Der Unfallchirurg
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After explosions, various injury mechanisms lead to multiple injuries that can affect the entire body. While high pressure peaks and exposure to heat, especially in the vicinity of a detonation, can cause severe injuries and organ damage, fragments also pose a considerable threat to explosion victims even over long distances. The recognition and treatment of life-threatening disorders and the assessment of the severity of the injury are just as challenging for the entire treatment team as long-term operative management, reconstruction strategies and rehabilitation of the complex injuries. Knowledge of the injury mechanics and the pathophysiology of blast injuries should help the interdisciplinary team to master this challenge.
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Observational Study
[Teamwork and stress in routine interventions: an observational study of multiprofessional OR teams].
Effective interprofessional teamwork and stress are important factors for quality of care and patient safety in the operating room (OR); however, there are just a few systematic investigations into the relationship of OR teamwork and occupational stress. ⋯ The findings suggest a profession-specific relationship between OR teamwork and occupational stress. Further research is necessary to investigate to what extent successful OR teamwork during routine procedures contributes to intraoperative stress.
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In consequence of a car accident a 20-year-old woman with bilateral fractures of the femur and an unilateral lower leg fracture was treated with external fixation. Afterwards she was soporific with signs of impaired consciousness and required intubation and intensive medical care surveillance. ⋯ Subsequently, definitive treatment was performed by intramedullary nailing. After neurological and orthopedic rehabilitation no performance inhibiting limitations remained.
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Non-union represents a severe complication and a major socioeconomic challenge in orthopedics and trauma surgery. Timely and reliable diagnostics are obligatory to be able to carry out the treatment of non-unions in a patient-specific and efficient manner. ⋯ It can display the microperfusion inside the non-union gap in real time and provide valuable information for exclusion of an infection or on the healing progress after revision surgery. An establishment of this diagnostic modality in routine orthopedic trauma surgery contributes to optimization of the treatment of non-unions.
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The v. Bodelschwingh Foundation Bethel can look back on a tradition of more than 150 years in the treatment of people with disabilities. The trauma patient collective is regularly characterized by the most severe mental and physical developmental disorders and (multiple) disabilities, with and without behavioral disorders and concomitant internal diseases. ⋯ Due to a high postoperative complication rate, conservative treatment plays a crucial role. The decision for surgical treatment must be made on an interdisciplinary and individual basis, taking all factors into account. Special attention must be paid to the procedure to be chosen (stability, functional needs).