Der Unfallchirurg
-
Fractures of the ankle joint belong to the most often occurring injuries. The aftercare in plaster lasts several weeks and is problematic especially in elderly patients. ⋯ This treatment concept can be recommended because patient comfort is increased and the risk of immobilization is excluded.
-
According to international and national studies and clinical guidelines, patients with medial hip neck fracture should receive surgery as soon as medically reasonable after hospitalization, preferably within 48 h. Analysis of the German quality registry data of 2006 showed, however, that in 13 out of the 16 federal states less than 85% of patients were operated on within 48. Delayed surgery was found especially during the weekend. ⋯ Patients with medial hip neck fracture should receive operative treatment without delay, if no medical contra-indications for immediate surgery. In particular appropriate organizational measures should be taken to ensure an early surgical treatment even during weekends.
-
Elastically stable intramedullary nailing is a safe surgical procedure used to treat mid-shaft clavicular fractures of types A and B according to the Orthopaedic Trauma Association (OTA) classification. In the case reported intramedullary fixation with a Kirschner wire and an incorrectly performed surgical technique led to pseudoarthrosis (non-union). After revision surgery with an elastically stable titanium nail and a correct surgical technique, fracture healing was achieved.
-
Arthrodesis of the elbow joint (EA) is a rare salvage procedure which is disliked by both surgeons and patients. The aim of this study was to analyze the indications, the operation techniques and the outcome of EA in patients treated at our clinic. Between January 1997 and December 2005 a total of 20 patients with a mean age of 55 years (range 27-85 years) were treated with EA at our clinic. ⋯ The patients achieved 56 points in the Morrey score, 38.29 points in the DASH (disabilities of the arm, shoulder and hand) score and 80 points in the Constant-Murley score. The indication of EA depends on several factors, therefore it is essential to take the patients' functional requirements into consideration and the best arthrodesis angle should be validated pre-operatively. In these cases the patients can regain good grip strength and a high level of stability within defined functional limitations.
-
A change is emerging in the hospital landscape due to health political measures, which in consequence also influences the prehospital medical care in emergencies. The main focus of this study was to gather information about emergency medical care after traffic accidents on the basis of data from Bavarian emergency medical services. In 2006 there were 14,261 traffic accidents in Bavaria where an emergency doctor attended the scene. ⋯ In order to assure sufficient trauma care for seriously injured persons a continuous 24 h availability of emergency trauma facilities is necessary. For this purpose it is necessary to establish regional trauma networks between receiving hospitals as well as air rescue services at night time. Furthermore, a cost-efficient compensation of the structural, personnel and logistic expenses for the treatment of the severely injured has to be assured.