Der Unfallchirurg
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Damage to health caused by complications and errors is part of the reality of medical treatment. In order to avoid further negative consequences in the event of legal claims as a result of excessive processing times or unjustified refusals, a good cooperation between the physician and claims management in the clinic and the legal processor in liability insurance is required. In order to avoid false assumptions in claims processing, a critical analysis of the facts of the case is necessary. In addition, findings from claims management must be recorded and effectively implemented in the clinical practice.
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This article presents the case of a rapidly progressing pyoderma gangrenosum (PG) following a minor trauma and surgical intervention. A 46-year-old patient was admitted to hospital after a minor trauma of the right lower leg with a suspected diagnosis of erysipelas bullosum. ⋯ Additionally, the patient was treated with hyperbaric oxygenation (HBO). The 2‑year follow-up showed a gradual restitution of the soft tissues.
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Ankle fractures and associated ligamentous injuries are the most common injuries of a load-bearing joint. There is still no general consensus with respect to the pathomechanism, the treatment indications and surgical techniques. ⋯ This detects relevant pathologies, such as bony syndesmotic avulsion and partial impaction of the tibial plafond that may go unnoticed on plain radiographs. Anatomic reconstruction of the ankle mortise, the detection and treatment of syndesmotic instability, reconstruction of the tibial notch and exact placement of the distal fibula into the latter are important prognostic factors.
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The diagnostics and treatment of pediatric skeletal trauma can be fundamentally different from adults. Based on in-house data the diagnostic approach to the most frequently encountered pediatric injury patterns is discussed. ⋯ Both diagnostic methods cause stochastic radiation damage. Therefore, it is important to perform the safest examination for the child while injuries are correctly diagnosed.