Der Unfallchirurg
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Hand surgery often needs only a short length of stay in hospital. Patients' comorbidity is low. Many hand surgery procedures do not need inpatient structures. Up until 2006 special procedures of hand surgery could not be coded. The DRG structure did not separate very complex and less complex operations. Specialized hospitals needed a proper case allocation of their patients within the G-DRG system. ⋯ The changes in the DRG structure and the implementation of the new OPS code for complex cases establish a strong basis for the identification of different patient costs. Different case allocation leads to different economic impacts on departments of hand surgery. Whether the new OPS code becomes a DRG splitting parameter has to be calculated by the German DRG Institute for further DRG versions.
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The fingertip is an extremely specialized end organ with a highly developed sense of touch. In this article, we present the different ways of reconstructing a traumatized fingertip. ⋯ The advantages and disadvantages of each flap are highlighted. We develop an algorithm to facilitate finding the correct type of reconstruction.