Der Unfallchirurg
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Replantation using microsurgical techniques is a fairly new procedure in Vietnam. We reviewed and evaluated our 7-year results of thumb replantation in Vietnamese patients following traumatic thumb amputation. ⋯ Vascular thrombosis was the cause of all failures. Proper debridement, standardized microvascular techniques, timely detection of thrombosis formation, and reoperation using vein grafts play a decisive role in the final success.
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A questionnaire study was conducted to ask trauma surgery centers about thrombosis prophylaxis methods and strategies for the diagnosis and therapy of heparin-induced thrombocytopenia (HIT). ⋯ While pharmacological thrombosis prophylaxis following trauma surgery seems to be generally performed according to guidelines, diagnosis and treatment of HIT need to be systematized.
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The objective of our study is to evaluate the functional and subjective results following subtalar dislocations without any associated bone injuries and to examine whether the direction of dislocation has any effect on the post-traumatic results. ⋯ Despite the severity of the injury, the functional and subjective results of subtalar dislocations without any bone injuries are good. Generally, no early post-traumatic arthrosis occurs if there are no associated bone injuries. No differences were established between medial and lateral subtalar dislocations.
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Review
[Surviving multiple trauma--what comes next? The rehabilitation of seriously injured patients].
The survival chances of multiple trauma patients have improved continuously over the last decades. Therefore, not only the question of whether the patient survives a serious accident arises, but rather how the patient survives it. The after effects of trauma are seen not only physically, but also psychologically and socially. ⋯ The International Classification of Functioning, Disability and Health (ICF) provides a system to classify the after effects of trauma, which can be measured with the help of assessment instruments. Knowing which parameters can influence trauma after effects is essential for the planning, organization, and implementation of a rehabilitation programme following severe injury. The requirements of an optimal rehabilitation process place high demands on the rehabilitation facility and on the rehabilitation team, which ultimately can only be fulfilled by specialized facilities.