Der Unfallchirurg
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Comparative Study
[Constant Score and Neer Score. A comparison of score results and subjective patient satisfaction].
The Constant- and the Neer-Score are widely used to assess shoulder function after trauma or shoulder diseases. The objective of this study was to compare the correlation of score result with the patient subjective assessment. We hypothesized that there is a clinically relevant difference between the score result and the patient assessment, especially for highly selective patient groups. ⋯ The hypothesis of a clinically relevant difference between the subjective and the score-based assessment of shoulder function can be confirmed. Our results suggest that for clinical practice, statements and therapy strategies recommended in the literature, that are just based on score results might not be valid for all patient-groups (e.g. elderly patients).
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Comparative Study
[Repositioning femoral neck fracture in younger patients. Valgus or anatomic reposition?].
In a retrospective study, 51 patients with femoral neck fractures received open reduction and internal fixation. They were divided into two groups. Group A included all patients treated with anatomical reduction. ⋯ According to the Hip-Score of Merle d'Aubigné, the patients treated with anatomical reduction had a better functional outcome after 10 years. With respect to the results we recommend in younger patients (< 60 years) anatomical reduction in Pauwels I and Garden-II-fractures. Valgusreduction should be performed as well in Pauwels II and III as Garden-III-and-IV-fractures.
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We report on a 50-year-old female patient with bimalleolar fracture and subsequent posttraumatic arthrosis who was treated by minimally invasive nonresection tibiotalar compression arthrodesis using internal fixation and cancellous bone grafting. The advantages of this technique include minimal exposure of tissues, good control of the relationship between the tibia and the talus, and short hospital stay.
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The aim of this study was to quantify and compare the quality of life after multiple trauma for patients with and without posttraumatic cognitive achievement deficits. We examined 173 multiple trauma patients 2-6 years after their injury. The patients were asked to rate their quality of life according to the established measure scales Nottingham Health Profile, Spitzer Index, Everyday Life Questionnaire, to a visual analogue scale and to the new "revised Aachen Longterm Outcome Score" established in our hospital. ⋯ In spite of this, the craniocerebral trauma is no global predictor of posttraumatic quality of life. These results show that the quality of life after multiple trauma is not only influenced by approved predictors such as injury severity but also significantly by the presence of cognitive achievement deficits. The KMS seems to be an easy test to evaluate those cognitive deficits.
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The therapy of acromioclavicular dislocations remains controversial. In particular, for injuries classified as Rockwood/Tossy Type III good results have been reported with different operative techniques as well as with conservative treatment. The objective of this study was to obtain data about the current treatment for Rockwood/Tossy III injuries in German trauma departments. ⋯ For more severe acromioclavicular injuries (Rockwood IV to VI) all clinics recommend an operative treatment. The operative techniques of choice for acromioclavicular injuries are K-wire fixation (37%) or a coraco-clavicular cerclage (32%). Of the latter, 73% use a resorbable material, while the remainder use wires.