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[Kyphoplasty in osteoporotic spinal fractures.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 dor...
Source: Der Unfallchirurg - November 11, 2009 Category: Orthopaedics Authors: Prokop A, Löhlein F, Chmilniecki M, Volbracht J, Manner M Tags: Unfallchirurg Source Type: journals

[In Process Citation]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Authors: PMID: 19902164 [PubMed - in process] (Source: Der Unfallchirurg)
Source: Der Unfallchirurg - November 1, 2009 Category: Orthopaedics Tags: Unfallchirurg Source Type: journals

[Functional and subjective results following subtalar dislocations.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Der Unfallchirurg - October 29, 2009 Category: Orthopaedics Authors: Jungbluth P, Wild M, Thelen S, Fritz B, Windolf J, Hakimi M Tags: Unfallchirurg Source Type: journals

[Variability of the screw position after 3D-navigated sacroiliac screw fixation : Influence of the surgeon's experience with the navigation technique.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Der Unfallchirurg - October 29, 2009 Category: Orthopaedics Authors: Konrad G, Zwingmann J, Kotter E, Südkamp N, Oberst M Tags: Unfallchirurg Source Type: journals

[Marjolin's ulcer : Malignant transformation of a crural ulcer due to posttraumatic chronic osteomyelitis.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Der Unfallchirurg - October 28, 2009 Category: Orthopaedics Authors: Bula P, Bula-Sternberg J, Wollina U, Haroske G, Bonnaire F Tags: Unfallchirurg Source Type: journals

[Thrombosis prophylaxis in trauma surgery units in Germany : A survey.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Der Unfallchirurg - October 28, 2009 Category: Orthopaedics Authors: Hinz P, Lubenow N, Wessel A, Greinacher A, Ekkernkamp A Tags: Unfallchirurg Source Type: journals

[Minimally invasive plate osteosynthesis on the proximal upper limb : Instructions for surgery.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19851716 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg)
Source: Der Unfallchirurg - October 23, 2009 Category: Orthopaedics Authors: Neubauer T, Wagner M Tags: Unfallchirurg Source Type: journals

[Current status of minimally invasive plate osteosynthesis: specific part II.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 a...
Source: Der Unfallchirurg - October 23, 2009 Category: Orthopaedics Authors: Neubauer T, Wagner M Tags: Unfallchirurg Source Type: journals

[Surgical treatment of the multiple trauma patient : Responsibility from site of the accident up to rehabilitation.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19847381 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg)
Source: Der Unfallchirurg - October 22, 2009 Category: Orthopaedics Authors: Hildebrand F, Krettek C Tags: Unfallchirurg Source Type: journals

[Development and perspectives for orthopedic and trauma research in Germany.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 stru...
Source: Der Unfallchirurg - October 21, 2009 Category: Orthopaedics Authors: Claes LE Tags: Unfallchirurg Source Type: journals

[Microsurgical thumb replantation following traumatic amputation : Preliminary results in Hanoi, Vietnam.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Der Unfallchirurg - October 21, 2009 Category: Orthopaedics Authors: Hoang NT, Staudenmaier R, Feucht A, Klöppel M, Hoehnke C Tags: Unfallchirurg Source Type: journals

[Prophylactic ventilation of severely injured patients with thoracic trauma - does it always make sense?]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 7...
Source: Der Unfallchirurg - October 17, 2009 Category: Orthopaedics Authors: Mahlke L, Oestern S, Drost J, Frerichs A, Seekamp A Tags: Unfallchirurg Source Type: journals

[Realization and implementation of a trauma network of the German Association of Trauma Surgery (DGU) exemplified by the Trauma Network of eastern Bavaria.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Der Unfallchirurg - October 9, 2009 Category: Orthopaedics Authors: Ernstberger A, Leis A, Dienstknecht T, Schandelmaier P, Nerlich M Tags: Unfallchirurg Source Type: journals

[Surviving multiple trauma - what comes next? : The rehabilitation of seriously injured patients.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Der Unfallchirurg - October 9, 2009 Category: Orthopaedics Authors: Simmel S, Bühren V Tags: Unfallchirurg Source Type: journals

[Importance of hypothermia in multiple trauma patients.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Der Unfallchirurg - October 9, 2009 Category: Orthopaedics Authors: Hildebrand F, Probst C, Frink M, Huber-Wagner S, Krettek C Tags: Unfallchirurg Source Type: journals

[Multiple trauma in pediatric patients.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 des...
Source: Der Unfallchirurg - October 9, 2009 Category: Orthopaedics Authors: Jakob H, Brand J, Marzi I Tags: Unfallchirurg Source Type: journals

[Current concepts in the therapy of polytraumatized patients.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19812987 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg)
Source: Der Unfallchirurg - October 8, 2009 Category: Orthopaedics Authors: Hildebrand F, Krettek C Tags: Unfallchirurg Source Type: journals

