%3DAbstract Authors: Krettek C PMID: 20020093 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3106984 Sat, 19 Dec 2009 00:00:00 +0100 3106984 [Fractures of the lateral clavicle.] http://www.medworm.com/index.php?rid=3106983&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%3D20020094%26dopt%3DAbstract Authors: Koppe D, Reilmann H Fractures of the lateral clavicle end account for 12-15 percent of all clavicle fractures. In contrast to the clear treatment of midshaft fractures the therapy of the distal third is still open to controversy. The high non-union rate up to 40 percent that occurs with the lateral end fractures shows the special biomechanical mechanisms. The role of the coracoclavicular ligaments is comparable to the acromioclavicular joint disruption. To make a clear decision about the therapy we need a treatment based classification such as the one by Jäger and Breitner, which distinguishes four different fracture types. The treatment options reach from conservative therapy up to numerous different operative techniques. The aim of this article is to demonstrate a simpl... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3106983 Sat, 19 Dec 2009 00:00:00 +0100 3106983 [Hip dislocation and fracture of the femoral head caused by low impact trauma.] http://www.medworm.com/index.php?rid=3102136&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%3D20013253%26dopt%3DAbstract We report on the diagnostic and therapeutic measures and compare this procedure with information from the literature. PMID: 20013253 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3102136 Thu, 17 Dec 2009 00:00:00 +0100 3102136 [Therapy standards after flexor tendon and nerve injuries of the hand : Results from a survey of German centres for hand surgery.] http://www.medworm.com/index.php?rid=3102140&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%3D20013108%26dopt%3DAbstract CONCLUSION: There seem to be no uniform treatment guidelines for flexor tendon repair if concomitant nerve injury is present. Against the background of the current literature early controlled mobilization after tendon and nerve repair seems to be justified. PMID: 20013108 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3102140 Wed, 16 Dec 2009 00:00:00 +0100 3102140 [Partial weight-bearing in rehabilitation : Strategies for instruction and limitations.] http://www.medworm.com/index.php?rid=3102142&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%3D20012428%26dopt%3DAbstract Authors: Klöpfer-Krämer I, Augat P Following trauma or surgery on the musculoskeletal system the primary aim is always as complete a restitution of mobility as possible. By mobilization with partial weight-bearing this is possible. The preferred way of teaching partial weight-bearing is the use of conventional bathroom scales. This method proves to be simple as well as time and cost-saving, but the transferability to the patient's daily life is questionable. Training and control of partial weight-bearing under dynamic conditions, such as normal walking, and walking up and down stairs seem to be very important. Different investigations have shown that the minority of subjects recruited could manage to maintain the given load of partial weight-bearing. Furthermore, the actual r... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3102142 Sat, 12 Dec 2009 00:00:00 +0100 3102142 [Fractures of the neck of the femur in younger patients (15-50 years old) : Systematic literature research on medial fractures of the neck of the femur in young patients.] http://www.medworm.com/index.php?rid=3079678&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%3D19998019%26dopt%3DAbstract Authors: Sachse D, Bludau F, Obertacke U Non-pathologic fractures of the neck of the femur in younger patients aged between 15 and 50 years old are rare injuries. These are so-called effectual injuries with very high energy induction due to traffic accidents, falls and sport accidents, causing healthy bones to be fractured and often leading to multiple injuries. The short-term and long-term complications of such injuries sometimes give rise to substantial problems, in particular from non-union fractures and avascular necrosis of the head of the femur. In the literature (and from some experts) the impression is occasionally given that there might be "proven" successful therapeutic procedures for the methods and in particular the timing of treatment of fractures of the neck of the femur ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3079678 Thu, 10 Dec 2009 00:00:00 +0100 3079678 [Time intervals during and after emergency room treatment : An analysis using the trauma register of the German Society for Trauma Surgery.] http://www.medworm.com/index.php?rid=3079681&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%3D19997717%26dopt%3DAbstract CONCLUSION: The duration of time intervals depends on injury severity, treatment after completion of emergency trauma care and the level of the trauma centre. Time management in emergency trauma care can potentially be optimized after completion of the last diagnostic procedure in the emergency room. PMID: 19997717 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3079681 Wed, 09 Dec 2009 00:00:00 +0100 3079681 [Intramedullary nailing of proximal tibial fractures : Complications and risk factors.] http://www.medworm.com/index.php?rid=3079680&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%3D19997718%26dopt%3DAbstract Authors: Josten C, Marquass B, Schwarz C, Verheyden A INTRODUCTION: We performed a consecutive study on patients with proximal tibial fractures without joint participation to determine the early clinical and radiological outcome. PATIENTS: From January 2000 to December 2005, 22 fractures of the proximal and proximal diaphyseal tibia without joint participation were operated on using the new tibia nail. A total of 18 patients (82%) completed full follow-up after 6 weeks and 3 and 6 months. RESULTS: Two primary and one secondary malalignment were observed Two of them were initially polytraumatised. Furthermore, two patients developed a delayed union, and one non-union occurred. Risk factors for limited bony consolidation were smoking and an open fracture. Screw or nail breakage did not o... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3079680 Wed, 09 Dec 2009 00:00:00 +0100 3079680 [Time delay in resuscitation room treatment and the effect on outcome.] http://www.medworm.com/index.php?rid=3079679&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%3D19998018%26dopt%3DAbstract Authors: Ruchholtz S PMID: 19998018 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3079679 Wed, 09 Dec 2009 00:00:00 +0100 3079679 [Unidirectional versus multidirectional palmar locking osteosynthesis of unstable distal radius fractures : Comparative analysis with LDR 2.4 mm versus 2.7 mm matrix-smartlock.] http://www.medworm.com/index.php?rid=3071878&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%3D19967335%26dopt%3DAbstract CONCLUSION: Unidirectional palmar locking plates are equally suited for the therapy of C1 and C2 fractures as multidirectional palmar locking plates but multidirectional plates require a longer fluoroscopy time. PMID: 19967335 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3071878 Sun, 06 Dec 2009 00:00:00 +0100 3071878 [Value of the clinical examination in suspected meniscal injuries : A meta-analysis.] http://www.medworm.com/index.php?rid=3060245&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%3D19960176%26dopt%3DAbstract CONCLUSION: Meniscal injury can be detected by several functional tests. Using the Thessaly test can improve the physical examination by means of probability of the correct diagnosis, but the results are based on a single study. In patients with ambiguous findings in the physical examination or with suspected combined injury, further diagnostic procedures such as magnetic resonance imaging are necessary to confirm the diagnosis. In clinically certain cases the use of additional diagnostic imaging procedures should be avoided as other authors have shown that with few exceptions this has no influence on the therapy. PMID: 19960176 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=3060245 Sat, 05 Dec 2009 00:00:00 +0100 3060245 [Kyphoplasty in osteoporotic spinal fractures.] http://www.medworm.com/index.php?rid=2981812&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%3D19902163%26dopt%3DAbstract Authors: Prokop A, Löhlein F, Chmilniecki M, Volbracht J, Manner M Kyphoplasty has been the standard procedure for osteoporotic fractures for more than 5 years but the material costs are still very high. The aim of this study was to clarify whether pain reduction could be achieved without increasing the rate of new fractures and also in what areas costs could possibly be reduced. From 15.01.2007 until 15.01.2008, a total of 100 patients with 126 recent osteoporotic spinal fractures were treated by kyphoplasty with an average operation time of 38 min and follow-up times up to 12 months. During this follow-up period 15 lateral and 2 dorsal cement leakages remained asymptomatic and 1 dorsal leakage caused an incomplete paraparesis, which was finally cured completely. All patients wer... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2981812 Wed, 11 Nov 2009 00:00:00 +0100 2981812 [In Process Citation] http://www.medworm.com/index.php?rid=2981811&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%3D19902164%26dopt%3DAbstract Authors: PMID: 19902164 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2981811 Sun, 01 Nov 2009 00:00:00 +0100 2981811 [Functional and subjective results following subtalar dislocations.] http://www.medworm.com/index.php?rid=2940164&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%3D19862495%26dopt%3DAbstract CONCLUSION: Despite the severity of the injury, the functional and subjective results of subtalar dislocations without any bone injuries are good. Generally, no early post-traumatic arthrosis occurs if there are no associated bone injuries. No differences were established between medial and lateral subtalar dislocations. PMID: 19862495 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2940164 Thu, 29 Oct 2009 00:00:00 +0100 2940164 [Variability of the screw position after 3D-navigated sacroiliac screw fixation : Influence of the surgeon's experience with the navigation technique.] http://www.medworm.com/index.php?rid=2940163&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%3D19862496%26dopt%3DAbstract CONCLUSION: In the clinical setup a malpositioning of sacroiliac screws is possible even with the use of 3D navigation. One reason may be a low level of navigation experience of the surgeon in combination with low experience in the conventional technique. Therefore even in navigation-based placement of sacroiliac screws the malpositioning rate is dependent on the surgeon's experience with the navigation technique. The correct placement of the screws should be controlled intraoperatively using the 3D image intensifier. PMID: 19862496 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2940163 Thu, 29 Oct 2009 00:00:00 +0100 2940163 [Marjolin's ulcer : Malignant transformation of a crural ulcer due to posttraumatic chronic osteomyelitis.] http://www.medworm.com/index.php?rid=2940166&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%3D19859679%26dopt%3DAbstract We report on the case of an 81-year-old female patient who developed a squamous cell carcinoma in a long-lasting therapy-resistant crural ulcer of the lower leg due to posttraumatic chronic osteomyelitis. Eventually the lower leg had to be amputated because of massive destruction of soft tissue and the tibia bone. Based on the desolate wound conditions plastic reconstruction by a pivoted muscle flap and surgical covering with mesh graft plastic was also necessary.The amputation stump had completely healed 6 months after surgery and the patient is fitted with an artificial limb ensuring independent mobility even outside the home. Up to the present there is no evidence of any tumor recurrence or progression. PMID: 19859679 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2940166 Wed, 28 Oct 2009 00:00:00 +0100 2940166 [Thrombosis prophylaxis in trauma surgery units in Germany : A survey.] http://www.medworm.com/index.php?rid=2940165&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%3D19859680%26dopt%3DAbstract CONCLUSIONS: While pharmacological thrombosis prophylaxis following trauma surgery seems to be generally performed according to guidelines, diagnosis and treatment of HIT need to be systematized. PMID: 19859680 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2940165 Wed, 28 Oct 2009 00:00:00 +0100 2940165 [Minimally invasive plate osteosynthesis on the proximal upper limb : Instructions for surgery.] http://www.medworm.com/index.php?rid=2922629&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%3D19851716%26dopt%3DAbstract Authors: Neubauer T, Wagner M PMID: 19851716 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2922629 Fri, 23 Oct 2009 23:00:00 +0100 2922629 [Current status of minimally invasive plate osteosynthesis: specific part II.] http://www.medworm.com/index.php?rid=2922628&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%3D19851717%26dopt%3DAbstract Authors: Neubauer T, Wagner M With the increasing use of minimally invasive plate osteosynthesis in the last years almost every anatomical region was included in this new technique. Thus, it is not used any more for certain fractures and problematic areas, but also in fractures where it represents a challenge to established osteosynthesis techniques like intramedullary nailing or conventional plating. Therefore the challenge for the treating surgeon increased to find the right answer for the particularities of an individual fracture by choosing the optimal method. The most popular indications for the use of minimally invasive plate osteosynthesis are presented and the technical details are discussed. The possibilities for complications - in a common way and for specific fractures - are... