Der Unfallchirurg
-
Bone substitutes are used to supplement or substitute autogenous transplantation of cancellous bone. These materials should provide a scaffold structure and support bone healing alone or in combination with other substances. ⋯ Moreover, biomaterials can be stored, also ensuring ready availability. This educational article gives an overview of bone substitutes currently in clinical use.
-
Absolute indications for removing intramedullary locking nails (ILN) are undisputed, but there are also relative indications when implant removal might be discussed. The aim of our study was to evaluate complications of ILN removal in the upper and lower extremities. ⋯ The complication rate of interlocking nail removal is too high to justify such a procedure without clear indication.
-
Meta Analysis Comparative Study
[Prehospital trauma care training course. Integration of emergency physician and rescue services].
With the emergence of a trauma network in the metropolitan area of Nuremberg, Germany, the question arose whether prehospital trauma management and emergency department management could be better integrated. A training scheme was designed for prehospital trauma care by the rescue services of the Workers' Samaritan Federation Germany (ASB), the Bavarian Red Cross, Maltese Ambulance, St. Johns Ambulance, representatives of the emergency physicians, and physicians of Rummelsberg Hospital. ⋯ Conversion into practice was facilitated by teamwork. The course is free of charge to all rescue services and members of the concept group. With a qualified prehospital system that works smoothly with the ATLS concepts, improved prehospital care for trauma patients seems possible.
-
Severe intraoperative bleeding may endanger the patient's life, necessitate additional human resources and increase perioperative costs. The aetiology of perioperative coagulopathy is complex and consists of depletion, consumption and dilution of clotting factors and thrombocytes. Cofactors like hypothermia, acidosis and severe anaemia may aggravate coagulopathy. ⋯ Evaluation of the clinical bleeding situation and coagulation tests, in particular point-of-care testing like thrombelastography, should be used to guide and control the therapeutic strategy. Fresh frozen plasma, concentrates of clotting factors, platelet concentrates and antifibrinolytic drugs are available for therapy of perioperative coagulopathy. To obtain optimal benefit for the patient, these products should be applied based on a therapeutic algorithm.
-
Case Reports Meta Analysis
[Dislocation as a rare complication of resurfacing of the hip joint. Case report and meta-analysis].
Resurfacing of the hip joint experienced a revival in the 1990s. Today metal-on-metal bearing is a therapy option especially for younger, active patients. In comparison to stemmed total hip replacements resurfacing offers advantages, in particular in view of the femoral bone loss. ⋯ In comparison to conventional total hip replacement, dislocation is a rare complication. With conventional total hip replacement the dislocation rate is 2-5%. In the international literature the dislocation rate with resurfacing is 0.21%.