Der Unfallchirurg
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Clinical Trial
[Balloonsacroplasty: C-arm or CT controlled application? : Experience with 46 patients.]
Sacral insufficiency fractures are often overlooked and lead to severe therapy-resistant pain. These fractures can be most sensitively detected with magnetic resonance imaging (MRI). Similar to balloon kyphoplasty, sacroplasty provides fixation of these fractures with cement. ⋯ Balloon sacroplasty results in a reliable and significant reduction in pain for sacral insufficiency fractures. The C-arm controlled cement application resulted in more frequent extravasation and complications than CT-guided application.
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The reform of occupational insurance medical treatment in 2011 also resulted in many changes for occupational insurance consultants in private practice. The transformation of the physicians participating in treatment status (H-Arzt) to accident insurance consultant status (D-Arzt) has resulted in a significant increase in numbers in outpatient fields, which in some cases leads to increased competition. The tentative flexibilization of the conditions for participation of a D‑Arzt is welcomed but must be broadened to safeguard the future. ⋯ The regularly checked obligation for further education initially led to irritation but has now been extensively coordinated with the mandatory further education for contract physicians. As from 1 January 2016 many smaller alterations and specifications in the implementation regulations have been undertaken. The scale of charges for physicians in invoicing with accident insurance companies as with other scales of charges is urgently in need of reform with respect to the performance rating and in particular to the classification.
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Joint infections of the hand may lead to irreversible lesions and impairment of hand function due to early cartilage damage. Furthermore, persistent infections which are not treated immediately can cause osteitis and/or spread systemically. Finger joints are prone to infection due to bite wounds or crush and sharp injuries. ⋯ If diagnosis and therapy are delayed, joint damage may be inevitable. Therefore, urgent treatment of the infected joint is imperative to preserve the function of the hand. This article reviews the current diagnostics and treatment of joint infections of the hand.