Der Unfallchirurg
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Surgery of sepsis in trauma surgery and orthopedics is attracting increasingly more attention due to the rising presence of multidrug-resistant pathogens and the increasing number of operative interventions. Despite extensive experience over decades neither the symptoms nor the treatment strategies have been evaluated and it has become obvious that a scientific investigation of this complex topic is necessary for optimization of patient care under economically sound conditions. The aim of this article is to give a snapshot from German healthcare institutions for trauma surgery and orthopedics to answer some questions on this topic from the section for bone and soft tissue infections (SeKuWi) of the German Society for Orthopedics and Trauma (DGOU) in cooperation with the German Society for Hospital Hygiene (DGKH).
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Case Reports
[Surgical treatment of a complex adolescent carpal fracture : A rare injury to the growing skeleton].
We report the case of a 15-year-old boy with combined fractures of the scaphoid, capitate, and hamate that represents a rare variation of the well-known Fenton's syndrome. Fixation was performed for the unstable fractures of the scaphoid and capitate with the use of cannulated Herbert screws and K‑wires respectively. ⋯ After 6 months, CT confirmed complete consolidation of the two surgically treated carpal fractures and the conservatively treated fracture of the hamate. Regarding function, the patient is able to incorporate the hand into his school-related activities and has a good range of motion, with strong closure of the fist.
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Impaired hemostasis represents a major risk factor for increased morbidity and mortality in patients with traumatic intracranial hemorrhage. In cases of polytrauma with major bleeding, hyperfibrinolysis may develop and this may result in excessive coagulopathy. ⋯ The basic principles of the pathophysiology and effects of coagulation impairment in this patient population are reviewed. Furthermore, the use of specific coagulation tests and the administration of hemostatic substances are discussed.
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As part of the expansion of the site-specific education profile of the medical curriculum MED@ULM of the University of Ulm, a new track "trauma care and trauma research" was established in the winter semester 2012/2013. The acceptance of the track was evaluated during the winter semester 2013/2014. ⋯ With the introduction of the new trauma track into the curriculum of the medical curriculum MED@ULM of the University of Ulm, a further possibility for medical students to focus on their own individual options was established. At least half of the track students wanted to be later active in the triad of patient care, teaching and research. Further investigations are necessary to determine whether the establishment of the trauma track has a positive influence on the number of new recruits in trauma surgery and anesthesiology.