Der Unfallchirurg
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Internal fracture fixation represents a widespread concept for the treatment of fractures. As the number of implants increases, person tracking may be possible. In spring 2010 near Rostock (Germany), human remains including a stainless steel nail were found. ⋯ Equipped with the actual patient's identity, out of academic interest a survey of clinical documents such as discharge letters and operative reports was performed, but was inconclusive. Although technically feasible, tracking the patient in this case based on the implant product number itself was unsuccessful. In this case report, the feasibility, validity and efficiency of this option are presented and discussed.
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Femoral shaft fractures in children are a common injury. Operative treatment is recommended for children above 3 years of age. The question of this investigation was the current clinical standard for the treatment of femoral shaft fractures in children under 3 years old. ⋯ Obviously, operative treatment of femoral shaft fractures in children younger than 3 years is routinely used despite the fact that there is no evidential basis for this approach. There are good arguments for and against operative and conservative forms of treatment. Indications for operative treatment include multiple trauma, open fractures, body weight over 20 kg, child already free walking and lack of stable fixation with conservative treatment. To achieve more evidence for the existing recommendation of the American Academy of Orthopaedic Surgeons (AAOS) and the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF, Working Group of the Scientific Medical Specialist Societies), further investigations are needed.
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The management of patients from administrative admission through the orthopedic-surgical treatment to completion of the billing is complex. Additional challenges originate from the necessity to treat patients in both outpatient and inpatient departments and in more than one medical sector. ⋯ The model of a medical controlling department as a service center with effective competence in the management of service and cost, functions as a successful solution to the problem. Central elements of a successful medical economical case management are a well-defined assignment of tasks and definitions of intersections, the integration of health professionals and administrative employees, the utilization of software for process control and the implementation of inlier controlling.