Der Unfallchirurg
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We report the case of a 28-year-old man who developed nonunion with complex deformity after treatment of a distal femoral fracture with an antegrade femoral nail. The resulting deformity was as follows: 10° varus, 21° external torsion, 1.8 cm of foreshortening and translation malalignment. After resection of the pseudarthrosis, a retrograde segmental transport nail was implanted. ⋯ The segment transport was performed using a magnetically driven internal transport nail. Seven months after surgery, bony consolidation of the distraction section and the docking site was observed. The leg axis was straight and the rotational movement ranges of the knee and hip corresponded the dimensions of the contralateral side.
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Photographic documentation of wounds, decubitus ulcers, tumors, open fractures and infections is an important part of digital patient files. It is unclear whether the photographic documentation has an effect on medical accounting with health insurance companies. ⋯ The use of Smartphone based photographic documentation can improve the overall quality of patient files and thus avoid loss of revenue. The implementation of digital devices with corresponding software is an important component of the digital structural change in hospitals.
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The aim of this study was to analyze the epidemiological trends and incidences in inpatient pelvic surgery in the period from 2005 to 2007. ⋯ There was an increase in the number of all analyzed pelvic procedures between 2005 and 2017. Especially the use of screw fixation increased. The introduction of new techniques (e.g. screw fixation of the sacroiliac joint) and progress and innovation in the field of three-dimensional navigation techniques, the demographic trend, greater mobility and higher demands on functionality of older patients might explain this increase in pelvic procedures.
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A seamless rehabilitation of polytrauma patients starting as early as possible is the primary goal in order to ensure long-term participation and quality of life. In reality, however, there is often still a large time gap between acute care and inpatient rehabilitation, the "rehab hole". The aim of the phase model of trauma rehabilitation is to ensure a complete rehabilitation chain. ⋯ It supports the trauma surgeon at the end of the acute treatment with the needs-based indications for further rehabilitation and serves as an argumentation aid to the payers of the rehabilitation. In addition to the early rehabilitation Barthel index (FRB) for assessing the need for care and mobility, other relevant characteristics are recorded. From a rehabilitation point of view, a special effort arises from an increased diagnostic and therapeutic needs, through specialist care and treatment in nonorthopedic areas, extensive wound management, pain therapy measures, the provision of aids and special psychological care for the seriously injured.
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The case of a 56-year-old male patient with locking of the knee in extension without trauma is presented. Patient history, clinical examination and radiographs confirmed a superior dislocation of the patella. ⋯ Knowledge of this uncommon cause of a locked knee joint leads to immediate treatment avoiding complex imaging modalities, such as computed tomography (CT) or magnetic resonance imaging (MRI). No further treatment was necessary in the majority of the cases published in the literature.