Der Unfallchirurg
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Articular fractures of the dorsal part of the distal phalanx may result in a painful dysfunction and a bothersome deformity of the distal interphalangeal joint. For this injury multiple treatment procedures exist. We performed a survey among German hand surgeons and a review of the literature in order to present current concepts of treatment and to verify the feasibility of a randomized trial. ⋯ Complications more often occur after operative treatment. The type of injury and the individual demands of the patient are the most relevant factors for the choice of treatment. From the results of the survey and the review of the literature, a randomized trial of conservative and operative treatment has to be considered as a challenge.
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Review Case Reports
[Three case reports of frostbite. Management and literature].
Due to social and demographic changes as well as new leisure activities, the number of frostbite injuries in the general population is on the increase. Because the injuries are primarily located on the hands and feet the consequences for those concerned are devastating. We provide help in grading and introduce concrete therapeutic regimes for frostbite which are illustrated by three case reports from our clinical experience with varying risk profiles.
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Review Case Reports
[Removal of a bent intramedullary tibia nail. Case report and review of literature].
Breakage or deformity of intramedullary nails of the lower extremities is the result of subsequent high energy trauma, falling or noncompliance of the patient in partial weight bearing. We describe the removal of a bent tibia nail in a young patient who sustained another high energy trauma on the same limb. ⋯ The most customized procedure depends on the available capabilities and the individual case because of the rare occurrence of bent nails. Soft tissue damage, degree of bending and re-osteosynthesis must be considered in individual treatment strategies.
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Benchmarking is a very popular business process and meanwhile is used in research as well. The aim of the present study is to elucidate key numbers of German university trauma departments regarding research and teaching. ⋯ As a result the study shows that only well-known parameters such as fund-raising and impact factors can be used to benchmark university-based trauma centers. The German federal system does not allow a nationwide benchmarking.