Zeitschrift für Orthopädie und Unfallchirurgie
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Comparative Study
[Surgical outcome in pertrochanteric femur fracture: the impact of osteoporosis. Comparison between DHS and percutaneous compression plate].
The dynamic hip screw (DHS) often shows an impared outcome and a high incidence of therapeutic failure in patients with osteoporotic pertrochanteric femur fractures. This is caused predominantly by a fracture collapse and appears often in unstable fractures (31A2, 31A3). In a prospectively documented clinical study, we examined whether or not the percutaneous compression plate (PCCP, Gotfried) offers advantages following osteoporotic fractures. ⋯ Use of the minimally invasive PCCP technique in osteoporotic pertrochanteric femur fractures provides an alternative to the dynamic hip screw, especially with regard to surgical time and outcome. Advantages occurred also in the re-operation rate following fracture fixation complications. The cut-out rate was significantly lower than in the DHS group in unstable fractures.
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Comparative Study
[What is the value of the whole body spiral CT in the primary radiological imaging of severely injured children?].
Whole body spiral CT scans have become a routine method in the radiological imaging of severely injured patients in emergency rooms of an increasing number of hospitals. The routine use of CT scans is, however, still discussed controversially, especially with regard to its use in children. This is mainly due to the reportedly higher level of exposure to radiation of CT scans as compared to plain radiographs. The aim of the present study was to compare the dose of exposure to radiation of a whole body CT scan to that of a plain radiograph protocol in an animal model for severely injured children. ⋯ Based on our data and a review of the literature we will use whole body spiral CT scans as the preferred method in the primary radiological imaging of severely injured patients. In our opinion, the evident benefit of a reduced time of imaging in combination with superior image information outweighs the higher level of exposure to radiation.
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The aim of the present study was to evaluate a strategy for the management of accompanying osteoporosis after inpatient treatment of fragility fractures. ⋯ By use of a multifaceted osteoporosis intervention, more patients received diagnostics and therapy according to the guidelines of osteoporosis after fragility fractures. Without appropriate information, more than 60 % of the high-risk-patients did not receive adequate osteoporosis management. Future research should address barriers to appropriate osteoporosis management. Because of the chronic character of the disease and the necessity of a long-term therapy, continuous medical care and information of patients with osteoporosis is necessary to prevent subsequent fractures.
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Comparative Study
[Visual circle scale (VCS)--a patient-friendly scale to measure pain compared to VAS and Likert scale].
The visual analogue scale (VAS) and Likert scale (LS) are widely used but the patients might have difficulties to work with these scales and there might be errors in calculation. The visual circle scale (VCS) is a graphic construct with a simple grading to augment the understanding and ease for calculation. ⋯ The VCS is able to measure pain comparably to the known scales (VAS, Likert scale). From the patients point of view it is the preferred scale to work with.