Der Unfallchirurg
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Road traffic crashes pose a major threat to individuals and national health systems. Developing countries account for 48% of motorized vehicles, but for 91% of the 1.3 million fatalities per annum. ⋯ This article reviews current prognoses of deaths and disabilities, the characteristics of crashes in low and middle income countries and evidence-based road safety interventions. This article is considered a wake-up call for trauma, orthopaedic, and emergency surgeons in high-income countries to join the global community in fighting the neglected yet potentially curable epidemic named road traffic injuries.
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The diagnostic value of X-rays, computed tomography (CT) and magnetic resonance imaging (MRI) for proximal humeral fractures (PHF) was compared in order to test the hypothesis that MRI gives relevant additional information. ⋯ X-ray imaging is the basis method for the diagnosis of PHF but needs further multiplanar imaging to demonstrate complete fracture patterns. Imaging of fractures is equally good for MRI and CT and MRI also provides additional therapy-relevant information about the rotator cuff and head perfusion.
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Motor vehicle accidents are the leading cause of severe injuries. Outcome of these victims is substantially influenced by rescue time and primary trauma centre care. ⋯ Therefore, all new vehicles should be equipped with an automatic crash notification system by 2014. BMW is the first manufacturer to install an enhanced automatic crash notification system (eACN), which could optimize the rescue triage by estimating the risk for severe injuries (MAIS3+) based on telemetric transmitted accident data.
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Luxations of the sternoclavicular joint are rare injuries. We present a case of anterior dislocation which was caused by a minor fall onto the right shoulder. Diagnosis was delayed by 2 weeks which prevented treatment by closed reduction. ⋯ Subsequently, fixation to the medial side was achieved by a suture anchor that was placed into the manubrium. The presented case highlights this simple and safe method to treat dislocations of the sternoclavicular joint in which standard treatment cannot be performed. A detailed description for each operation step is given and our experience in terms of aftercare and outcome is reported.
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The societies of western countries are facing enormous economic and social challenges. Despite a declining population size the number of elderly patients is growing and will lead to an increase in cases of trauma in the near future. In addition, the health care system will have to be financed by a reduced labor force. ⋯ The bottleneck within the surgical specialties in case of efficient scheduling will be the capacity utilization of the operating theatres. Additional separate outpatient operating theatres adjacent to hospitals could be an efficient instrument for using resources and economizing medical procedures. Considering the socio-demographic alterations of our society an adequate discussion regarding the general medical conditions is essential.