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2922628 Fri, 23 Oct 2009 23:00:00 +0100 2922628 [Surgical treatment of the multiple trauma patient : Responsibility from site of the accident up to rehabilitation.] http://www.medworm.com/index.php?rid=2922630&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%3D19847381%26dopt%3DAbstract Authors: Hildebrand F, Krettek C PMID: 19847381 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2922630 Thu, 22 Oct 2009 23:00:00 +0100 2922630 [Development and perspectives for orthopedic and trauma research in Germany.] http://www.medworm.com/index.php?rid=2916594&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%3D19844668%26dopt%3DAbstract Authors: Claes LE The conditions for experimental orthopedic and trauma research in Germany have improved during recent years. At present, however, only a few research centers provide significant and continuous research. Recently advertised new professorships considerably enhance the chances of further improvement and it is hoped that this process will continue. The recruitment of orthopedic and trauma surgeons for professional research remains an unsolved problem due to financial and working conditions. To do both qualified research and clinical work on a high level over a long period of time is hardly possible within the existing structures. This problem can only be solved by establishing professional research laboratories with permanent scientific and technical staff and limited lea... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2916594 Wed, 21 Oct 2009 23:00:00 +0100 2916594 [Microsurgical thumb replantation following traumatic amputation : Preliminary results in Hanoi, Vietnam.] http://www.medworm.com/index.php?rid=2916593&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%3D19844669%26dopt%3DAbstract DISCUSSION: Vascular thrombosis was the cause of all failures. Proper debridement, standardized microvascular techniques, timely detection of thrombosis formation, and reoperation using vein grafts play a decisive role in the final success. PMID: 19844669 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2916593 Wed, 21 Oct 2009 23:00:00 +0100 2916593 [Prophylactic ventilation of severely injured patients with thoracic trauma - does it always make sense?] http://www.medworm.com/index.php?rid=2909174&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%3D19838660%26dopt%3DAbstract Authors: Mahlke L, Oestern S, Drost J, Frerichs A, Seekamp A For therapy of blunt thoracic trauma in multiple injured patients, some studies have recommended prophylactic ventilation with kinetic therapy for 3-5 days. In contrast other clinics prefer to reduce the time of ventilation and to extubate as soon as possible. In this retrospective study our patient collective was investigated to find out if early extubation is linked to a higher complication rate. A total of 26 ventilated patients with severe thoracic trauma and an abbreviated injury scale score (AIS thorax) >3 were included in the study. The mean time of ventilation was 98.4 h and in patients without head injury 71.3 h. Out of 22 patients 4 had to be reintubated which had to be repeated for 2 patients. Of the patients 3 ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2909174 Sat, 17 Oct 2009 23:00:00 +0100 2909174 [Realization and implementation of a trauma network of the German Association of Trauma Surgery (DGU) exemplified by the Trauma Network of eastern Bavaria.] http://www.medworm.com/index.php?rid=2880467&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%3D19816667%26dopt%3DAbstract This article describes the experiences gained during the implementation of the trauma network in eastern Bavaria. PMID: 19816667 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2880467 Fri, 09 Oct 2009 23:00:00 +0100 2880467 [Surviving multiple trauma - what comes next? : The rehabilitation of seriously injured patients.] http://www.medworm.com/index.php?rid=2880466&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%3D19816668%26dopt%3DAbstract Authors: Simmel S, Bühren V The survival chances of multiple trauma patients have improved continuously over the last decades. Therefore, not only the question of whether the patient survives a serious accident arises, but rather how the patient survives it. The after effects of trauma are seen not only physically, but also psychologically and socially. These affect quality of life and are evident years after the accident. The International Classification of Functioning, Disability and Health (ICF) provides a system to classify the after effects of trauma, which can be measured with the help of assessment instruments. Knowing which parameters can influence trauma after effects is essential for the planning, organization, and implementation of a rehabilitation programme following s... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2880466 Fri, 09 Oct 2009 23:00:00 +0100 2880466 [Importance of hypothermia in multiple trauma patients.] http://www.medworm.com/index.php?rid=2880465&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%3D19816669%26dopt%3DAbstract Authors: Hildebrand F, Probst C, Frink M, Huber-Wagner S, Krettek C Multiple trauma patients frequently demonstrate a hypothermic core temperature, defined as a temperature below 35 degrees C, already at admission in the emergency room. As a drop of the core temperature below 34 degrees C has been shown to be associated with a significant increase in post-traumatic complications, this limit is considered to be critical in these patients. Multiple trauma patients with hypothermia demonstrate a markedly increased mortality rate compared to normothermic patients with the same injury severity. Therefore effective rewarming measures are essential for adequate bleeding control and successful resuscitation. If and to what extent the induction of controlled hypothermia in the early phase of tr... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2880465 Fri, 09 Oct 2009 23:00:00 +0100 2880465 [Multiple trauma in pediatric patients.] http://www.medworm.com/index.php?rid=2880464&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%3D19816670%26dopt%3DAbstract Authors: Jakob H, Brand J, Marzi I Important prerequisites to adequately treat pediatric patients with multiple trauma are a profound knowledge of the underlying mechanisms of injury, common injury patterns and the associated mortality. The younger the child the more injury patterns as well as organ-specific injury severity differ in comparison to adult trauma patients. Traumatic brain and thorax injuries are the key to the prognosis of the injured child. Abdominal injuries rarely require surgery in contrast to adults. Spine and pelvic injuries as well as injuries of the extremities make age-adapted surgical procedures mandatory. The present article describes the established primary diagnostic evaluation after admittance to the emergency room as well as specific treatment options for p... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2880464 Fri, 09 Oct 2009 23:00:00 +0100 2880464 [Current concepts in the therapy of polytraumatized patients.] http://www.medworm.com/index.php?rid=2876560&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%3D19812987%26dopt%3DAbstract Authors: Hildebrand F, Krettek C PMID: 19812987 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2876560 Thu, 08 Oct 2009 23:00:00 +0100 2876560 [Minimally invasive plate osteosynthesis: current state : Part 1: general information.] http://www.medworm.com/index.php?rid=2833979&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%3D19779691%26dopt%3DAbstract Authors: Neubauer T, Wagner M Minimally invasive techniques and developments of implants with angular stability have led to a renaissance of plate osteosynthesis for fracture stabilization in recent years. They represent a major source of success which has facilitated minimally invasive plate osteosynthesis (MIPO) or even made it feasible. For implants with LCP technology all current types of screws can be used and/or combined. However, the treating surgeon is still confronted with the decision which fixation mode, absolute or relative stability, is required for each individual fracture. Moreover, reduction techniques, intra-operative imaging and the biomechanical features of the selected implant require a more meticulous preoperative planning. Minimizing the surgical trauma has result... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2833979 Fri, 25 Sep 2009 23:00:00 +0100 2833979 [University benchmarking : A current status analysis.] http://www.medworm.com/index.php?rid=2833981&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%3D19777198%26dopt%3DAbstract Authors: Raschke MJ, Josten C, Gebhard F, Ruchholtz S, Stöckle U, Meffert R, Zwipp H Lump sum reimbursement and the resulting concentration of medical treatment in maximum care clinics have led to substantial increase in economic pressure on university hospitals. Nearly all hospitals have introduced business ratios to economically judge each department. In order to evaluate the validity and comparability the business ratios of seven university traumatology departments were evaluated. Structural data as well as cost calculation results in different cost groups were evaluated. Major differences could be identified despite the fact that the cost calculations were all based on the same method (InEK method). In particular the costs for distribution to other medical specialties such as ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2833981 Thu, 24 Sep 2009 23:00:00 +0100 2833981 [Medical care reality in trauma surgical clinics in Germany : A survey of the professional committee of the German Society for Trauma Surgery.] http://www.medworm.com/index.php?rid=2833980&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%3D19777199%26dopt%3DAbstract Authors: Bonk AD, Hoffmann R, Siebert H, Wölfl C Due to revised conditions of medical care in Germany, in particular the introduction of the newly designated specialist for orthopaedics and trauma surgery, the working conditions in trauma surgical clinics in Germany has changed. In May 2008 the professional committee of the German Trauma Society conducted a survey at the 729 trauma surgical clinics and departments in order to establish the true level of care at these particular sites. The results of the 90,000 variables presented in the following article, reflect the changes in trauma care as well as in the medical care structures and emphasize the increased work load. In particular the lack of qualified candidates underlines the main explanation for vacant posts and is also evalu... