Der Unfallchirurg
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A precise medical history and specific symptom-oriented clinical tests of the wrist joint should always precede any radiological, computed tomography (CT) or magnetic resonance imaging (MRI) diagnostics. In many cases, specific clinical tests of the wrist joint allow at least a preliminary diagnosis, which can be supported by standard radiography using correct projections. ⋯ Exact identification of the palpable anatomic landmarks is mandatory for correct application and interpretation of the various clinical tests. The results of the clinical tests in combination with radiological imaging can often detect precisely ruptures of distinct wrist joint ligaments and localized arthritis.
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Since the publication of the first mass casualty triage protocol approximately 30 years ago, numerous adaptions and alternatives have been introduced and are currently in use throughout the world. This variety may represent a challenge for the cooperation between emergency medical providers and the interoperability of emergency medical services often required during mass casualty incidents. To enhance cooperation and interoperability a standardization of triage protocols is required. ⋯ There is not sufficient evidence to declare one of the triage protocols superior in all aspects to the others and no triage protocol has been implemented on a comprehensive level in Germany. In order to initialize a national or regional convergence process towards an interoperability of emergency medical services, the model uniform core criteria for mass casualty triage approach has been identified as being appropriate.
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Observational Study
[Prevalence of blood-borne pathogens among 275 trauma patients : A prospective observational study].
Previous studies have indicated that the prevalence of human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV) virus infections among trauma patients seems to be higher compared to the general population. ⋯ To the best of our knowledge this study is the first report on the prevalence of blood-borne infections among trauma patients at a level I trauma center in an urban area in Germany. Compared to the general population the prevalence of blood-borne infections was higher but considerably lower than indicated in previous international studies. Considering the broad implications of occupationally transmitted blood-borne infections occupational safety is of paramount importance.
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Classical Article
[Nerve injuries after elbow luxation fractures in childhood : Indication and timing for surgical revision].
Supracondylar humerus fractures are very common in pediatric populations. In cases of dislocated fractures, closed reduction and percutaneous K‑wire fixation is recommended. Initially, 10-16 % of the patients also present lesion of the ulnar nerve as well as median nerve palsy in 6.4% and radial nerve palsy in 2.6 % of cases, respectively. ⋯ With the help of the presented case we discuss the indication and the point of surgical revision. Clinical assessment and neurosonography are essential for an exact diagnosis.