Der Orthopäde
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We report on a case of complex nerve damage during total hip arthroplasty. The most severe clinical symptom was proximal leg paresis with diffuse sensory loss. ⋯ The treatment of retroperitoneal hemorrhage is controversial but in most instances a conservative approach is favored. The prognosis of neurological damage is sobering as only 20 % of victims are expected to achieve complete restitution.
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Diseases and injuries of the musculoskeletal system are the most common reasons for rehabilitation in Germany. The statutory health insurance, pension funds and the German social accident insurance are service providers for rehabilitation. Rehabilitation is based on the international classification of functioning, disability and health (ICF). ⋯ This will be a burden for the health system in acute care medicine and rehabilitation. Improving activities and participation following diseases and injuries of the musculoskeletal system will end in an increase in utilization of rehabilitation. This needs to be considered and reflected in an adjusted higher budget for costs in rehabilitation.
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The foundation of the German Society for Orthopedics in 1901 was due to a separation from the faculty of surgery because a surgical approach alone did not adequately deal with the symptoms. Orthopedists were initially considered as a fringe group. The conservative treatment approach was initially at the forefront and operative measures were a side line. ⋯ The demographic development presents new requirements which must be dealt with. Technical solutions are often very promising especially in this field. Technical orthopedics remains an important component of the specialty of orthopedics and trauma surgery and with an increasing tendency due to more recent research and development.