Der Unfallchirurg
-
Osteopathy as a manual procedure is an important therapeutic tool in postoperative care. The essence of diagnostic and manual medical procedures in osteopathy is explained. ⋯ The functional significance of the fasciae and myofascial chains is examined in more detail. Finally, the range of applications and effects of osteopathy in postoperative care are presented.
-
Successful treatment of complex regional pain syndrome (CRPS) depends mainly on an early diagnosis and an adequate treatment concept with active participation of the patient. ⋯ Good patient education regarding the clinical picture and course of the disease form the basis for the treatment of CRPS. The patient should always be considered holistically and treated correspondingly by a multiprofessional team. Active involvement of the patient in the treatment from the beginning is always essential.
-
The care of distal periprosthetic femoral fractures (PFF) is becoming a major interdisciplinary challenge due to demographic developments. The operative treatment is often performed (depending on the type of fracture) by means of locking plate fixation (LPF), although little data on the clinical outcome exist by now. The aim of the study is to identify risk factors for a poor outcome and increased mortality METHODS: In this retrospective study, 36 cases with distal PFF were examined. Exclusively treatment with LPF were included. Relevant previous illnesses (ASA score, Charlson index), fracture morphology and major complications were recorded as well as 1- and 3- year mortality. The clinical outcome was detected by using the Lysholm score. ⋯ This case series displayed a high absolute mortality even if the rate was slightly lower compared to previously published data. The rate of secondary dislocations, lack of fracture healing or follow-up operations were also low. The LPF therefore appears to be a suitable treatment for fractures with a stable prosthesis. However, there is a high variability in the clinical outcome regardless of the type of fracture and significantly increased mortality rates in previously ill patients.
-
After a fall a 52-year-old female patient suffered an unstable fracture of lumbar vertebral body 3 and a stable fracture of thoracic vertebral body 12 without neurological deficits. In addition to the balloon kyphoplasty of thoracic vertebral body 12, percutaneous fixator internal instrumentation of lumbar vertebral bodies 2-4 was carried out with cement-augmented pedicle screws. ⋯ After the onset of detachment of the cement parts, we decided on an endovascular removal using the sling technique. The postinterventional course was uncomplicated.