Der Unfallchirurg
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Comparative Study Controlled Clinical Trial
[Elastic stable intramedullary nailing of clavicular midshaft fractures: comparison of open vs closed fracture reduction].
The aim of this study was to compare the outcome of open reduction versus closed reduction of midclavicular fractures using elastic stable intramedullary nailing (ESIN) in both groups. ⋯ There was no difference comparing right- and left-sided injuries and the outcomes were consistent irrespective of the treatment method. When appropriately indicated open and closed intramedullary nailing are very successful modalities of treatment. There were no significant differences in shoulder function after either procedure.
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Diagnosis-Related Groups (DRG) are a patient classification system grouping related types of patients treated to the resources they consumed. In this analysis, we compared the Austrian and the German DRG systems. ⋯ Reimbursement of the top 15 diagnoses in hand surgery in Austria is 8% higher than in Germany. Except for one case, mean values as well as upper and lower thresholds of length of stay are considerably shorter in Austria. Comparison of international data to refine a national compensation system is advocated.
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Comparative Study
[Intraoperative 3-dimensional imaging - beneficial or necessary?].
With reference to two large retrospective studies we would like to make a contribution to the discussion whether intraoperative 3-dimensional imaging is only a helpful tool or state of the art for some special indications. ⋯ Correct assessment of alignment and joint line reconstruction are not possible by means of fluoroscopy in every case of syndesmotic injuries and calcaneal fractures. Therefore, intraoperative 3-dimensional imaging should be used in the treatment of these injuries due to the high intraoperative revision rates and the clinical relevance.
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The aim of this study was to evaluate the clinical and radiological results of 37 consecutive patients (Ø age 37.9; 4♀, 33♂) following arthroscopically assisted and image intensifier-controlled AC joint reconstruction using the double TightRope™ technique for acute AC joint separations grade V according to Rockwood. ⋯ Following arthroscopic AC joint stabilization using the double TightRope™ technique, despite partial recurrent instability, favorable clinical results can be expected.
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Osteoporosis is a major health problem worldwide and is included in the WHO list of the top ten major diseases. However, it is often undiagnosed until the first fracture occurs, due to inadequate patient education and lack of insurance coverage for screening tests. ⋯ Anamnestic risk factors correlate with pathological BMD more than bone-specific laboratory values. The LOS Questionnaire used in this study would therefore function as a cost-effective primary diagnostic instrument for identification of osteoporosis patients.