Der Unfallchirurg
-
Nonunion of the scaphoid is a severe complication of often insufficiently treated scaphoid fractures or those which have been diagnosed too late. The treatment of scaphoid nonunion is challenging und should be performed by experienced hand surgeons. The anatomical shape, the retrograde blood supply and the biomechanics of the scaphoid complicate the healing process. ⋯ The available data do not enable the establishment of a superior treatment procedure. The most common surgical procedure used to treat scaphoid nonunion is autologous bone grafting combined with screw fixation. This article provides an up to date overview of the management and standard procedures for the primary treatment of scaphoid nonunion without a circulatory disorder.
-
Digitalization and standardization of documentation in medicine are increasingly progressing. In the decision of the Federal Joint Committee (G-BA) for a staged system of emergency structures in hospitals and in the report of the expert committee for development in the healthcare system on needs-oriented guidance of healthcare, the actuality of the topic is underlined with concrete naming of future tasks. ⋯ Digitalization makes the secondary use of primary clinical routine data possible. Digitalization decreases redundancies of data transmission by avoiding manual data input in, for example registers.
-
Nearly 80 years ago in the autumn of 1939 Gerhard Küntscher successfully stabilized a patient with the first intramedullary nailing surgery. As a result, the research interest in osteosynthesis significantly increased. ⋯ The study showed the eminent impact that the close cooperation between Küntscher and Pohl had on the success of the intramedullary nail. The synergy of Küntscher's medical expertise and Pohl's ingenuity found solutions for problems other people could not solve. World War II interrupted this close interaction but at the same time helped to disseminate the technique globally which in turn contributed to the advancement of the idea.
-
The development of emphysema after intramedullary nailing can represent an easily manageable complication but in the differential diagnostics it could, however, be a life-threatening infection with Clostridium perfringens. This is a report about the case of an extensive subcutaneous and retroperitoneal emphysema, which developed after intramedullary nailing of a pertrochanteric femoral fracture and where such an infection was suspected.