Der Unfallchirurg
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The therapy of the midshaft clavicle fracture, in particular dislocated midshaft fractures, remains controversial. Therefore the objective of this study was to obtain data about the current treatment for midshaft clavicle fractures. ⋯ This survey demonstrates a high rate (26%) of German trauma hospitals operating clavicular midshaft fractures. This result is consistent with recently published studies showing better results for operative treatment of dislocated midshaft clavicular fractures compared to conservative therapy.
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Comment Letter
[Diagnostic strategy in occult fractures of the sacrum].
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Delegation of medical treatment and responsibility from doctors to nonphysicians are being advocated more and more by public health politicians. The opinion of the German Union of Orthopaedic and Trauma Surgery is outlined. ⋯ Delegating must not result in deterioration of patient care or destruction of the medical profession. Options and risks of delegation are discussed.
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This paper describes the successful nonoperative treatment of a 31-year-old male patient with thoracic and abdominal gunshot wounds. Once stabilized in the emergency department (ED), he was transferred to our general surgical department. On the first day after his admission, diagnostic peritoneal lavage (DPL) was performed, revealing a small amount of hemorrhagic fluid. ⋯ The patient began to tolerate oral feeding quite soon; he was discharged from the general surgical department in a good state of wellbeing on day 13 after admission. This case report supports the idea that nonoperative treatment with repeated physical examination can be an alternative to laparatomy for abdominal gunshot injuries. Further clinical and experimental trials should be performed to test how safe this alternative is.