Der Unfallchirurg
-
We describe the case of an 88-year-old woman who presented with painful symptoms of the pelvis after low-energy trauma. Conservative treatment with pain therapy and pain-adapted mobilization was unsuccessful. Diagnostics showed a fragility fracture of the pelvic ring; therefore, we performed photodynamic bone stabilization (IlluminOss™) of the pubic bone and percutaneous cement-augmented fixation of the iliosacral joint assisted by computed tomography (CT) fluoroscopy. Imaging showed a stable healed fracture 4 months after surgery.
-
Randomized Controlled Trial Comparative Study
[Detection of intrinsic ligament and TFCC lesions of the wrist : Direct versus indirect MRI arthrography.]
The purpose of this study was to validate the diagnostic value of direct magnetic resonance imaging (dMRI) arthrography and indirect MRI (iMRI) arthrography concerning intrinsic ligament injuries and tears of the triangular fibrocartilage complex (TFCC). ⋯ Indirect MRI arthrography is a suitable method for detection of injuries of the TFCC and intrinsic ligaments of the wrist with good sensitivity and specificity. Despite the low number of patients the results of this study showed that there were no essential differences between dMRI and iMRI arthrography with respect to the diagnostic value for carpal injuries of the wrist.
-
The bone marrow edema syndrome (BMES) is a painful joint disease which usually affects healthy middle aged persons. It is usually treated conservatively. ⋯ Complete restitution of the bone marrow edema in the knee and the disappearance of clinical complaints were observed 8 weeks after a single therapy with 60 mg denosumab (Prolia®) as a subcutaneous injection. No side-effects of the therapy were noted.
-
Comparative Study
[Deployment and efficacy of ground versus helicopter emergency service for severely injured patients : Analysis of a nationwide Swiss trauma center].
The influence of the transport mode, i.e. Helicopter Emergency Medical Service (HEMS) versus ground-based Emergency Medical Service (EMS) on the mortality of multiple trauma patients is still controversially discussed in the literature. ⋯ Using the newly established revised injury severity classification (RISC) score there was a tendency towards a better outcome for patients transported by HEMS (standardized mortality ratio 1.06 for HEMS versus 1.29 for EMS). Overall a short preclinical time and the presence of an emergency physician (EP) were associated with a better outcome.