Der Unfallchirurg
-
Review
[Anterior cruciate ligament rupture in children with open growth plate : Diagnostics and treatment].
Anterior cruciate ligament (ACL) ruptures in pediatric patients with open growth plate are of concern and the number of injuries is increasing. The possibilities for diagnostics using magnetic resonance imaging (MRI) have improved and are without radiation exposure to the growing skeleton. The MRI should be performed routinely in every case of adequate trauma also to recognize additional injuries to the knee joint. ⋯ Despite the different surgical techniques, the general recommendation is for replacement of the ACL. Extensive procedures with an increased risk of epiphyseal injury should be avoided and anatomical techniques should be preferred. The results are good to very good and with adequate knowledge of the special features of children, complications are rare.
-
Every year up to 35,000 people in Germany are severely injured in accidents in traffic, during work or leisure activities. The 24-h availability of the trauma room as well as surgical and intensive care unit capacities are essential to provide optimal acute care. This study analyzed the frequency of utilization of the resource trauma room in a level I trauma center in the past. ⋯ The data at hand showed a constant number of severely injured trauma patients admitted to a level I trauma center over the past few years. At the same time, there was a significant increase in utilization of the trauma room; however, in a considerable number of patients admitted to the trauma room the diagnostic process resulted in non-traumatic diagnostic findings. In the analyzed cohort, especially patients admitted to the trauma room due to trauma mechanism or without an accompanying emergency physician contributed to this development, necessitating an increased operational readiness of the trauma room team.
-
The future of emergency departments in Germany is influenced by increasing numbers of patients, demographic changes, new therapeutic concepts, current legislation and expert opinions. There is a lack of reliable data concerning the quantity and the type of injuries and diseases presenting in emergency departments. ⋯ The present study analyzed the frequency of major diagnoses corresponding to the various medical disciplines including more than 500,000 patients. Of the emergency cases included, 43% were allocated to trauma surgery or orthopedics. These patients presented in the emergency departments around the clock and necessitate the permanent attendance of a trauma and emergency surgeon. Thereby, timely surgical care and decisions regarding indications for surgery and admission are ensured. Competence in trauma and emergency surgery is therefore essential for emergency departments.
-
Femoral shaft fractures after completion of growth predominantly affect young people with healthy bones. The causes are mostly high-velocity traffic accidents, crushing or running over mechanisms and falls from a great height. Gunshot wounds are relatively rare in Germany but have a certain importance internationally and in military medicine. ⋯ Spiral fractures are a sign of indirect force and are therefore frequently found in older patients with osteoporosis. Atypical fractures under or following bisphosphonate treatment are a new entity, which are typically subtrochanteric and begin on the lateral side of the bone. The characteristics of pathological fractures, femoral shaft fractures in childhood and adolescence as well as periprosthetic fractures are not dealt with in this article.
-
Abstract