Der Unfallchirurg
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Legal appraisals of possible treatment errors in childhood and adolescence are rare, often refer to the treatment of trauma of the upper limbs and are frequently recognized. From the activity of the first author as an expert witness 31 expert opinions (25%) referred to the upper limbs. Supracondylar humeral fractures, radius neck fractures, radial condyle fractures and distal radius fractures were predominant. ⋯ Insufficient recognition of instability (radial condyle), inadequate reduction and inadequate stabilization (radius neck, supracondylar) as well as untreated malalignments and secondary dislocations (wrist) were the main reproaches. Poor communication and deficient documentation often aggravate the situation. Working along clear algorithms can help to avoid legal proceedings and assignment of guilt.
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Case Reports
[Circular soft tissue defect after prolonged application of a strangulating compression stocking].
Wearing a compression stocking over a longer period of time can lead to deep skin and soft tissue defects. This article presents a case of a circular necrosis with an exposed tendon of the tibialis anterior muscle and the Achilles tendon. ⋯ Due to the short operating and anesthesia times, this flap is a good option for lower leg reconstruction, particularly in multimorbid patients. This case raises awareness of the importance of adequate patient training before commencing compression therapy.
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Observational Study
[Endoprosthetic treatment of pertrochanteric femoral fractures with concomitant coxarthrosis : A consecutive observational study with a control group].
Hip replacement for pertrochanteric femoral fractures (PF) is challenging due to its complexity. Studies regarding this procedures are limited, therefore this monocentric study was conducted. The null hypothesis was no effect between replacement and internal fixation according to revision and mortality. ⋯ In this study, a significantly higher rate of infection and mortality was observed in patients with hip replacement for a PF and with a concomitant coxarthrosis; compared to osteosynthesis of PF without coxarthrosis. Further studies are mandatory to provide the appropriate treatment for patients with this fracture pattern.