Der Unfallchirurg
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Pelvic arterial bleeding constitutes a potentially life-threatening event, which can be difficult to control with surgical procedures alone, especially in the case of ligamentous ruptures and a subsequently increased pelvic volume. ⋯ An interdisciplinary approach should be used in the indications for AE; which can be used as definitive treatment as well as in combination with surgical procedures. To improve the clinical outcome any delay between establishing the indications and the start of the intervention must be avoided.
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Avulsion injuries of the gluteus medius and gluteus minimus muscles represent a diagnostic and therapeutic challenge. Such injuries are rarely to be expected in high-energy trauma. Degenerative damage or iatrogenic injuries in the context of hip surgery are more frequently identified as the cause. ⋯ Therapeutically, a stepwise approach is indicated according to the extent of rupture and quality of the gluteal tendon and muscle tissues. Specific conservative training regimens, mini-open/endoscopic anatomic reconstruction techniques in cases of gluteal muscle integrity and muscle transfer techniques as salvage option with chronic mass ruptures are available. The common goal is the restoration of everyday occupational and private activities to regain the quality of life.
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Injuries to the hamstring muscles and tendon complex are among the most frequent muscular injuries with proximal hamstring tendon avulsion being a particularly severe form. The surgical treatment of these injuries is superior to conservative management with respect to patient satisfaction, recovery of muscle strength and function as well as return to sport rates. It is therefore the method of choice. ⋯ All available anchors systems provide good to excellent clinical outcomes and an explicit advantage for one anchor system could so far not be shown.
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Injuries to the hamstring muscles and tendon complex are among the most frequent muscular injuries with proximal hamstring tendon avulsion being a particularly severe form. The surgical treatment of these injuries is superior to conservative management with respect to patient satisfaction, recovery of muscle strength and function as well as return to sport rates. It is therefore the method of choice. ⋯ All available anchors systems provide good to excellent clinical outcomes and an explicit advantage for one anchor system could so far not be shown.