Zeitschrift für Orthopädie und Unfallchirurgie
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Expert commissions (Gutachterkommissionen) and arbitration offices (Schlichtungsstellen) in Germany are expert panels for the extrajudical resolution of malpractice claims. The performance of arbitration panel proceedings ("Schlichtungsverfahren") is based on the German medical and insurance jurisdiction. ⋯ The results are discussed with regard to the avoidance of mistakes in diagnosis and treatment and the problems of medical assessment.
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The aim of the study was to evaluate the application of a navigation system (Brainlab) to control length and torsion intraoperatively while nailing a femoral shaft fracture. ⋯ The application of a navigation system for repositioning of femoral shaft axes and controlling the length and torsion while nailing complex femoral shaft fractures is associated with some additional work. Nevertheless, in our study a relevant rotational deviation can be avoided by using the navigation system. To prove the advantage of the navigation system over the conventional technique, clinical studies with larger number of cases are necessary.
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Also after bagatelle trauma, some patients can develop a complex regional pain syndrome (CRPS). The limb concerned usually shows a marked temperature difference to the contralateral side. Apart from a doughy swelling, the patient is impaired in particular by burning pain and a restricted range of motion. The objective of the present study was to examine the influence of early thoracic sympathetic nerve blockade on the basis of clinical and quantified blood flow parameters. ⋯ Outpatient CT-assisted temporary sympathetic nerve blockade is an effective and low-complication therapeutic option for the supportive treatment of patients with CRPS.
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This cohort study shows the results after treatment of comminuted radial head fractures combined with elbow instability, using radial head arthroplasty. ⋯ An arthroplasty with a radial head prosthesis can be recommended for unreconstructible comminuted radial head fractures with ligament injury.
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Isolated patellofemoral arthroplasty is discussed controversially. The aim of this nation-wide survey in Germany and review of the literature was to determine the current status of patellofemoral arthroplasty. ⋯ Isolated patellofemoral arthroplasty has only low significance among surgeons performing knee arthroplasty in Germany. The majority of surgeons do not believe in the success of the procedure. Almost one third of published cases in the literature needed to be revised.