[Minimally invasive plate osteosynthesis: current state : Part 1: general information.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 t...
Source: Der Unfallchirurg - September 25, 2009 Category: Orthopaedics Authors: Neubauer T, Wagner M Tags: Unfallchirurg Source Type: journals

[University benchmarking : A current status analysis.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)...
Source: Der Unfallchirurg - September 24, 2009 Category: Orthopaedics Authors: Raschke MJ, Josten C, Gebhard F, Ruchholtz S, Stöckle U, Meffert R, Zwipp H Tags: Unfallchirurg Source Type: journals

[Medical care reality in trauma surgical clinics in Germany : A survey of the professional committee of the German Society for Trauma Surgery.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 loa...
Source: Der Unfallchirurg - September 24, 2009 Category: Orthopaedics Authors: Bonk AD, Hoffmann R, Siebert H, Wölfl C Tags: Unfallchirurg Source Type: journals

[Therapy-resistant tibial pseudarthrosis : Treatment success with BMP-7 combined with autologous bone.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 pa...
Source: Der Unfallchirurg - September 19, 2009 Category: Orthopaedics Authors: Siebenlist S, Kraus T, Burghardt R, Döbele S, Stöckle U, Ganslmeier A Tags: Unfallchirurg Source Type: journals

[Coagulation management in multiple trauma.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 fo...
Source: Der Unfallchirurg - September 17, 2009 Category: Orthopaedics Authors: Waydhas C, Görlinger K Tags: Unfallchirurg Source Type: journals

[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.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Der Unfallchirurg - September 11, 2009 Category: Orthopaedics Authors: Smektala R, Hahn S, Schräder P, Bonnaire F, Schulze Raestrup U, Siebert H, Fischer B, Boy O Tags: Unfallchirurg Source Type: journals

[Standardised primary care of multiple trauma patients : Prehospital Trauma Life Support(R) und Advanced Trauma Life Support(R).]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Der Unfallchirurg - September 5, 2009 Category: Orthopaedics Authors: Wölfl CG, Gliwitzky B, Wentzensen A Tags: Unfallchirurg Source Type: journals

[Surgical management of life-threatening injuries.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: Der Unfallchirurg - September 5, 2009 Category: Orthopaedics Authors: Flohé S, Nast-Kolb D Tags: Unfallchirurg Source Type: journals

[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).]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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). PMI...
Source: Der Unfallchirurg - September 5, 2009 Category: Orthopaedics Authors: Bail HJ, Kleber C, Haas NP, Fischer P, Mahlke L, Matthes G, Ruchholtz S, Weidringer JW Tags: Unfallchirurg Source Type: journals

[The Trauma Network of the German Society for Trauma 2009.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 geo...
Source: Der Unfallchirurg - September 5, 2009 Category: Orthopaedics Authors: Kühne CA, Mand C, Sturm J, Lackner CK, Künzel A, Siebert H, , Ruchholtz S Tags: Unfallchirurg Source Type: journals

[Damage Control Orthopedics : What is the current situation?]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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, retrospec...
Source: Der Unfallchirurg - September 5, 2009 Category: Orthopaedics Authors: Bouillon B, Rixen D, Maegele M, Steinhausen E, Tjardes T, Paffrath T Tags: Unfallchirurg Source Type: journals

[Transpedicular osteotomy with dorsal wedge osteotomy : Treatment of post-traumatic or postinfection kyphotic malalignment of the thoraco-lumbar spine.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Der Unfallchirurg - September 5, 2009 Category: Orthopaedics Authors: Klostermann CK, Hette K, Pflugmacher R Tags: Unfallchirurg Source Type: journals

[Tissue engineering of bone tissue : Principles and clinical applications.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 cel...
Source: Der Unfallchirurg - August 31, 2009 Category: Orthopaedics Authors: Schmidt-Rohlfing B, Tzioupis C, Menzel CL, Pape HC Tags: Unfallchirurg Source Type: journals

[In Process Citation]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19756459 [PubMed - in process] (Source: Der Unfallchirurg)
Source: Der Unfallchirurg - August 31, 2009 Category: Orthopaedics Authors: Ipaktchi K, Vogt PM Tags: Unfallchirurg Source Type: journals

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Unfallchirurg. 2009 Aug 28; Authors: Kühne CA, Siebert H, Ruchholtz S PMID: 19711047 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg)
Source: Der Unfallchirurg - August 27, 2009 Category: Orthopaedics Authors: Kühne CA, Siebert H, Ruchholtz S Tags: Unfallchirurg Source Type: journals

[Operative treatment of instable osteoporotic spine fractures : A good guide in coding of diagnosis.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: Der Unfallchirurg - August 27, 2009 Category: Orthopaedics Authors: Prokop A, Wollny M, Futterer N, Berner U, Volbracht J, Windolf J, Siebert H Tags: Unfallchirurg Source Type: journals

