Der Unfallchirurg
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Non-union represents a severe complication and a major socioeconomic challenge in orthopedics and trauma surgery. Timely and reliable diagnostics are obligatory to be able to carry out the treatment of non-unions in a patient-specific and efficient manner. ⋯ It can display the microperfusion inside the non-union gap in real time and provide valuable information for exclusion of an infection or on the healing progress after revision surgery. An establishment of this diagnostic modality in routine orthopedic trauma surgery contributes to optimization of the treatment of non-unions.
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In 2020 a total of 126 patients attended the practice with distortion trauma of the ankle. Based on a thorough clinical and ultrasound examination 25 ligamentous injuries of the anterior talofibular ligament (ATFL, 9.8%), 8 osseous ligament avulsions (6.3%), 7 injuries of the lateral calcaneocuboid ligament (CC ligament, 5.6%), 5 lesions of the calcaneofibular ligament (CFL) each combined with ATFL injuries (3.9%) and 1 syndesmosis injury (0.6%) were recorded. This didactic article presents a comprehensible ultrasound examination course in an instructive manner from the clinical practice. ⋯ The talofibular advance can be measured on the monitor. Instability of the anterior syndesmosis can be visually demonstrated on the monitor using the sonographic Frick test. A final ultrasound control on the monitor confirms the structural healing and the re-establishment of ligamentous stability.
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The journal Der Unfallchirurg and the German Society for Trauma Surgery (DGU) are connected by a colorful story, which reaches a climax in a mutual anniversary year in 2022. Der Unfallchirurg, initially named the Monthly Journal for Trauma Medicine (Monatsschrift für Unfallheilkunde) had already endured 125 years as the specialist journal of the DGU in 2019; however, in 1944 in the 51st year the publication came to a halt due to the upheaval and serious consequences of the Second World War and only reappeared in 1949 with the 52nd year. In its 100-year history the DGU passed through 4 temporally definable phases with respect to content, politics and personnel, to which must be added its preliminary phase as the Division of Trauma Medicine (Abtheilung für Unfallheilkunde) within the Society of German Natural Scientists and Physicians (GDNÄ). In the synopsis on the history of the specialist journal, this article analyzes the more than 125-year development of the DGU.
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Spondylodiscitis and postoperative wound infections are the most frequent infectious diseases of the thoracic and lumbar spine. Every spinal surgeon will come into contact with such patients during his or her career. Knowledge particularly of the diagnostics, conservative and surgical treatment as well as microbiological considerations of antibiotic treatment are therefore of particular importance and are explained in this article.
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Joint empyema, also known as septic arthritis, is a severe disease associated with considerable morbidity and mortality. Failing to initiate immediate treatment can result in irreversible joint destruction within a short time. The knee joint is most frequently involved, followed by the shoulder and hip joints. ⋯ An arthrotomy must be carried out only rarely. A pre-emptive antibiotic treatment is initially administered and is later adjusted according to the resistogram. This article gives an overview on the pathophysiology, diagnostics and general management of joint empyema.