Der Unfallchirurg
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Clinical Trial
[3D navigated osteosynthesis of calcaneal fractures. Open and minimally invasive techniques].
It is hypothesized that misplacement of sustentacular screws during osteosynthesis of intraarticular calcaneal fractures can be reduced with the help of navigation. A method for three-dimensional (3D) navigated placement of sustentacular screws for treating intraarticular calcaneal fractures is presented and evaluated. ⋯ Through a combination of intraoperative 3D imaging and navigation, placement of sustentacular screws is possible and can yield precise and reliable results. Especially in minimally invasive treatment, a high quality of osteosynthesis can be achieved.
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Persistent dysphagia after ventral instrumentation of a patient with a cervical spine fracture and diffuse idiopathic skeletal hyperostosis (DISH, or Forestier's disease) is a rare but dramatic complication. In this case report some pathogenetic factors are discussed. Accurate resection of the spondylophytes should be considered to avoid a ventral protrusion of the plate.
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Case Reports
[Bilateral hydrothorax and hydromediastinum after puncture of the right subclavian vein].
Complications after the percutaneous insertion of central venous catheters are pneumothoraces, catheter-associated infections and thrombosis. In rare cases, late problems occur as a disruption of the main thoracic duct or vascular erosion. ⋯ The following case report describes a rare catheter complication in a 16-year-old polytraumatised patient. The differentiation to a chylothorax and suitable therapy are described.
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Mediastinal emphysema is usually seen in cases of blunt thoracic trauma or cervical injury accompanied by tracheobronchial or esophageal perforation. Characteristic of this injury is severe retrosternal pain. We present the case of a man with extensive mediastinal and cervical emphysema caused by a simple midfacial fracture and accompanied by no symptoms.
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This study is the first to document the quality of inpatient care provided to elderly patients with distal radius fracture in Germany. ⋯ Unexpected findings were the predominance of general anaesthesia and percutaneous K-wire osteosynthesis. Osteoporosis, affecting a majority of elderly women, is neglected in clinical practice. Good quality of care is reflected by the low rate of complications.