Der Unfallchirurg
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The treatment of fractures of the medial malleolus in juveniles is of particular relevance. In patients under 10 years old fractures of the distal tibia affect almost exclusively the medial malleolus in the extension line of the medial talus edge in a proximal direction. ⋯ When fractures of the medial malleolus remain unrecognized or are treated inadequately, growth disturbances can occur (e.g. excessive or reduced growth, axis deviation). The diagnostics, indications (conservative or surgical treatment), treatment and follow-up care must be discussed and the corresponding legal aspects must be taken into consideration.
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The German Association of Trauma Surgery has developed a concept for the quality-assured care of severely injured patients; this concept includes the establishment of trauma networks. In this study, hospitals and emergency services in Lower Saxony were asked about their demands on the Hannover regional trauma network. ⋯ The demands of trauma centers on a trauma network correspond with the aims formulated by the German Association of Trauma Surgery. These demands depend on the level of trauma care provided. Close cooperation with emergency services is essential to strengthen collaboration within the trauma network.
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The natural tibiofemoral joint (TFJ) functions according to a roll-glide mechanism. In the stance phase (0-20 degrees flexion), the femur rolls backwards over the tibia plateau, while further flexion causes increased gliding. This kinematics is based on the principle of a quadruple joint. ⋯ Within the framework of the authorization tests, the endoprosthesis was examined according to ISO/WC 14243 in a knee simulator. The abrasion rates were, thereby, lower than or at least as good as those for conventional endoprostheses. The presented data demonstrate a novel concept in knee arthroplasty, which still has to be clinically confirmed by long term results.
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The aim of this investigation was to describe the current situation and atmosphere among residents and consultants in traumatology, using the results of a questionnaire. Wishes and needs concerning training programs in traumatology were addressed. ⋯ The study reports on the atmosphere among residents and consultants in traumatology. Despite European regulations, the individual workload is exceptionally high. It is a clear task of hospital administrators to increase the attractiveness of hospital jobs in order to ensure qualified personnel in the future.