Der Orthopäde
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The choice of implant in an infection of the spine depends on what type of infection it is: discitis, spondylodiscitis, early infection after spinal surgery, or a late infection. The appropriate treatment strategies vary. ⋯ In implant-associated early infections, surgical sanitization is often sufficient without changing the implant. In late infections, implant exchange is necessary because of biofilm.
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The corona pandemic poses enormous financial challenges for hospitals. Using the example of a clinic for orthopaedics and trauma surgery, the performance development of the first 5 weeks in comparison to last year and an evaluation of the compensation measures laid down by law will be evaluated. ⋯ The measures taken by the Government are an important pillar for the economic security of German hospitals. The lack of differentiation of measures by specialty leads to insufficient compensation for orthopaedics and trauma surgery.
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Review
[Periprosthetic fractures of the acetabulum and femur : Causes-classification-treatment algorithms].
Both increasing implantation numbers of total hip replacements and demographic change with higher populations of older people, indicate that there will be an increase in periprosthetic fractures in the future. ⋯ In the classification of periprosthetic fractures of the femur, the Vancouver classification has prevailed in recent years, which in addition to a description of the localization of the fracture also considers the stability of the prosthesis and bone quality. Based on this, therapeutic algorithms have been developed that can vary from the conservative approach via osteosynthetic options to a replacement of the prosthesis. In order to allow the description of periprosthetic fractures on all joints, the Vancouver classification has been extended to the UCS classification by including the AO/OTA bone and joint coding system. In the selection of the treatment method, the consideration of individual patient factors such as activity level and secondary diagnoses is essential. Based on the established classifications, the importance of the different therapeutic methods is presented.
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Meta Analysis
Anterior versus posterior instrumentation for treatment of thoracolumbar tuberculosis : A meta-analysis.
To compare clinical and functional outcomes of anterior versus posterior debridement and spinal fixation for surgical treatment of thoracolumbar tuberculosis. ⋯ The anterior and posterior approaches are equally good methods for treatment of thoracolumbar tuberculosis. The anterior approach results in less blood loss, whereas posterior instrumentation is better suited for correction of kyphotic angle.