Der Unfallchirurg
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[Using the international classification of functioning, disability and health (ICF) in trauma care].
The International Classification of Functioning, Disability and Health (ICF) provides a comprehensive and structured treatment management and outcome evaluation in trauma care based on specific ICF core sets and the ICF-based Rehab-CYCLE. The Rehab-CYCLE allows the problem-based assessment of functioning in a multi-professional team under physician-guidance and the definition of long-term, intervention and cycle goals. ⋯ Together with the patient additional intervention goals are identified, intervention principals adapted and the further treatment setting planned based on a multi-professional outcome evaluation. The standardized documentation is reported multi-professionally on the ICF assessment sheet which reflects the patient perspective with all their problems and needs as well as the perspective of the treatment team.
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The number of elderly and old patients with fractures is steadily increasing. Identification of relevant functional deficits and comorbidities is crucial for an efficient treatment strategy and outcome assessment in this patient group. ⋯ A combination of disease and body region-specific scores with generic scores seems to be reasonable. It can also be sensible to include instruments for health economic analyses.
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Road traffic crashes pose a major threat to individuals and national health systems. Developing countries account for 48% of motorized vehicles, but for 91% of the 1.3 million fatalities per annum. ⋯ This article reviews current prognoses of deaths and disabilities, the characteristics of crashes in low and middle income countries and evidence-based road safety interventions. This article is considered a wake-up call for trauma, orthopaedic, and emergency surgeons in high-income countries to join the global community in fighting the neglected yet potentially curable epidemic named road traffic injuries.
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The diagnostic value of X-rays, computed tomography (CT) and magnetic resonance imaging (MRI) for proximal humeral fractures (PHF) was compared in order to test the hypothesis that MRI gives relevant additional information. ⋯ X-ray imaging is the basis method for the diagnosis of PHF but needs further multiplanar imaging to demonstrate complete fracture patterns. Imaging of fractures is equally good for MRI and CT and MRI also provides additional therapy-relevant information about the rotator cuff and head perfusion.