Der Unfallchirurg
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Controlled Clinical Trial
[Shortening deformities of the clavicle after diaphyseal clavicular fractures : Influence on patient-oriented assessment of shoulder function.]
The aim of this study was the evaluation of patient-oriented outcome scores for shoulder function and residual complaints after diaphyseal clavicular fractures with respect to shortening deformities. ⋯ The results of this study showed that shortening deformities after clavicular fractures in adults have a large impact on the functional result and patient-oriented outcome scores. The aim of the therapy of diaphyseal clavicular fractures should therefore concentrate on reconstruction of the anatomical length of the clavicle.
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Clinical Trial
[Out-of-hospital airway management in trauma patients : Experiences with the C-MAC® video laryngoscope.]
Securing the airway is the top priority in trauma resuscitation. The most important factor for successful endotracheal intubation (ETI) is good visualization of the vocal cords. The aim of this study was to summarize the practical experiences with the C-MAC® video laryngoscope as initial device in out-of-hospital airway management of trauma patients. ⋯ The use of the C-MAC® video laryngoscope by experienced anesthesiologists in an out-of-hospital setting seems to be a safe method even in patients with an immobilized cervical spine. Adverse laryngoscopy results (C/L III and IV) were reduced compared to other studies.
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Registries are a topic of lively debate amongst all stakeholders in healthcare, politics and economics. In general, registries are national or international (prospective) databases documenting the current state of diagnostic, therapeutic and long-term outcome variables of subjects with a distinct condition or health problem. The access to and handling of registry information is subject to strict legal, methodological and ethical principles and regulations before these data can be scientifically utilized and reentered into the routine daily practice. ⋯ Currently there is only indirect evidence that registries influence outcomes and the quality of care. Recent statistical techniques may allow quasi-experimental modelling of observational information. In orthopedic and trauma surgery, current and upcoming registries should be wisely utilized to develop and evaluate innovations and to make informed decisions relevant to care.
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The so-called transitional fractures describe articular fractures in adolescents with partial closure of the epiphyseal growth plate. This shows a specific stereotype fracture pattern, which can be differentiated into biplane, triplane I and triplane II fractures depending on the involvement of the metaphysis and the number of fragments. The diagnostics and therapy can differ from fractures where the epiphyseal growth plate is still open. The main focus for surgical treatment is the reconstruction of the articular surface whereas relevant growth disturbances no longer need to be feared when the epiphysis has already begun to close.