Der Unfallchirurg
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Review Case Reports
[Proximal avulsion of the tendon of the rectus femoris muscle : Case description and literature review].
Injuries of the thigh muscles are among the most common sports injuries. In soccer they represent nearly 30% of all injuries. The rectus femoris muscle in particular is often exposed to injuries due to its anatomical features. ⋯ After persistent complaints over 2 months operative treatment was performed by anchor refixation of the tendon. During the follow-up at 6 weeks postoperatively, there was a very good functional result with good mobility and only slightly reduced strength with early full load and movement. The anamnesis revealed no deficits in the side to side comparison 1.5 years after the trauma.
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Emergency exit and escape routes in public buildings, such as schools, hospitals and administrative offices are controlled by legal rules and regulations. Thereby escape from the building is very well organized in cases of internal threats (e.g. fire, active shooter and hostage situations). Complex buildings with numerous rooms are a special challenge to emergency and law enforcement personnel. Without additional means of orientation a targeted localization of the incident is not possible in many cases. ⋯ For targeted localization of an internal incident there only seem to be three German systems worldwide that enable an intuitive and immediate orientation and guidance within buildings. An increasing threat of worldwide terrorism and the fact that hospitals are seen as crucial infrastructures for attacks by terrorists make the implementation of guidance and orientation systems in hospitals urgently necessary. This is the first review dealing with this topic.
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In view of the increasing violence and aggression against medical personnel in healthcare facilities, there are considerations by the legislature to punish violent offenders in hospitals more severely. Hospital and emergency room staff are increasingly confronted by physically and psychologically violent patients or their relatives. Sometimes medical treatment in a hospital or emergency room is an exceptional physical or mental situation for many patients and their relatives. ⋯ Structural, organizational and personal measures as well as concepts for dealing with aggressive patients are the cornerstones of employee protection. Professional training courses on de-escalation, self-protection and self-defense can also contribute to the protection of employees and are gladly accepted by the staff. Even in the extreme case of a rampage situation, hospital deployment and alarm plans have to be developed and established.
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The routine use of patient reported outcome measurements (PROMs) can support the orientation of healthcare systems towards the value and usefulness for patients. The collation of patient reported experience measurements (PREMs) is suitable for bringing transparency to the patient orientation of healthcare processes and the experience gained. ⋯ By means of newly developed patient surveys per medical service area, they will be used as additional sources for the legally binding quality assurance. Although this gives more weight to the evaluation of the quality of treatment by patients, special features must be taken into account in the development and implementation for orthopedics and trauma surgery in order to avoid misinterpretation of the results and subsequent misguidance in the healthcare system.
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The future progressive aspiration of evidence-based medicine makes it necessary to carry out a comprehensive documentation of functional treatment after trauma surgery. Especially the subjective, patient-centered satisfaction with treatment results will be the focus of attention. ⋯ Additionally, modern technical options have the potential to evaluate specific joint function even better. Parameters, such as range of motion can soon be measured by the patient using the widely spread smartphone technology.