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2833980 Thu, 24 Sep 2009 23:00:00 +0100 2833980 [Therapy-resistant tibial pseudarthrosis : Treatment success with BMP-7 combined with autologous bone.] http://www.medworm.com/index.php?rid=2820903&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%3D19768394%26dopt%3DAbstract Authors: Siebenlist S, Kraus T, Burghardt R, Döbele S, Stöckle U, Ganslmeier A Delayed union or non-union of long bone shaft fractures still presents a surgical challenge. Especially if there is a predisposition for pseudarthrosis such as adiposity, diabetes mellitus, local disruption of blood supply or lack of hormones, the established procedures of autologous cancellous bone grafting or plate fixation with compression often lead to insufficient results. In the following article the successful use of bone morphogenetic protein BMP-7 [recombinant human osteogenetic protein-1 (rhOP-1)], combined with autologous bone grafting for therapy of a therapy-resistant tibial non-union is described. In a patient with multiple risk factors the tibial fracture was completely cured after t... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2820903 Sat, 19 Sep 2009 23:00:00 +0100 2820903 [Coagulation management in multiple trauma.] http://www.medworm.com/index.php?rid=2808332&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%3D19760384%26dopt%3DAbstract Authors: Waydhas C, Görlinger K More than 25% of poytraumatized patients present in the emergency department with a coagulopathy which results in a 4-fold increase in mortality. The detection of microvascular bleeding is the major clinical indicator. Measurement of fibrinogen, activated partial thromboplastin time and prothrombin time as well as thrombelastometry are required. A prerequisite for the substitution of coagulation factors and platelets is an immediate surgical control of bleeding and correction of hypothermia, acidosis and hypocalcemia. The goals for platelet count, fibrinogen, PT and aPTT are well established. The use of an algorithm for transfusion and coagulation management results in optimized therapy and improved outcome. Substituted coagulation products are only... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2808332 Thu, 17 Sep 2009 23:00:00 +0100 2808332 [Medial hip neck fracture: influence of pre-operative delay on the quality of outcome : Results of data from the external in-hospital quality assurance within the framework of secondary.] http://www.medworm.com/index.php?rid=2801567&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%3D19756453%26dopt%3DAbstract CONCLUSIONS: Patients with medial hip neck fracture should receive operative treatment without delay, if no medical contra-indications for immediate surgery. In particular appropriate organizational measures should be taken to ensure an early surgical treatment even during weekends. PMID: 19756453 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2801567 Fri, 11 Sep 2009 23:00:00 +0100 2801567 [Standardised primary care of multiple trauma patients : Prehospital Trauma Life Support(R) und Advanced Trauma Life Support(R).] http://www.medworm.com/index.php?rid=2801569&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%3D19756451%26dopt%3DAbstract CONCLUSION: PHTLS(R) und ATLS(R) are established and standardised concepts, which are constantly reviewed and updated according to the latest medical knowledge. They provide the opportunity to standardise prehospital and primary clinical trauma management for all specialties and hospitals, while incorporating own knowledge. PMID: 19756451 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2801569 Sat, 05 Sep 2009 23:00:00 +0100 2801569 [Surgical management of life-threatening injuries.] http://www.medworm.com/index.php?rid=2801568&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%3D19756452%26dopt%3DAbstract Authors: Flohé S, Nast-Kolb D Life-threatening situations after multiple trauma which then require interruption of the diagnostic algorithm and immediate surgical treatment after admission are a challenge for the multidisciplinary trauma team. Emergency surgery after trauma may be necessary for the abdomen, the pelvis, the chest as well as the head. Therefore, several disciplines may be involved. Damage control surgery is the leading surgical strategy in emergency surgery in unstable trauma patients. The main aspects of damage control surgery are outlined in this article. The goal of damage control surgery is to gain control of bleeding as soon as possible without additional surgical trauma. Packing plays a central role in damage control surgery of the abdomen and the pelvis. Surg... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2801568 Sat, 05 Sep 2009 23:00:00 +0100 2801568 [Distribution planning of injured persons in mass disasters or catastrophes : Structuring of hospital capacities exemplified by the catastrophe network of the German Society for Trauma Surgery (DGU).] http://www.medworm.com/index.php?rid=2801566&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%3D19756454%26dopt%3DAbstract Authors: Bail HJ, Kleber C, Haas NP, Fischer P, Mahlke L, Matthes G, Ruchholtz S, Weidringer JW Relevant changes have occurred in disaster management in Germany due to legal alterations and the introduction of the diagnosis-related groups (DRG) system. This has resulted in a reduction in bed capacities and an increase in bed utilization. In addition to the preclinical deployment strategy the provisional aspects of disaster medicine with the problem of the emergency service/hospital interface will be described. A suggestion for a solution for optimization of patient allocation in mass disasters or catastrophes will be demonstrated with the catastrophe network of the German Society for Trauma Surgery (DGU). PMID: 19756454 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2801566 Sat, 05 Sep 2009 23:00:00 +0100 2801566 [The Trauma Network of the German Society for Trauma 2009.] http://www.medworm.com/index.php?rid=2801565&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%3D19756455%26dopt%3DAbstract Authors: Kühne CA, Mand C, Sturm J, Lackner CK, Künzel A, Siebert H, , Ruchholtz S In 2009, 3 years after the foundation of the Trauma Network of the German Society for Trauma (TraumaNetzwerkD DGU), the majority of German hospitals participating in the treatment of seriously injured patients is registered in regional trauma networks (TNW). Currently there are 41 trauma networks with more than 660 hospitals in existence, 18 more are registered but are still in the planning phase.Each Federal State has an average of 39 trauma centres of different levels taking part in the treatment of seriously injured patients and every trauma network has an average catchment area of 8708 km(2). The most favourable geographical infrastructure conditions exist in Nordrhein-Westfalen, the least ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2801565 Sat, 05 Sep 2009 23:00:00 +0100 2801565 [Damage Control Orthopedics : What is the current situation?] http://www.medworm.com/index.php?rid=2801564&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%3D19756456%26dopt%3DAbstract Authors: Bouillon B, Rixen D, Maegele M, Steinhausen E, Tjardes T, Paffrath T Damage Control Orthopedics is a strategy for treatment of fractures in severely injured patients. The aim is to reduce secondary damage and thereby improve the patient's outcome. The relevant fractures are primarily stabilized with external fixators instead of a primary definitive osteosynthesis. The less traumatic and shorter surgical procedure is thought to reduce the additional trauma load and should thereby minimize the "second hit" situation. After stabilization of the patient on the intensive care unit secondary definitive ostesynthesis can then be performed after 4-14 days.The available animal studies, retrospective clinical studies and prospective cohort studies seem to support the concept of damage c... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2801564 Sat, 05 Sep 2009 23:00:00 +0100 2801564 [Transpedicular osteotomy with dorsal wedge osteotomy : Treatment of post-traumatic or postinfection kyphotic malalignment of the thoraco-lumbar spine.] http://www.medworm.com/index.php?rid=2801563&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%3D19756457%26dopt%3DAbstract CONCLUSIONS: Transpedicular wedge resection osteotomy of the thoracic and lumbar spine offers a safe surgical technique for the treatment of fixed postinflammatory kyphotic deformities. PMID: 19756457 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2801563 Sat, 05 Sep 2009 23:00:00 +0100 2801563 [Tissue engineering of bone tissue : Principles and clinical applications.] http://www.medworm.com/index.php?rid=2801562&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%3D19756458%26dopt%3DAbstract Authors: Schmidt-Rohlfing B, Tzioupis C, Menzel CL, Pape HC Complex fractures are still a major clinical challenge. The treatment options of large bony defects either with autografts or allografts are limited in terms of material availability and tissue in-growth. Tissue engineering might offer a solution to this problem. In an interdisciplinary approach artificial bony tissue can be generated which mimics normal bone in terms of function and morphology. So far tissue engineering of bone is mainly confined to laboratory investigations whereas clinical applications are still in the beginning. This manuscript presents the most important scaffolds as well as growth factors and cell systems. Furthermore, it focuses on clinical studies for the treatment of large bony defects using tissue en... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2801562 Mon, 31 Aug 2009 23:00:00 +0100 2801562 [In Process Citation] http://www.medworm.com/index.php?rid=2801561&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%3D19756459%26dopt%3DAbstract Authors: Ipaktchi K, Vogt PM PMID: 19756459 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2801561 Mon, 31 Aug 2009 23:00:00 +0100 2801561 http://www.medworm.com/index.php?rid=2744744&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%3D19711047%26dopt%3DAbstract Unfallchirurg. 2009 Aug 28; Authors: Kühne CA, Siebert H, Ruchholtz S PMID: 19711047 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2744744 Thu, 27 Aug 2009 23:00:00 +0100 2744744 [Operative treatment of instable osteoporotic spine fractures : A good guide in coding of diagnosis.] http://www.medworm.com/index.php?rid=2744743&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%3D19711048%26dopt%3DAbstract Authors: Prokop A, Wollny M, Futterer N, Berner U, Volbracht J, Windolf J, Siebert H The combination of kyphoplasty and fixateur interne is an essential therapy with osteoporotic unstable fractures. Material costs of 5500 Euro are not sufficiently covered by returns through DRG I09. Thus operations are often performed in 2 stages, an initial one and a second 30 days later. This means more strain for the patient and partly also loss of correction.Therefore in 2008 we requested the InEK that codes for one-and two-segmental implantation of material in a vertebrae with preceding restoration of vertebral height (5-839.a0 and 5-839.a1) combined with a percutaneous dorsal operation with a screw-rod system in the future would be represented by I19B in G-DRG system with returns of 11,110,40 Eur... