Der Unfallchirurg
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Aneurysmal bone cysts predominantly occur in young adults and the long bones, the lumbar spine and the pelvis are mainly affected. This article presents the case of a 22-year-old woman with the very rare localization of an aneurysmal bone cyst of the atlas and an atlas fracture after a minor trauma. ⋯ Due to the unstable fracture it was decided to carry out surgical treatment with occipitocervical stabilization in combination with a transoral bone graft. After a period of 11 months the fracture had completely healed and the implants were removed without any complications.
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Review Meta Analysis
[Differences in the use of health care services - is everything unethical?].
Regional differences in the use of health services have been known for several decades. This variability is often overall regarded as undesirable in discussions and ethical-moral argumentation takes place. The description and analysis of this variability and the underlying causes are the subject of numerous investigations in various health care systems. ⋯ The description of regional differences is an important step toward provision of evidence-based and tailored health care. Differences in health care provision and especially regionally varying high intervention rates are not per se problematic. Whether a patient receives an intervention or not should, however, not depend any more on where he or she lives and which physician is being consulted, but on his or her individual medical condition or preferences. Target group-oriented evidence-based information can help to minimize undesirable variability.
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Peripheral vascular injuries are the cause of high morbidity in trauma patients. Up to 5 % of all patients with injuries of the extremities present with concomitant vascular lesions. While open peripheral vascular injuries are associated with a high mortality at the scene of the accident, closed vascular injuries present the danger of developing critical tissue ischemia with a high risk of amputation and limb loss. ⋯ A correct diagnosis and early treatment of peripheral vascular injuries place enormous demands on interdisciplinary teams consisting of emergency physicians, orthopedic surgeons, vascular surgeons, anesthesiologists and radiologists. The top priority in the context of emergency care is hemorrhage control by applying direct pressure and dressings until definitive surgical treatment. Hypovolemic shock, reperfusion injury and compartment syndrome are complications of peripheral vascular injuries that must be recognized and treated in the early stages.
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Clinical Trial
[Repositioning options with percutaneous dorsal stabilization : For burst fractures of the thoracolumbar junction.]
The purpose of this investigation was to evaluate the options of percutaneous systems for reducing relevant posttraumatic kyphosis in spinal burst fractures. Clinical advantages of percutaneous techniques are evident from the literature and a disadvantage can be a lack of repositioning options in reducing the fracture kyphosis. Better results seem to be possible with new techniques and especially monoaxial percutaneous screws. ⋯ A significant reduction of posttraumatic kyphosis of thoracolumbar burst fractures is possible with percutaneous techniques. Prerequisites are percutaneous monoaxial screws and tools and a special percutaneous technique as described.
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Case Reports
[Challenges in the context of medical care during a naval research expedition : A case report.]
Exploration for natural resources in the seabed of the Indian Ocean was undertaken by the German government institution of earth sciences and resources ("Bundesanstalt für Geowissenschaften und Rohstoffe", BGR) in November 2012. To provide for the medical safety of crew and scientists, a cooperation between the BGR and the trauma department of the Hannover Medical School was established. Research by physicians accompanying the naval expedition revealed that medical consultations mainly occur because of respiratory infections, abdominal discomfort, genitourinary discomfort and seasickness, with the rate of traumas being between 31% and 41%. ⋯ We recommend contacting police, customs, the federal institute for drugs and medical devices as well as the labour inspectorate, preferably in both the originating country and the destination, to prepare custom formalities and to obtain formal documents and approvals beforehand. It is advisable to be prepared not only for emergency situations, but also for general medical and dental problems. Improvisation in the treatment of special health problems is an unavoidable requisite.