Der Unfallchirurg
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Review
[Exoskeletons for rehabilitation of patients with spinal cord injuries : Options and limitations].
Mobile exoskeletons are increasingly being applied in the course of rehabilitation and provision of medical aids to patients with spinal cord injuries. ⋯ Although exoskeletons are not yet an established tool in the treatment of spinal cord injuries, the systems will play a more important role in rehabilitation of patients with spinal cord injuries in the future. Neurologically controlled exoskeletons show beneficial effects in the treatment of acute and chronic spinal cord injuries and might therefore evolve to be a useful alternative to conventional locomotion training.
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The rehabilitation of patients with diseases of the musculoskeletal system and injuries has a high priority in Germany. The costs are essentially borne by the statutory health insurance companies (reha before nursing), pension schemes (reha before pension) and German statutory accident insurance. ⋯ Maintaining the ability to work and independence results in an increase in the need for rehabilitation; however, this also necessitates an adaptation of processes and structures in order to be able to meet these challenges.
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Osteoporosis-associated fractures represent a risk factor for developing further fragility fractures. Therefore, guideline-oriented osteoporosis intervention is of utmost importance during inpatient fracture treatment. ⋯ The majority of elderly patients with fractures also suffer from osteoporosis, independent of gender. Even nowadays, osteoporosis is predominantly not diagnosed until the incidence of a fracture. Therefore, the trauma surgeon is in a key position to initiate diagnosis and treatment of osteoporosis.
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Anatomical reconstruction of acetabulum fractures and rigid osteosynthesis are required to achieve good postoperative results. In the 7(th) decade of life changes of bone quality impair stability of fixation devices in bone. ⋯ Primary implantation with alloarthroplasty of the hip joint in case of a complex fracture of the acetabulum can be recommended for elderly patients if an anatomic or good reconstruction of the hip joint cannot be achieved.
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A 12-year-old boy suffered a rare occurrence of a traumatic spondylolisthesis (L5/S1) without neurological alterations after being partially buried underneath a collapsing brick wall. Additionally he sustained a third degree open fracture of the left distal fibula and epiphysiolysis of the left distal tibia. A closed reduction and percutanous dorsal instrumentation L5/S1 as well as an open reduction and osteosynthesis of the tibia and fibula were performed. After 6 months the instrumentation was completely removed and an unrestrained range of motion of the lumbar spine and the upper ankle joint was regained.