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2744743 Thu, 27 Aug 2009 23:00:00 +0100 2744743 [Sense and nonsense of the delegation options for medical duties.] http://www.medworm.com/index.php?rid=2704298&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%3D19680617%26dopt%3DAbstract Authors: Hoffmann R, Siebert H PMID: 19680617 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2704298 Thu, 13 Aug 2009 23:00:00 +0100 2704298 [Reader's letters.] http://www.medworm.com/index.php?rid=2695799&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%3D19672570%26dopt%3DAbstract Authors: Sarkar MR, Ring O, Gäbler C PMID: 19672570 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2695799 Wed, 12 Aug 2009 23:00:00 +0100 2695799 [Is surgical treatment in the casualty department endangered in future by a lack of generalists? : Results of a survey.] http://www.medworm.com/index.php?rid=2695803&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%3D19669720%26dopt%3DAbstract Authors: Siebert H PMID: 19669720 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2695803 Tue, 11 Aug 2009 23:00:00 +0100 2695803 [The economic challenges of polytrauma care.] http://www.medworm.com/index.php?rid=2695802&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%3D19669721%26dopt%3DAbstract Authors: Probst C, Schaefer O, Hildebrand F, Krettek C, Mahlke L Following the introduction of DRGs ("diagnosis-related groups") in Germany, reimbursements changed from a per diem rate to a flat charge per patient. DRGs are defined by the German Institute for the Hospital Remuneration System (InEK, Institut für das Entgeltsystem im Krankenhaus) along with the respective reimbursement. The revenues are set according to the diagnoses and procedures. In complex cases like serious injury this applies for the average diagnoses and procedures. As a result, several groups reported costs of polytrauma care as high as <euro> 70,000 with losses as high as <euro> 20,000. In the USA, a similar constellation has lead to the closure of trauma centers. The main reasons for the financ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2695802 Tue, 11 Aug 2009 23:00:00 +0100 2695802 [Subcutaneous avulsion of the flexor digitorum profundus muscle.] http://www.medworm.com/index.php?rid=2695801&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%3D19669722%26dopt%3DAbstract Authors: Tylla A, Strube T The diagnostic and treatment of a closed avulsion of the flexor digitorum profundus muscle at its insertion of the little finger is presented. This happened as a 41-year-old woman wanted to hold a dog lead in her left hand and suddenly the dog started to run. In the literature the flexor digitorum profundus (FDP) and flexor pollicis longus (FPL) tendons were found to be more frequently ruptured than the flexor digitorum superficialis tendon. Closed ruptures of the FDP have been rarely reported. In the case described here there was no torn fragment at the distal end of the FDP tendon and the bone structure of the phalanx distales was intact. The operative treatment, postoperative care and clinical course are presented. PMID: 19669722 [PubMed - as supplied ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2695801 Tue, 11 Aug 2009 23:00:00 +0100 2695801 [The factor "Time" : Its impact in pathophysiology and therapy of multiple trauma.] http://www.medworm.com/index.php?rid=2695800&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%3D19669723%26dopt%3DAbstract Authors: Bogner V, Mutschler W, Biberthaler P Pathophysiology of multiple trauma is characterized by different trauma-associated repercussions like organ destruction, haemorrhage, immune cell activation by foreign antigen, for example. The length of time while such impairments take hold of the organism substantially impacts the extent of the post trauma secondary injury. Short interruptions in microcirculation can mostly be compensated, whereas elongated ischemic periods definitely cause structural cell damage up to death. The current review highlights the importance of the time duration of posttrauma second hits on the pathophysiology of systemic inflammation and multiple organ failure. The quick termination of such secondary impairments by immediate therapeutic intervention mainly im... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2695800 Tue, 11 Aug 2009 23:00:00 +0100 2695800 [Safe:Trac course series of the German Society for Trauma Surgery on patient safety.] http://www.medworm.com/index.php?rid=2662696&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%3D19644664%26dopt%3DAbstract Authors: Burghofer K, Lackner CK Based on crew resource management of the airline industry the German Society for Trauma Surgery (Deutsche Gesellschaft für Unfallchirurgie, DGU) was the first scientific community in Germany to develop and implement a training course for patient safety. The S:training courses contain four course formats which focus on the prehospital life support (S:PLS), the operating room (S:OR), the trauma room (S:TR) and the intensive care unit (S:ICU). In the training the importance of the human factor for the management of acute major trauma is developed by means of presentations, training videos, practical training, discussions and realistic case scenarios associated with the special working environment of the participants. A specially developed course manua... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2662696 Fri, 31 Jul 2009 23:00:00 +0100 2662696 [Facial perforation trauma : An unusual injury in a skiing accident.] http://www.medworm.com/index.php?rid=2658172&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%3D19641892%26dopt%3DAbstract We describe a case of a 48-year-old man who sustained a perforation trauma from an 11 cm long wooden tree branch in the middle of the face in a skiing accident. He suffered from additional injuries, such as fractures of the ribs and hand, but was neurologically without pathologic findings and was cardiopulmonary stable.The branch penetrated the head from the sinus maxillaris through the maxilla just missing the internal and external carotid arteries and ending just short of the cervical vertebra. The patient was transported to a center for oral and maxillofacial surgery and underwent several operations.He could return to his normal social and professional life 8 months after the accident. PMID: 19641892 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2658172 Thu, 30 Jul 2009 23:00:00 +0100 2658172 [Quality of prehospital and early clinical care of pediatric trauma patients of school age compared to an adult cohort : A matched-pair analysis of 624 patients from the DGU trauma registry.] http://www.medworm.com/index.php?rid=2658171&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%3D19641893%26dopt%3DAbstract Authors: Laurer H, Wutzler S, Wyen H, Westhoff J, Lehnert M, Lefering R, Marzi I, Conflicting reports exist regarding the quality of prehospital treatment of pediatric trauma patients. The purpose of this investigation was to determine whether prehospital treatment and emergency management in pediatric trauma patients were similar to that in adult patients. All patients who had been prospectively documented in the registry of the German Trauma Society (DGU) between 2002 and 2005 were selected for this study. A total of 312 matched pairs of adult and pediatric patients suffering from identical injuries were defined and compared with respect to cause of trauma, diagnostic and therapeutic interventions, and outcome. Within the study group, 63% were male, and the average age was 10.5+/-2.... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2658171 Thu, 30 Jul 2009 23:00:00 +0100 2658171 [Emergency care for traffic accidents in Bavaria : Current process analysis depending on hospital and emergency service structures.] http://www.medworm.com/index.php?rid=2638582&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%3D19629424%26dopt%3DAbstract Authors: Lackner CK, Bielmeier S, Burghofer K A change is emerging in the hospital landscape due to health political measures, which in consequence also influences the prehospital medical care in emergencies. The main focus of this study was to gather information about emergency medical care after traffic accidents on the basis of data from Bavarian emergency medical services. In 2006 there were 14,261 traffic accidents in Bavaria where an emergency doctor attended the scene. The patients were primarily cared for by land-based rescue services and air rescue services were only used in 19.1% of the cases. Of the patients involved in a traffic accident 47.6% were transported to a primary health care hospital. A prehospital interval of more than 60 min occurred in 20% of the missions. Of t... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2638582 Fri, 24 Jul 2009 23:00:00 +0100 2638582 [Embolization of life-threatening intercostal hemorrhaging in a severely injured patient : A rarity in trauma care.] http://www.medworm.com/index.php?rid=2638581&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%3D19629425%26dopt%3DAbstract Authors: Hußmann B, Taeger G, W.e I, Waydhas C, Schoch B, Nast-Kolb D, Lendemans S Transarterial embolization of ruptured intercostal arteries due to massive bleeding represents an infrequent indication in severely injured patients. The current literature shows isolated case descriptions but no clinical trials exist. In the case depicted here embolization is represented as a form of therapy after haemorrhagic shock caused by a ruptured intercostal artery. The embolization carried out led to an immediate cessation of bleeding. The vital signs returned to normal immediately after the procedure and surgical intervention could be avoided. The course of the disease represented in the following shows the effectiveness of this type of treatment not only for bleeding due to pelvic fractur... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2638581 Fri, 24 Jul 2009 23:00:00 +0100 2638581 [Results and complications in the treatment of periprosthetic femur fractures with a locked plate system.] http://www.medworm.com/index.php?rid=2638585&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%3D19629421%26dopt%3DAbstract CONCLUSION: Fixation of periprosthetic femur fractures with a locked plate system provided satisfactory results in patients with a THA, however, the relatively high implant failure rate in fractures above a stable TKA is a cause for concern. PMID: 19629421 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2638585 Thu, 23 Jul 2009 23:00:00 +0100 2638585 [Recurrent synovial chondromatosis of the tarsometatarsal joint : Case report and review of literature.] http://www.medworm.com/index.php?rid=2638584&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%3D19629422%26dopt%3DAbstract We present a case report of a 32-year-old male with synovial chondromatosis in the tarsometatarsal joint area, which is an uncommon localization. PMID: 19629422 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2638584 Thu, 23 Jul 2009 23:00:00 +0100 2638584 [Wound care within an Interplast mission.] http://www.medworm.com/index.php?rid=2638583&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%3D19629423%26dopt%3DAbstract Authors: Ottomann C, Hartmann B As of 2001, the Centre for Severely Burned Patients at the Unfallkrankenhaus (Casualty Hospital) in Berlin has been working together with the sole centre for wound care in Kyrgyzstan. This cooperation consists not only of on-site operative applications; since the first contact with our Kyrgyzstani colleagues we have sought to improve the overall level of wound therapy in Kyrgyzstan. For this purpose, we organised educational trips to Germany for our Kyrgyzstani colleagues in addition to the numerous material donations (donations-in-kind). From the beginning of this project the motto of our cooperation was"helping them help themselves". This is in corresponds to the modern challenges of the OECD (Organisation for Economic Cooperation and Development) of d... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2638583 Thu, 23 Jul 2009 23:00:00 +0100 2638583 [Shortage of new recruits in surgery : Where do the problems of a reform of further education lie? Position of a person affected.] http://www.medworm.com/index.php?rid=2638587&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%3D19626305%26dopt%3DAbstract Authors: Krüger M The shortage of young people in curative medicine and particularly in surgery can be experienced every day. The main arguments of the new generation are the lacking structure of further education, the sometimes suboptimal German framework conditions in the health service and the non-inclusion of the young generation in structural and content aspects of a reform of the General Medical Council, professional organizations and associations. Unfortunately, the sometimes well-meant approaches to a reform of the new further education rules are not in a position to rectify these deficits. Newer surveys seem to show that there has even been a deterioration of the further education situation. We need a new further education culture which is marked by the will to also want ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2638587 Wed, 22 Jul 2009 23:00:00 +0100 2638587 [Learning cannot be forced only encouraged : Citation by form teacher Dr. Gottfriedsen 1976.] http://www.medworm.com/index.php?rid=2638588&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%3D19626304%26dopt%3DAbstract Authors: Tempka A PMID: 19626304 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2638588 Tue, 21 Jul 2009 23:00:00 +0100 2638588 [Best matching : Experimental comparison of different matching procedures for use in computer navigation.] http://www.medworm.com/index.php?rid=2638586&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%3D19626306%26dopt%3DAbstract CONCLUSION: In our study pairpoint matching was the only procedure without misplacement and on average had the largest safety margin for drillings. Thus this method was the most precise procedure. The region matching procedure offers the advantage of the fastest matching with comparable precision. PMID: 19626306 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2638586 