Zeitschrift für Orthopädie und Unfallchirurgie
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The aim of this study was to evaluate the functional results and determine/record the complications after treating distal humerus fractures with an anatomically precontoured and angular-stable double plate system (LCP Distal Humerus Plates, Synthes GmbH, Umkirch). ⋯ By using the anatomically precontoured and angular-stable LCP distal humerus plates system a stable osteosynthesis allowing early physiotherapy is achieved in the majority of patients. Due to early initiation of physical therapy the functional results might be improved. Despite using the LCP system complications at the distal humerus fracture side were seen frequently, emphasising the challenging surgical procedure and demonstrating the need for further implant and surgical procedure improvement.
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Successful four-corner fusion after scaphoid excision provides pain relief und preserves an acceptable movability of the wrist. However, this treatment option for advanced carpal collapse is not without complications, such as malunion, hardware impingement or incomplete correction of lunate extension. K-wires, staples, Herbert screws or, recently, locking plates are all possible fixation techniques after scaphoid excision. Only a few studies including mid-term results using K-wires are available. The aim of our study was to evaluate clinical and radiological mid-term results after scaphoid excision and four-corner arthrodesis using K-wires for stage II and III scapholunate and scaphoid non-union advanced collapse. ⋯ Scaphoid excision and four-corner arthrodesis for advanced collapse of the wrist enjoy great satisfaction by the patients, with a high degree of pain reduction. This method shows persistent strength and movability in mid-term-results. Compared to alternative fixation techniques, the use of K-wires is a low-risk and low-cost treatment option, although removal of the K-wires is commonly necessary.
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Nowadays, complex arthroscopic procedures of the knee joint, such as ACL reconstruction, are routinely carried out on an outpatient basis. The reduced time spent with the patient places high demands on the surgeon with regard to the management of such cases. The aim of this study was to evaluate the current standards of perioperative management following outpatient arthroscopic surgery of the knee in Germany. ⋯ DVT prophylaxis with LMWH, general anaesthesia, postoperative cryotherapy and personal availability by phone can be considered part of the standard perioperative management following outpatient knee arthroscopy in Germany. However, a wide variety of treatment options can be found regarding topics such as analgesia, antibiotic prophylaxis, tourniquet, knee drainage and physiotherapy.
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Academic careers often place the burden of research on top of clinical work. This conflict denotes a demanding task especially in surgical disciplines, such as orthopaedics and traumatology. Driven by changes in the social system, concerning, e.g., leisure and parentship, the future organisation of the academic workplace needs to address these individual issues. With the aim to evaluate individual motivation towards combining research, clinical work and private life and to receive suggestions for improvement we conducted a survey addressing residents employed in the orthopaedic and traumatological departments of German university hospitals. ⋯ Individual solutions seem to be necessary to achieve a scheduled efficiency of clinical and research careers. This includes structural developments (like a professionally headed lab) and the establishment of dynamic clinical structures. It seems possible that the clinical organisation of physicians in teams might offer solutions to cope with the demands of surgical training and clinical care on the one hand and research on the other hand.
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Displaced midclavicular fractures in children are generally treated non-operatively. But there is a lack of age-related data concerning the functional and cosmetic results following conservative treatment and patients' content with the treatment. ⋯ The method of choice in children under the age of ten with a displaced clavicular fracture is the non-surgical treatment supported by sufficient pain medication. Older children reach good results but suffer from more pain and are dissatisfied by the cosmetic results and immobilisation. Because of this, active older children and adolescents with a displaced clavicular fracture benefit from elastic stable intramedullary nailing.