Der Unfallchirurg
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We report about an 81-year-old male patient who suffered a medial femoral neck fracture after a fall on the left leg. A total hip arthroplasty was planned based on the appropriate indications. The planning was complicated by the presence of an intramedullary Küntscher femoral nail inserted after a motorcycle incident approximately 60 years ago. After fenestration of the proximal lateral femur, the nail was sawn off and a cemented total hip arthroplasty and plate osteosynthesis were performed.
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Estimated treatment costs of severely injured patients were often added to registry-based analyses. In the past, the TraumaRegister DGU® used a modular cost estimator for this purpose. A recent research project initiated by the German Trauma Society (DGU) evaluated the reimbursement of severely injured patients in the German DRG system. This project also allowed the generation of an improved update of the registry's cost estimator. ⋯ Using only key data available for all patients in the registry, a valid cost estimator for acute care costs is now available in the TraumaRegister DGU®.
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Percutaneous internal fixation of pelvic fractures is increasing in popularity with multiple new techniques reported. ⋯ Percutaneous fixation of pelvic fractures requires high-quality imaging and can be aided by computer navigation. Safe techniques are reproducible; however, not all patients and fracture patterns can be treated using these techniques.
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Three-dimensional (3D) imaging can enhance trauma care by allowing better evaluation of bony detail and implant position compared to conventional fluoroscopy or x‑ray. Intraoperative 3D imaging further improves this evaluation by allowing any necessary revisions to be made in the operating room prior to the patient emerging from anesthesia. ⋯ Improved image volume, resolution, and software capability have allowed surgeons to obtain high-quality, wide field views of bony anatomy that can include the uninjured side as a comparison. In this paper, the evolution of intraoperative 3D imaging over the past 25 years is discussed.