Der Unfallchirurg
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In addition to the advantages for patients and physicians, the progression of digitalization will also have economic implications for healthcare systems in toto worldwide. The integration of digital innovations enables healthcare institutions to transform their current activities and processes and to create a new form of patient care. ⋯ Economic redistribution due to digitalization of medicine will become increasingly apparent in the future. Ethical considerations as well as data protection will be important topics. At the same time investments and digital innovations must be sponsored by the government and industry. Scientific studies are necessary to secure the evidence of new methods for practice in orthopedics and trauma surgery.
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Numerous processes are involved in the orthopedic and trauma surgery operating room (OR). Technical progress, particularly in the area of digitalization, is increasingly changing routine surgical procedures. ⋯ Digital technology in the OR can improve treatment quality, patient and staff safety and cost efficiency; however, the networking of devices, implementation of innovations in existing structures and the sometimes high acquisition costs are still limiting factors.
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The increasing digitalization of social life opens up new possibilities for modern health care. This article describes innovative application possibilities that could help to sustainably improve the treatment of severe injuries in the future with the help of methods such as big data, artificial intelligence, intelligence augmentation, and machine learning. ⋯ In this context, it is a good example of the problem areas such as data transfer, interoperability, standardization of data sets, parameter definitions, and ensuring data protection, which still represent major challenges for the digitization of trauma care. In addition to the further development of new analysis methods, solutions must also continue to be sought to the question of how best to intelligently link the relevant data from the various data sources.
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Various diseases or groups of diseases can trigger bone marrow edema (BME). The task of the appraiser is to work out the role of a diagnosed BME in the context of the causality based on liability; however, the inconsistent ICD 10 coding of the BME complex also poses a problem, especially for medically untrained insurance clerks. The coding of the BME as a fracture provided by the coding guidelines poses a problem when assessing reserves for damage settlement. Based on the etiology of BME an algorithm is presented that should make it easier for the expert as well as for the insurance clerk in the case of liability and also for the private accident insurance to classify the diagnosis of BME in the case.
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Case Reports
[U-shaped fractures of the sacrum-what is the correct treatment? : A presentation of three cases].
Sacral U‑shaped fractures are rare but severe injuries. Due to the resulting spinopelvic dissociation they are highly unstable. Reduction and stabilization are usually required and decompression may be necessary due to frequent concomitant neurological injuries. In the literature there is no consensus with respect to the selection of the surgical approach. ⋯ Surgical treatment is necessary, with minimally invasive techniques offering advantages over open surgery. A distinction must be made between lumbopelvic fixation and posterior pelvic ring fixation. Multiple aspects must be taken into consideration of the indications when selecting the surgical technique.