[Sense and nonsense of the delegation options for medical duties.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19680617 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg)
Source: Der Unfallchirurg - August 13, 2009 Category: Orthopaedics Authors: Hoffmann R, Siebert H Tags: Unfallchirurg Source Type: journals

[Reader's letters.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19672570 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg)
Source: Der Unfallchirurg - August 12, 2009 Category: Orthopaedics Authors: Sarkar MR, Ring O, Gäbler C Tags: Unfallchirurg Source Type: journals

[Is surgical treatment in the casualty department endangered in future by a lack of generalists? : Results of a survey.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19669720 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg)
Source: Der Unfallchirurg - August 11, 2009 Category: Orthopaedics Authors: Siebert H Tags: Unfallchirurg Source Type: journals

[The economic challenges of polytrauma care.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 th...
Source: Der Unfallchirurg - August 11, 2009 Category: Orthopaedics Authors: Probst C, Schaefer O, Hildebrand F, Krettek C, Mahlke L Tags: Unfallchirurg Source Type: journals

[Subcutaneous avulsion of the flexor digitorum profundus muscle.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 phalan...
Source: Der Unfallchirurg - August 11, 2009 Category: Orthopaedics Authors: Tylla A, Strube T Tags: Unfallchirurg Source Type: journals

[The factor "Time" : Its impact in pathophysiology and therapy of multiple trauma.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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...
Source: Der Unfallchirurg - August 11, 2009 Category: Orthopaedics Authors: Bogner V, Mutschler W, Biberthaler P Tags: Unfallchirurg Source Type: journals

[Safe:Trac course series of the German Society for Trauma Surgery on patient safety.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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, discuss...
Source: Der Unfallchirurg - July 31, 2009 Category: Orthopaedics Authors: Burghofer K, Lackner CK Tags: Unfallchirurg Source Type: journals

[Facial perforation trauma : An unusual injury in a skiing accident.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 h...
Source: Der Unfallchirurg - July 30, 2009 Category: Orthopaedics Authors: Günkel S, Siewert C, Kruse A, Simmen HP Tags: Unfallchirurg Source Type: journals

[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.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 intervention...
Source: Der Unfallchirurg - July 30, 2009 Category: Orthopaedics Authors: Laurer H, Wutzler S, Wyen H, Westhoff J, Lehnert M, Lefering R, Marzi I, Tags: Unfallchirurg Source Type: journals

[Emergency care for traffic accidents in Bavaria : Current process analysis depending on hospital and emergency service structures.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 tra...
Source: Der Unfallchirurg - July 24, 2009 Category: Orthopaedics Authors: Lackner CK, Bielmeier S, Burghofer K Tags: Unfallchirurg Source Type: journals

[Embolization of life-threatening intercostal hemorrhaging in a severely injured patient : A rarity in trauma care.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 eff...
Source: Der Unfallchirurg - July 24, 2009 Category: Orthopaedics Authors: Hußmann B, Taeger G, Wanke I, Waydhas C, Schoch B, Nast-Kolb D, Lendemans S Tags: Unfallchirurg Source Type: journals

[Results and complications in the treatment of periprosthetic femur fractures with a locked plate system.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Der Unfallchirurg - July 23, 2009 Category: Orthopaedics Authors: Pressmar J, Macholz F, Merkert W, Gebhard F, Liener UC Tags: Unfallchirurg Source Type: journals

[Recurrent synovial chondromatosis of the tarsometatarsal joint : Case report and review of literature.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Der Unfallchirurg - July 23, 2009 Category: Orthopaedics Authors: Köhler T, Kellermann S, Kipke K, Fruth R, Dahlen C Tags: Unfallchirurg Source Type: journals

[Wound care within an Interplast mission.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: Der Unfallchirurg - July 23, 2009 Category: Orthopaedics Authors: Ottomann C, Hartmann B Tags: Unfallchirurg Source Type: journals

[Shortage of new recruits in surgery : Where do the problems of a reform of further education lie? Position of a person affected.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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 ...
Source: Der Unfallchirurg - July 22, 2009 Category: Orthopaedics Authors: Krüger M Tags: Unfallchirurg Source Type: journals

[Learning cannot be forced only encouraged : Citation by form teacher Dr. Gottfriedsen 1976.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19626304 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg)
Source: Der Unfallchirurg - July 21, 2009 Category: Orthopaedics Authors: Tempka A Tags: Unfallchirurg Source Type: journals

[Best matching : Experimental comparison of different matching procedures for use in computer navigation.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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)
Source: Der Unfallchirurg - July 21, 2009 Category: Orthopaedics Authors: Schäffler A, König B, Haas NP, Stöckle U Tags: Unfallchirurg Source Type: journals