Tue, 21 Jul 2009 23:00:00 +0100 2638586 [Inaugural ortho-trauma update seminar : Comprehensive continuing education over 2 days.] http://www.medworm.com/index.php?rid=2624256&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%3D19618152%26dopt%3DAbstract Authors: Ayazpoor U PMID: 19618152 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2624256 Sat, 18 Jul 2009 23:00:00 +0100 2624256 [Bite injuries of the hand.] http://www.medworm.com/index.php?rid=2624255&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%3D19618153%26dopt%3DAbstract Authors: Lichte P, Kobbe P, Taeger G, Nast-Kolb D, Hierner R, Oberbeck R Bite injuries of the hand have a clearly increased risk for infection compared with other regions. Surgical treatment of the wound is indicated, and the debridement must be done thoroughly and with consideration of the wound closure. Antibiotic therapy may be indicated in addition to the surgery if signs of infection exist. Antibiotics alone are not a suitable treatment. Common complications in cases of deficient primary therapy are flexor tenosynovitis, purulent arthritis, and phlegmons of the dorsal hand. These are emergencies and need immediate surgical intervention. PMID: 19618153 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2624255 Sat, 18 Jul 2009 23:00:00 +0100 2624255 [Value of MRI in preoperative diagnostics of proximal humeral fractures compared to CT and conventional radiography.] http://www.medworm.com/index.php?rid=2624254&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%3D19618154%26dopt%3DAbstract CONCLUSIONS: X-ray imaging is the basis method for the diagnosis of PHF but needs further multiplanar imaging to demonstrate complete fracture patterns. Imaging of fractures is equally good for MRI and CT and MRI also provides additional therapy-relevant information about the rotator cuff and head perfusion. PMID: 19618154 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2624254 Sat, 18 Jul 2009 23:00:00 +0100 2624254 [Primary total elbow replacement for complex intra-articular distal humerus fractures.] http://www.medworm.com/index.php?rid=2624253&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%3D19618155%26dopt%3DAbstract CONCLUSION: Primary total elbow arthroplasty for complex intra-articular distal humerus fractures in elderly patients has good functional results and is an alternative to osteosynthesis. PMID: 19618155 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2624253 Sat, 18 Jul 2009 23:00:00 +0100 2624253 [Randomized clinical trials in trauma surgery : Decision-making in an area of conflict between eminence and evidence.] http://www.medworm.com/index.php?rid=2606853&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%3D19597770%26dopt%3DAbstract This study is funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Association), it is endorsed by the board of Deutschen Gesellschaft für Unfallchirurgie (DGU, German Society for Casualty Surgery) and it is embedded in a joint program of the DFG and the Federal Ministry of Education and Research (BMBF) to support clinical studies in Germany. Moreover, the study is supported by the ChirNet Site at Witten/Herdecke-Köln (http://www.chir-net.de).Without a doubt, this RCT is one of the most important studies carried out in the field of care for the critically injured patient, because the results will have a profound influence on the future management of femoral shaft fractures in multiple trauma patients and because successful completion of this study will underline th... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2606853 Tue, 14 Jul 2009 23:00:00 +0100 2606853 [Treatment results of pertrochanteric and subtrochanteric femoral fractures : A retrospective comparison of PFN and PFNA.] http://www.medworm.com/index.php?rid=2606852&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%3D19597771%26dopt%3DAbstract CONCLUSION: The philosophy of the PFNA blade with better fixation through an increased implant-bone-interface and smaller cross-section, compaction of cancellous bone as well as an antirotational fixation, seems to show advantages compared to the double screw system of the PFN. PMID: 19597771 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2606852 Tue, 14 Jul 2009 23:00:00 +0100 2606852 [The challenge of auditing by medical health insurance inspectors : Development of individual case inspections according to section sign section sign275ff SGB V.] http://www.medworm.com/index.php?rid=2606851&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%3D19597772%26dopt%3DAbstract CONCLUSIONS: To cope with the changes in the German DRG system hospitals have to be flexible. The experiences with the regular MDK visitations can positively influence hospital organizational structures. PMID: 19597772 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2606851 Tue, 14 Jul 2009 23:00:00 +0100 2606851 [Volar locking compression plating versus dorsal plating for fractures of the distal radius : A prospective, randomized study.] http://www.medworm.com/index.php?rid=2606850&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%3D19597773%26dopt%3DAbstract CONCLUSION: Despite significant advantages of the volar locked compression plating, subjective satisfaction did not differ between the two groups. PMID: 19597773 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2606850 Tue, 14 Jul 2009 23:00:00 +0100 2606850 [Fractures of the shaft of the femur.] http://www.medworm.com/index.php?rid=2571663&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%3D19575174%26dopt%3DAbstract Authors: Lögters T, Windolf J, Flohé S The femur is the largest, longest and strongest bone in the human skeleton. Fractures of the shaft of the femur can result from high energy as well as low energy trauma and 30% of patients have multiple injuries. In the clinical diagnostic special attention must be paid to the peripheral neurovascular status as well as the possibility of a compartment syndrome. Fractures of the femur shaft are defined according to the AO classification. Treatment is as a rule operative, except for children up the end of 4 years old. Medullary nailing is nowadays the method of choice and the nails can be implanted in an anterograde or retrograde direction. The introduction of nails after boring out the medullar is associated with an increased healing rate... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2571663 Thu, 02 Jul 2009 23:00:00 +0100 2571663 [Open reduction and dorsal spondylodesis C0-C2 in atlanto-occipital dislocation.] http://www.medworm.com/index.php?rid=2538246&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%3D19557377%26dopt%3DAbstract We report the case of a 73-year-old male patient who was suffered trauma after a syncopal fall onto a railway track in the form of an atlanto-occipital dislocation. The diagnostic revealed a bilateral fracture of the occipital condyles coupled with a ventral atlanto-occipital dislocation (Jeanneret type 4) and also an odontoid fracture (Anderson type 2). The patient underwent dorsal spondylodesis of C0-C2 in combination with Magerl's C1-C2 screw fixation. Pre-operatively and postoperatively no neurological abnormalities were found. This rarely occurring and survived tramatological situation is described using the present case as an example. PMID: 19557377 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538246 Fri, 26 Jun 2009 23:00:00 +0100 2538246 [Avoidance of wrong site surgery : Experiences by the introduction of measures for quality control and patient safety in a surgical casualty hospital.] http://www.medworm.com/index.php?rid=2538252&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%3D19543870%26dopt%3DAbstract Authors: Reuther F Wrong site surgery leads to substantial individual injury to the affected patient. Therefore, organizations such as the WHO, the Joint Commission International (JCI) and the Action Alliance Patient Safety (APS) have developed procedures for avoidance of wrong site surgery. This is based on the active incorporation of patients in the process of intervention identification. In this manner the disclosure to the patient, marking of the site of surgery, identification before induction of anesthesia and the team time out are documented in a checklist recommended by the APS before the operation begins. In the DRK Clinics in Berlin the procedure for avoidance of wrong site surgery was introduced before the second recertification by the JCI for implementation of the patient s... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538252 Sat, 20 Jun 2009 23:00:00 +0100 2538252 [Clean Hands Campaign : No chance for hospital infections!] http://www.medworm.com/index.php?rid=2538251&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%3D19543871%26dopt%3DAbstract Authors: Reichardt C, Eberlein-Gonska M, Schrappe M, Gastmeier P There are approximately 500,000 hospital acquired infections per year in Germany of which about 20-30% (100,000-150,000) could be prevented. Hospital acquired infections are associated with increased mortality and prolonged hospital stay. Based on approximately 4 additional days of hospital stay, nosocomial infections cause additional 2 million hospital days per year. In other words, 6 hospitals each with 1,000 beds would be caring solely for patients with nosocomial infections for 1 year in Germany. Experts agree that careful hand hygiene is the single most effective measure to prevent transmission of pathogens. The rate of nosocomial infections can be reduced by improved compliance of hand hygiene as demonstrated in the... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538251 Sat, 20 Jun 2009 23:00:00 +0100 2538251 [Intracortical dedifferentiated chondrosarcoma.] http://www.medworm.com/index.php?rid=2538250&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%3D19543872%26dopt%3DAbstract Authors: Thöm K, Bontikous S, Engelhardt M, Düring T, Schulte M Chondrosarcoma is the second most frequent mesenchymal malignant tumour of the bone. Classification of this kind of tumour is made by clinical, radiological und pathological means. A case of an intracortical chondrosarcoma was first reported by Babinet et al. 2003 [2]. During the staging examination of a 59-year-old patient referred to our clinic because of a squamous cell carcinoma of the oropharynx, we also found a highly malignant intracortical dedifferentiated chondrosarcoma of the distal femur shaft. Due to the primary assumption of bone metastasis of the oropharynx tumour, marginal extralesional tumour resection was performed followed by composite osteosynthesis. Considerations on differential diagnosis and... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538250 Sat, 20 Jun 2009 23:00:00 +0100 2538250 [New bone-ligament-bone transplant from plantar plates of the toes and possible use in reconstruction of the scapholunate ligament : An anatomical study.] http://www.medworm.com/index.php?rid=2538254&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%3D19506809%26dopt%3DAbstract CONCLUSIONS: It can be concluded from the data that this new graft of the proximal interphalangeal joint of the 3rd and 4th toes can be a suitable replacement for the scapholunate ligament. PMID: 19506809 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538254 Tue, 09 Jun 2009 23:00:00 +0100 2538254 [Late patellar tendon rupture 10 years after anterior cruciate ligament reconstruction using a bone-patellar tendon-bone graft.] http://www.medworm.com/index.php?rid=2538253&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%3D19506810%26dopt%3DAbstract We present the case of a patellar tendon rupture in a healthy 36-year-old man, who suffered a skiing accident 10 years after uneventful ACL reconstruction with a BTB graft. PMID: 19506810 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538253 Tue, 09 Jun 2009 23:00:00 +0100 2538253 ["nil nocere" - Cornerstone of medical practice.] http://www.medworm.com/index.php?rid=2538270&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%3D19436979%26dopt%3DAbstract Authors: Siebert H PMID: 19436979 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538270 Sun, 31 May 2009 23:00:00 +0100 2538270 [Chopart dislocation - a simple diagnosis?] http://www.medworm.com/index.php?rid=2538269&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%3D19436980%26dopt%3DAbstract Authors: Langenhan R, Kohler G The case of an initially overlooked transligamentary Chopart dislocation following distorsion trauma of the foot is presented and the treatment and long-term course are discussed. A 55-year-old female patient sustained severe injury to the left foot after falling from a height of 4 m.. The instep was severely swollen and there was deformity with adduction of the forefoot and supination position. The peripheral pulse and sensitivity were intact. The conclusion from local radiographic investigations was that there were no signs of fracture or dislocation. The patient travelled home in pain 1 week after the accident and registered in the casualty department at our hospital.Assessment of the radiographs revealed a transligamentary Chopart dislocation with dor... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538269 Sun, 31 May 2009 23:00:00 +0100 2538269 [Primary care hospital for a mass disaster MANV IV : Experience from a mock disaster exercise.] http://www.medworm.com/index.php?rid=2538268&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%3D19436981%26dopt%3DAbstract CONCLUSION: In a major disaster with more than 200 seriously injured patients the EVK model is a practicable and regional well tried solution that could increase the capacity of hospital admissions and advanced trauma life support, regardless of the type of casualty, season or weather conditions. It is possible to reduce the interval to advanced trauma life support, temporary fracture stabilization (damage control) and definitive surgical care by means of rapid and targeted utilization of resources and manpower. Physicians involved in the initial treatment play a key role and have to be highly trained (ATLS(R)). The EVK model is variable and can easily be established and adapted to regional conditions at basic regional hospitals as well as at level I trauma centers. PMID: 19436981 [Pub... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538268 Sun, 31 May 2009 23:00:00 +0100 2538268 [Treatment of hand burns.] http://www.medworm.com/index.php?rid=2538258&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%3D19495712%26dopt%3DAbstract Authors: Siemers F, Mailänder P Although burn injuries of the hand only account for approximately 2.5-3% of the total body surface area (TBSA), they are of great importance due to functional outcome, appearance and economic aspects.Initial treatment and diagnosis are important factors, which influence the further course of thermal injuries of the hand and which are found in up to 80% of treated burn injuries. Early decision-making is necessary if escharotomy or skin grafting is indicated. After preliminary evaluation and wound management a differentiation between non-surgical and surgical procedures is necessary. In the case of full thickness thermal injuries, debridement and skin grafting should be carried out. Further interdisciplinary management involves different professional ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538258 Sun, 31 May 2009 23:00:00 +0100 2538258 [Skin graft procedures in burn surgery.] http://www.medworm.com/index.php?rid=2538257&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%3D19495713%26dopt%3DAbstract Authors: Rennekampff HO Patients with extensive deep partial or full thickness burns require early excision of necrotic tissue, however, in many of these cases simultaneous autografting is not possible due to the general condition of the patient. In this instance temporary dressings like allogeneic or xenogeneic skin or foam dressings can be applied to minimize fluid and protein loss. In Europe glycerolized preserved allogeneic skin remains the treatment standard.Dermal replacements are considered to optimize the long-term outcome of split thickness skin grafting. Reduced contracture rates and increased pliability have been reported after additional dermal enhancement with either collagen-glycosaminoglycan matrix, acellular allogeneic dermis or collagen/elastin matrix. True regeneratio... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538257 Sun, 31 May 2009 23:00:00 +0100 2538257 [Risk management and patient safety.] http://www.medworm.com/index.php?rid=2538256&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%3D19495714%26dopt%3DAbstract Authors: Lessing C Risk management and patient safety are of indisputable importance for the quality of health care. At the same time they confront all professional groups in the health system with high demands. The Action Alliance for Patient Safety inc. wants to demonstrate ways in which measures for avoiding errors and improving safety can reach the healthcare practice. Interdisciplinary cooperation and the availability of mutually developed materials are the maxims of the work of the society. PMID: 19495714 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538256 Sun, 31 May 2009 23:00:00 +0100 2538256 [Learning from mistakes in hospitals : A system perspective on errors and incident reporting systems.] http://www.medworm.com/index.php?rid=2538255&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%3D19495715%26dopt%3DAbstract Authors: Hofinger G Analysis of incidents and near-incidents is an important factor for continuous improvement in patient safety in hospitals and for the promotion of organizational learning. From a system perspective, accidents occur when decision-making at several levels of a working system is faulty and the safety barriers fail. Human error is inevitable but accidents are not. Errors can be used as an opportunity for organizational learning and this is especially true for incidents when patients come to no harm. Starting with explanations of a system perspective on errors, this paper deals with the prerequisites for organizational learning and general rules for establishing incident reporting systems in hospitals. PMID: 19495715 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538255 Sun, 31 May 2009 23:00:00 +0100 2538255 [Standards of medical care for burn injuries, part 2.] http://www.medworm.com/index.php?rid=2538249&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%3D19543873%26dopt%3DAbstract Authors: Vogt PM, Krettek C PMID: 19543873 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538249 Sun, 31 May 2009 23:00:00 +0100 2538249 [Plastic reconstructive surgery for burn injuries.] http://www.medworm.com/index.php?rid=2538248&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%3D19543874%26dopt%3DAbstract Authors: Niederbichler AD, Vogt PM The stage-adjusted therapy of thermal injuries is based on pathophysiologic mechanisms as well as functional and aesthetic requirements. Plastic reconstructive surgical approaches are highly important in the prevention of the frequent grave sequelae of thermal trauma and to achieve optimal functional rehabilitation and favourable outcome. In reconstructive surgery of burns operative goals are subdivided into acute, secondary reconstructive, functional and aesthetic indications. The achievement of early wound closure to preserve functional skin and soft tissue components is an essential part of acute reconstructive procedures. Functional reconstructive and aesthetic procedures supplement the conservative treatment modalities of the secondary phase of b... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538248 Sun, 31 May 2009 23:00:00 +0100 2538248 [Treatment of metacarpal fractures : Recommendations of the Hand Surgery Group of the German Trauma Society.] http://www.medworm.com/index.php?rid=2538247&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%3D19543875%26dopt%3DAbstract Authors: Windolf J, Rueger JM, Werber KD, Eisenschenk A, Siebert H, Schädel-Höpfner M The major goal in the treatment of metacarpal fractures is to restore the normal function of the hand. Radiological criteria and the clinical extent of displacement should be individually considered when taking the decision for or against conservative treatment. Internal fixation techniques must protect soft tissue structures. Small screws and plates have proven effective for head and shaft fractures, whereas intramedullary splinting is favoured for neck fractures. In instable and displaced fractures of the base of the first metacarpal, surgery is regularly performed to restore the bony shape and articular surface. To prevent functional impairments, early mobilization is desirable both durin... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538247 Sun, 31 May 2009 23:00:00 +0100 2538247 [Fat embolism syndrome following lower limb fracture despite rapid external fixation : Two case reports and review of the literature.] http://www.medworm.com/index.php?rid=2538262&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%3D19440676%26dopt%3DAbstract Authors: Kleinert K, Marug D, Soklic P, Simmen HP Fat embolism syndrome (FES) is a rare complication occurring in 0.9-2.2% of patients following long bone fractures. Patients present with a classical triad of respiratory manifestations, cerebral effects and petechiae. The incidence of FES is reduced by early immobilization of fractures and by minimally invasive operative management. Nevertheless, two healthy young men suffered from FES after immediate (within 3 h after trauma) external fixation of lower leg fractures. This postoperative complication should always be considered even after conservative or minimally invasive therapy. PMID: 19440676 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538262 Thu, 14 May 2009 23:00:00 +0100 2538262 [Posttraumatic tracheal stenosis after complex fracture of the upper cervical spine : A rare complication.] http://www.medworm.com/index.php?rid=2538261&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%3D19440677%26dopt%3DAbstract We report on the clinical course and outcome of a case with a delayed high-grade tracheal stenosis after cervical spine injury, which could only be treated by emergency tracheotomy and partial transverse trachea resection.The 25-year-old female suffered a complex dislocated upper cervical spine fracture with a Jefferson fracture, an odontoid fracture and a dislocated C6/7 luxation fracture after a motor vehicle accident. Immediately after trauma inspiratory stridor was reported. Postoperatively, the tracheal stenosis increased and the histological examination of tissue collected during emergency bronchoscopy showed granulation tissue.Even if fractures of cervical spine injuries are treated successfully, soft tissue and tracheal injuries cannot be precluded. Therefore, it is most important ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538261 Thu, 14 May 2009 23:00:00 +0100 2538261 [Multiple femur and tibia shaft fractures in the severely injured : A therapeutic challenge.] http://www.medworm.com/index.php?rid=2538260&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%3D19440678%26dopt%3DAbstract We report the primary total definitive treatment of a patient with multiple fractures of the lower extremities. Postoperative respiratory insufficiency was treated successfully by non-invasive ventilation. PMID: 19440678 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538260 Thu, 14 May 2009 23:00:00 +0100 2538260 [Primary endoprosthetic replacement of fractured elbow in elderly patients.] http://www.medworm.com/index.php?rid=2538259&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%3D19440679%26dopt%3DAbstract CONCLUSION: In elderly patients primary endoprosthetic treatment of a distal intra-articular fracture of the humerus with a semi-constrained cemented prosthesis may offer an alternative to osteosynthesis thus enabling creation of a mobile, painless and stable cubital joint. PMID: 19440679 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538259 Thu, 14 May 2009 23:00:00 +0100 2538259 [Cost control in treatment of the severely injured by the trauma network DGU.] http://www.medworm.com/index.php?rid=2538273&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%3D19404595%26dopt%3DAbstract Authors: Ruchholtz S PMID: 19404595 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538273 Thu, 30 Apr 2009 23:00:00 +0100 2538273 [Atypical dislocated dens fracture type II with rotational atlantoaxial luxation after a riding accident.] http://www.medworm.com/index.php?rid=2538272&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%3D19404596%26dopt%3DAbstract We present a rare case of a combined dislocated odontoid dens fracture type II (Anderson/D'Alonzo) and rotational atlantoaxial luxation in a 15-year-old girl who was involved in a riding accident.She fell off her horse after it had stopped suddenly, losing consciousness for a few minutes. At presentation in the hospital, she had no complaints other than limited, painful neck movement. Radiologically, a posterior dislocation of an odontoid type II fracture (Anderson/D'Alonzo) was found. Computed tomography reconstruction demonstrated a rotational, hooklike fixed luxation of the left atlantoaxial facet joint. Manual repositioning after application of a cervical collar failed. Therefore, operative treatment was indicated for this highly unstable fracture. Posterior transarticular atlantoaxial... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538272 Thu, 30 Apr 2009 23:00:00 +0100 2538272 [Partial aplasia of the atlas in a child.] http://www.medworm.com/index.php?rid=2538271&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%3D19404597%26dopt%3DAbstract Authors: Bliemel C, Kuehl H, Ruchholtz S, Kühne CA Congenital anomalies of the atlas are rare but well documented. They can range from total agenesis to partial clefts of the posterior and/or anterior arches and are mostly incidental findings after a sustained trauma. It is essential to differentiate these congenital variants from fractures of the atlas to prevent the patient from unnecessary (neuro-) surgical intervention. In this article the case of a 10-year-old girl is described with an unusual finding of partial aplasia of the posterior arch. The clinical features and diagnostic and therapeutic procedures are discussed. PMID: 19404597 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538271 Thu, 30 Apr 2009 23:00:00 +0100 2538271 [In Process Citation] http://www.medworm.com/index.php?rid=2538267&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%3D19440642%26dopt%3DAbstract Authors: Vogt PM, Krettek C PMID: 19440642 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538267 Thu, 30 Apr 2009 23:00:00 +0100 2538267 [Circulation therapy for severe burn injuries.] http://www.medworm.com/index.php?rid=2538266&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%3D19440643%26dopt%3DAbstract Authors: Adams HA, Vogt PM, Patients with burn injuries to more than 10% of the body surface area (BSA) are in potential danger of traumatic hypovolemic shock and from 20% BSA a generalized burn edema can occur. In the preclinical setting an increased infusion therapy is generally unnecessary. Clinical circulation therapy is goal-directed taking hemoglobin concentration, hematocrit, MAP, diuresis, CVP and central venous sO(2 )into consideration. For initial volume replacement, balanced crystalloids with the addition of acetate and possibly malate are infused. Colloids should be given with great caution. Additional gelatine solution is only to be used in patients with impending hypotension and catecholamines should also be avoided if possible. If necessary, dobutamine is used to increa... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538266 Thu, 30 Apr 2009 23:00:00 +0100 2538266 [Immunology and sepsis syndrome in burn trauma.] http://www.medworm.com/index.php?rid=2538265&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%3D19440644%26dopt%3DAbstract Authors: Associate Professor Ipaktchi K, Vogt PM Despite significant advances in burn surgery and critical care, severe burn trauma defined as injuries covering more than 25% of the total body surface area, is still associated with high mortality and morbidity. Burn trauma is a whole body injury where peripheral dermal injury rapidly results in systemic inflammation and inflammatory core organ damage. The severe disturbance of internal homeostasis involves all vital organ systems and obligates early referral to specialized burn centers. Treatment of severely burned patients is a multifaceted challenge directed by pathophysiologic events which progress from local skin destruction, disruption of physicochemical and microvascular barriers to breakdown of peripheral and central circulation... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538265 Thu, 30 Apr 2009 23:00:00 +0100 2538265 [Dislocation of the adult elbow joint.] http://www.medworm.com/index.php?rid=2538264&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%3D19440645%26dopt%3DAbstract Authors: Mittlmeier T, Beck M Dislocations and fracture-dislocations of the elbow joint result in typical injury patterns of variable joint instability. A systematic and early in-depth analysis of the injury components offers the approach to the options of therapy and the evaluation of the risk potential of the individual lesion. Standardized diagnostic algorithms help to avoid an inadequate assessment of the extent of injury. With regard to the choice of therapy finding a balance between the concentric reduction of the elbow joint, stability and an early regain of motion provides the key to a good functional outcome. A great number of simple elbow dislocations have a good prognosis and can be managed with early motion due to the inherent joint stability after closed reduction. In cont... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538264 Thu, 30 Apr 2009 23:00:00 +0100 2538264 [Articulated external fixator at the elbow.] http://www.medworm.com/index.php?rid=2538263&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%3D19440646%26dopt%3DAbstract Authors: Mittlmeier T, Beck M The principle of the articulated external fixator following elbow dislocation and fracture-dislocations of the elbow joint is a helpful adjunct to the surgical armamentarium. It protects a difficult reconstruction of the joint surfaces, the capsule and the ligaments against potentially harmful forces while allowing passive and active motion to prevent arthrofibrosis due to long-term immobilization of the elbow joint. The articulated external fixator further represents a salvage procedure for delayed reconstructions and distraction arthrolysis, as well. A precise surgical technique is a prerequisite for the success of the procedure. PMID: 19440646 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2538263 Thu, 30 Apr 2009 23:00:00 +0100 2538263 [Medical aspects of resistance training.] http://www.medworm.com/index.php?rid=2314724&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%3D19347379%26dopt%3DAbstract Authors: Krettek C PMID: 19347379 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2314724 Wed, 01 Apr 2009 04:00:00 +0100 2314724 [Chronic relapsing compartment syndrome.] http://www.medworm.com/index.php?rid=2314684&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%3D19347380%26dopt%3DAbstract Authors: Stiegler H, Brandl R, Krettek C Chronic relapsing exertional compartment syndrome is not only found in young athletic subjects. Non-athletic patients can also suffer from exercise dependent pain in the lower limb. The syndrome is defined by increased tissue pressure in between a closed osteo-fibrous space resulting in disturbed microcirculation and finally irreversible neuroischemic damage. Pain increases during running and disappears gradually at rest. The diagnosis is based on the typical symptoms and so far on the pre-, 1 and 5 min post exercise intramuscular pressure measurement. We first describe sonographic criteria induced by increased compartment pressure, especially for the most frequent anterior compartment syndrome with compression of the deep veins, increased movem... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2314684 Wed, 01 Apr 2009 04:00:00 +0100 2314684 [Vascularized bone transfer.] http://www.medworm.com/index.php?rid=2314590&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%3D19347381%26dopt%3DAbstract Authors: Hierner R, Täger G, Nast-Kolb D Vascularized pedicled bone grafts are known since the beginning of the last century. Microvascular bone grafts (free vascularized bone transfer) are known since the beginning of the seventies. In many experimental and clinical studies vascularized bone grafts were compared to their non-vascularized analogues. Because of their own non-interrupted blood supply and thus nearly normal vitality vascularized bone grafts show more rapid fracture healing, more pronounced adaptation to the new mechanical loadings (e. g. graft hypertrophy), higher survival and consolidation rate in poor or bad recipient bed conditions (infection, bad vascularization) and some neovascularization potential on the surrounding tissue. Because of those properties, it beca... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2314590 Wed, 01 Apr 2009 04:00:00 +0100 2314590 [Options, planning and technique of the vascularized fibula diaphysis transplantat.] http://www.medworm.com/index.php?rid=2314589&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%3D19347382%26dopt%3DAbstract Authors: Hierner R, Husain N, Nast-Kolb D PMID: 19347382 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2314589 Wed, 01 Apr 2009 04:00:00 +0100 2314589 [The emergency ward today.] http://www.medworm.com/index.php?rid=2314581&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%3D19347383%26dopt%3DAbstract Authors: Siebert HR PMID: 19347383 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2314581 Wed, 01 Apr 2009 04:00:00 +0100 2314581 [Triage systems in central emergency units.] http://www.medworm.com/index.php?rid=2314556&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%3D19347384%26dopt%3DAbstract Authors: Bonk A, Siebert H, Seekamp A, Hoffmann R Central emergency units were established for medical and economic reasons in many German hospitals. The huge number of patients requiring treatment more or less urgent led to an Implementation of triage-systems, which are known from abroad.Five of those triage-systems with different approaches are going to be presented below. The Manchester-triage-system is the one of those, which can be transferred to German circumstances the best and is the most common clinical triage-system in Germany. Before implementing the abovementioned systems to German emergency unit all of them need further development. Furthermore a scientific verification of the efficiency and the safety of triage-systems is necessary. PMID: 19347384 [PubMed - in process... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2314556 Wed, 01 Apr 2009 04:00:00 +0100 2314556 [Overtriage must be avoided.] http://www.medworm.com/index.php?rid=2314732&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%3D19326088%26dopt%3DAbstract Authors: Kanz KG PMID: 19326088 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2314732 Sat, 28 Mar 2009 04:00:00 +0100 2314732 [Deep dermal alkali burns caused by work with screed.] http://www.medworm.com/index.php?rid=2314728&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%3D19326089%26dopt%3DAbstract CONCLUSION: The existing safety advice insufficiently reflects the potential risk of injury. The author demands a change in the safety warnings from "irritant" to "can cause alkali burns"; with such a change, workers may be better aware of the dangers of working with screed. PMID: 19326089 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2314728 Sat, 28 Mar 2009 04:00:00 +0100 2314728 [Exercise and cellular adaptation of muscle.] http://www.medworm.com/index.php?rid=2290379&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%3D19308345%26dopt%3DAbstract Authors: Tegtbur U, Busse MW, Kubis HP Resistance training and to a lesser extent endurance training are capable of enhancing protein synthesis in skeletal muscle via various signaling pathways. Additionally, the expression of muscle fiber types responds to different regimes of training stimuli and immobilization as characterized by changes in myosin heavy chain isoforms (I<-->IIA<-->IIX). Eccentric resistance training has been shown to be highly efficient in inducing sarcomeric protein assembly in the longitudinal orientation of muscle cells. However, concentric contractions lead to a hypertrophic response (increased fiber diameter) in muscle which can still be activated in old age. The central signaling pathway to mediate the elevation of protein synthesis in response to ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2290379 Wed, 25 Mar 2009 04:00:00 +0100 2290379 [Effect of power training on articular cartilage.] http://www.medworm.com/index.php?rid=2290377&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%3D19308346%26dopt%3DAbstract Authors: Ostermeier S Hyaline articular cartilage consists mainly of water, which is reversibly transferred to the joint space under compression to reduce friction between the cartilage surfaces. This water content is regulated by proteoglycanes, which are produced by chondrocytes. Under excessive compression of the cartilage surface the collagen matrix ruptures and water is irreversibly transferred into the joint space, which reduces the elasticity of cartilage tissue. Power training should lead to a submaximal loading of cartilage below the rupture limit as the capacity of cartilage tissue to adapt to higher loads is limited. When the cartilage tissue shows osteoarthritic changes the loading capacity of the cartilage matrix is significantly reduced, which should be taken into conside... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2290377 Wed, 25 Mar 2009 04:00:00 +0100 2290377 [Disorders of the patellofemoral joint induced by weight training.] http://www.medworm.com/index.php?rid=2290385&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%3D19305962%26dopt%3DAbstract Authors: Jagodzinski M, Haasper C, Krettek C The patellofemoral joint is stressed strongly during weight training. There are different individual preconditions that influence the stress distribution. Forces on tendons and cartilage are a function of angle and exercise. The most common disorders are tendinopathies and cartilage damage. Patellofemoral malalignment, high loads and overuse, uncontrolled exercises and steroids represent risk factors for injuries. Individual training concepts with controlled exercises that reduce peak loads are desireable. There is a wide scope of therapeutic options ranging from antiphlogistic therapy to the reconstruction of tendons and cartilage. PMID: 19305962 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2290385 Sat, 21 Mar 2009 04:00:00 +0100 2290385 [Minimally invasive fixation of a sacral bilateral fracture with lumbopelvic dissociation.] http://www.medworm.com/index.php?rid=2290381&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%3D19305963%26dopt%3DAbstract Authors: Mendel T, Kuhn P, Wohlrab D, Brehme K This case report describes our technique of percutaneous sacroiliac screw fixation of a bilateral sacral fracture with spinopelvic dissociation. It is based on the description of an iliosacroiliac bony corridor delimited by the following landmarks: the sacral ala in a superior-anterior direction, the first sacral foramen on both sides in an inferior-posterior direction, and the sacral channel posteriorly. The described operating method, which uses a 6.5-mm parallel drill sleeve, allows the safe and strictly transversal positioning of a 7.3-mm screw on each side with the threads interlocking. It provides a separate and fracture-adapted compression of the screws. The interlocking SI screw threads increase the pull-out strength. Operating tim... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2290381 Sat, 21 Mar 2009 04:00:00 +0100 2290381 [10 frequently asked questions about magnetic resonance imaging in patients with metal implants.] http://www.medworm.com/index.php?rid=2279354&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%3D19294339%26dopt%3DAbstract Authors: Biberthaler P PMID: 19294339 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2279354 Thu, 19 Mar 2009 04:00:00 +0100 2279354 [Is the structure of surgical clinics in Germany changing? : A current investigation into the structure of surgical clinics in the Federal Republic of Germany.] http://www.medworm.com/index.php?rid=2279355&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%3D19290506%26dopt%3DAbstract Authors: Lob G, Lob T, Bauer H, Niethard F, Polonius J, Siebert H Medical developments have led to extensive specialization in the field of surgery. This has already been reflected for many years in altered structure and organization forms of surgical clinics. Indispensable quality standards, statutory general conditions, increasing competition in service providers and health insurance with transparency of the service procedure all intensify this trend. The aim of this investigation was, therefore, to determine how far this differentiation of service supply in the field of surgery is also reflected in the area and in surgical departments and clinics of basic and routine supply. To achieve this, all available published information on the structure and organization of surgical clinics in... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2279355 Wed, 18 Mar 2009 04:00:00 +0100 2279355 [Discussion of emergency embolization for severe pelvic ring fractures with arterial bleeding.] http://www.medworm.com/index.php?rid=2270828&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%3D19288070%26dopt%3DAbstract Discussion of emergency embolization for severe pelvic ring fractures with arterial bleeding.] Unfallchirurg. 2009 Mar 15; Authors: PMID: 19288070 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2270828 Sun, 15 Mar 2009 04:00:00 +0100 2270828 [Classification of severely injured patients in the G-DRG system 2008.] http://www.medworm.com/index.php?rid=2270826&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%3D19288071%26dopt%3DAbstract DISCUSSION: With the ongoing development of the G-DRG system, reimbursement for the treatment of severely injured patient has improved, but the amount of underfinancing remains substantial. As treatment of severely injured patients must be reimbursed using the G-DRG system, this system must be further adapted to better meet the needs of severely injured patients. Parameters such as total surgery time, injury severity score (ISS) and LOS in ICU could be used for this purpose. In future, data obtained in trauma networks can help optimize reimbursement for the treatment of these patients. PMID: 19288071 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2270826 Sun, 15 Mar 2009 04:00:00 +0100 2270826 [Transoral vertebroplasty : An alternative for operative treatment of metastases of the upper cervical spine.] http://www.medworm.com/index.php?rid=2265428&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%3D19283355%26dopt%3DAbstract Authors: Krüger A, Schnabel M, Hegele A, Ruchholtz S, Stiletto R Analogue to the demographic changes and the accompanying increased incidence of tumorous diseases, the number of patients with metastatic bone tumors of the spine is also increasing. Metastatic bone tumors are the most significant cause of pain in cancer patients. Pain and instability are the main indications for surgery. Minimally invasive procedures are recommended in patients with a poor medical condition and with a poor prognosis.Transoral vertebroplasty can be successfully used to reduce pain and provide stability in the palliative treatment of metastases of the vertebral axis. This procedure has the advantage of providing rapid pain relief and spinal stabilization.The operative technique is described and discus... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2265428 Sat, 14 Mar 2009 04:00:00 +0100 2265428 [Ankle osteosynthesis infection : Vacuum therapy as the treatment of choice.] http://www.medworm.com/index.php?rid=2265427&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%3D19283356%26dopt%3DAbstract DISCUSSION: Vacuum therapy is a perfect strategy after surgical debridement and before secondary mesh grafting. It protects the stability of the bone and open-lying delicate structures in patients with infected osteosynthesis of the ankle and angiopathy and offers an easy, safe, and successful treatment path with a short inpatient time. PMID: 19283356 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2265427 Sat, 14 Mar 2009 04:00:00 +0100 2265427 [Ultrasound diagnosis of forearm fractures in children : A prospective multicenter study.] http://www.medworm.com/index.php?rid=2265431&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%3D19280166%26dopt%3DAbstract CONCLUSION: Ultrasound seems to be a valuable and safe alternative to X-ray diagnosis. Patients with inconclusive findings should undergo X-ray diagnosis. PMID: 19280166 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2265431 Fri, 13 Mar 2009 04:00:00 +0100 2265431 [Minimally invasive percutaneous instrumentation for spine fractures.] http://www.medworm.com/index.php?rid=2265430&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%3D19280167%26dopt%3DAbstract Authors: Prokop A, Löhlein F, Chmielnicki M, Volbracht J When operating unstable spine fractures by an open dorsal approach, detachment of paravertebral muscles results in bleeding and later functional disturbances. Long incisions over spinous processes cause pain and later cosmetic issues. With the sextant of Medtronic a system is at our disposal which permits a percutaneous approach with pedicle screws and longitudinal supports by a target device via six small incisions. From 15 November 2007 until 15 May 2008, 36 unstable spine fractures were treated by a minimally invasive technique; 14 men and 22 women were treated. The average age was 61 years (22-88 years). According to the Magerl classification there were mostly A3.3 fractures. The average incision-closure time was 42 min ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2265430 Fri, 13 Mar 2009 04:00:00 +0100 2265430 [Healing of free vascularized bone allotransplants : Optimizing by short-term immunosuppression and host-derived neovascularization.] http://www.medworm.com/index.php?rid=2265429&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%3D19280168%26dopt%3DAbstract Authors: Giessler GA, Friedrich PF, Shin RH, Bishop AT BACKGROUND: Living bone allotransplants (ATs) currently require long-term immunosuppression (IS), but this is impractical for extremity-preserving procedures. An alternative method to maintain viability of the transplant uses host-derived neoangiogeneic vessels combined with short-term IS. MATERIALS AND METHODS: Diaphyseal femoral defects in Dutch-Belted rabbits were reconstructed with a free microvascular AT from New Zealand White rabbits. Additionally, a host-derived intramedullary pedicled fascial flap was placed and short-term IS administered to two of four groups. Neovascularization and bone healing were quantified by microangiography and a custom radiographic score. RESULTS: Bone ATs with perfused fascial flaps achieved bone ... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2265429 Fri, 13 Mar 2009 04:00:00 +0100 2265429 [Guidelines for cardiopulmonary resuscitation : What is important for the trauma surgeon?] http://www.medworm.com/index.php?rid=2265438&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%3D19277752%26dopt%3DAbstract Authors: Krettek C PMID: 19277752 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2265438 Sun, 01 Mar 2009 05:00:00 +0100 2265438 [Guidelines on cardiopulmonary reanimation taking account of traumatological aspects.] http://www.medworm.com/index.php?rid=2265437&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%3D19277753%26dopt%3DAbstract Authors: Seekamp A PMID: 19277753 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2265437 Sun, 01 Mar 2009 05:00:00 +0100 2265437 [In Process Citation] http://www.medworm.com/index.php?rid=2265436&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%3D19277754%26dopt%3DAbstract Authors: PMID: 19277754 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2265436 Sun, 01 Mar 2009 05:00:00 +0100 2265436 [In Process Citation] http://www.medworm.com/index.php?rid=2265435&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%3D19277755%26dopt%3DAbstract Authors: PMID: 19277755 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2265435 Sun, 01 Mar 2009 05:00:00 +0100 2265435 [Operative treatment of traumatic fractures of the thoracic and lumbar spinal column : Part III: Follow up data.] http://www.medworm.com/index.php?rid=2265434&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%3D19277756%26dopt%3DAbstract Authors: Reinhold M, Knop C, Beisse R, Audigé L, Kandziora F, Pizanis A, Pranzl R, Gercek E, Schultheiss M, Weckbach A, Bühren V, Blauth M In this third and final part, the Spine Study Group (AG WS) of the German Trauma Association (DGU) presents the follow-up (NU) data of its second, prospective, internet-based multicenter study (MCS II) for the treatment of thoracic and lumbar spinal injuries including 865 patients from 8 trauma centers. Part I described in detail the epidemiologic data of the patient collective and the subgroups, whereas part II analyzed the different methods of treatment and radiologic findings. The study period covered the years 2002 to 2006 including a 30-month follow-up period from 01.01.2004 until 31.05.2006.Follow-up data of 638 (74%) patients were c... Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2265434 Sun, 01 Mar 2009 05:00:00 +0100 2265434 [In Process Citation] http://www.medworm.com/index.php?rid=2265433&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%3D19277757%26dopt%3DAbstract Authors: PMID: 19277757 [PubMed - in process] (Source: Der Unfallchirurg) Der Unfallchirurg journals http://www.medworm.com/rss/comments.php?id=2265433 Sun, 01 Mar 2009 05:00:00 +0100 2265433