Der Unfallchirurg
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Case Reports
[Atypical subtrochanteric femur fracture under alendronate therapy in spite of an intramedullar implant].
There are a number of case reports about women undergoing long-term bisphosphonate therapy who have suffered an atypical subtrochanteric or femoral shaft fracture due to an inadequate trauma. The present case reports on a patient who underwent a subtrochanteric femur fracture with the inserted AO femur interlocking nail.
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We report on a soldier with a gunshot wound to the midfoot. The diaphysis of MT 5 was pounded to pieces and there was a fracture in the diaphysis of MT 4. After debridement and fixation of MT 4 and MT 5 to MT 2 and 3 via two Kirschner wires we conducted a second look procedure with reconstruction of MT 5 via a piece of iliac crest. After eight weeks of unloading and removal of the last wire we started to put successively heavier weight on the foot.
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Multicenter Study
[Interdisciplinary treatment in geriatric traumatology from the trauma surgeons' perspective : Results of a survey in Germany].
Many patients treated on trauma surgery wards are geriatric trauma patients. To improve treatment of these often multimorbid patients, various interdisciplinary treatment concepts have been established in Germany between trauma surgeons and geriatricians. ⋯ The results of this survey underline the impact and the positive experiences in orthogeriatric services. Solutions have to be found to address the emerging problem of capacity constraints.
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Posterior cruciate ligament (PCL) injuries are still often overlooked and treatment of a ruptured PCL is inherently different in comparison to anterior cruciate ligaments (ACL). Conservative treatment is the first-line therapy for acute isolated PCL injuries leading to good clinical and biomechanical results. ⋯ The same is true for high grade chronic PCL insufficiency. Meticulous classification of PCL injuries taking all stabilizing factors of the knee joint as well as the time from injury into account are essential for successful treatment of PCL injuries.