Der Unfallchirurg
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Large financial resources are needed to treat fractures. Surprisingly little is, however, known about actual numbers, treatment methods or outcomes. A large population-based observational study can add valuable knowledge, especially if patient-reported results are included. ⋯ More than 285,000 fractures have been registered. The database is increasing at a rate of 70,000 fractures a year, i. e. one fracture every 7 min. The aim of this article is to describe the first seven years in the history of the SFR, with opportunities for the future as well as limitations.
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The principle of self-assessment is performed successfully in a wide variety of medical disciplines and is increasingly gaining importance in orthopedic trauma surgery. Through the development and validation of joint-specific self-assessment questionnaires that enable estimation of the range of motion, a large number of patient-based instruments are available for comprehensive follow-up examination. A recently performed proof of concept study showed a high patient acceptance and therefore the development of a prospective, patient-centered fracture register based on the self-assessment functional analysis seems to be promising. The data obtained should reflect not only the reality of fracture treatment but also generate valuable epidemiological data with which evidence-based guidelines can be formed.
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The aim of the surgical treatment of intra-articular bicondylar tibial plateau fractures is the anatomical reconstruction and direct biomechanical optimal fixation of the fractured articular surface and the leg axis, taking the frequently associated soft tissue damage into account. ⋯ This is an established and safe delivery strategy for complex fracture patterns with dorsally running fractures. The risk of intraoperative malreduction is low. Postoperative reduction losses depend on fracture, operation and especially patient-specific characteristics.
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Supramalleolar deformities require surgical correction to avoid posttraumatic osteoarthrosis of the knee or ankle joint and to prevent definitive treatment options, such as total ankle arthroplasty or arthrodesis of the ankle joint. Various methods for the operative correction of supramalleolar deformities have been described in the literature. ⋯ Supramalleolar dome type osteotomy is a technically difficult method for acute correction of supramalleolar deformities. The functional results and complication rates are comparable to those in the literature for alternative osteotomy techniques.
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Abstract