Der Unfallchirurg
-
Case Reports
[Application of transarticular C1/2 screws connected with C1 lateral mass screws in a rod-screw system].
Fractures of the second cervical vertebra with involvement of the odontoid process can mostly be treated conservatively by immobilization. In the case of high-grade unstable fractures and pseudarthrosis dorsal C1/2 spondylodesis should be considered. ⋯ During a follow-up of 36 months there was no screw loosening or dislocation. The presented alternative technique of dorsal C1/2 spondylodesis is a safe and effective method for stabilizing the atlantoaxial movement segment in cases of posttraumatic instability.
-
The main injury mechanism of rare pelvic girdle injuries in children is high-energy trauma with a high rate of accompanying injuries and a mortality up to 6%. Anatomical features often result in complex pelvic trauma. Emergency treatment is based on established standards in adults. ⋯ Most acetabular injuries can be treated conservatively. Considerable displacement or additional intra-articular injuries necessitate open reduction and internal fixation. Frequent follow-up examinations up to the end of the growth phase avoid posttraumatic acetabular dysplasia being overlooked.
-
The future progressive aspiration of evidence-based medicine makes it necessary to carry out a comprehensive documentation of functional treatment after trauma surgery. Especially the subjective, patient-centered satisfaction with treatment results will be the focus of attention. ⋯ Additionally, modern technical options have the potential to evaluate specific joint function even better. Parameters, such as range of motion can soon be measured by the patient using the widely spread smartphone technology.
-
Patient reported outcome measures (PROM) are considered a good method of measuring the results of treatment outcomes with the aim of improving the functional, cognitive and mental state of patients and the quality of life during and after treatment. The publication of these results serves the patient's interest in finding the best provider for a treatment. The existing interest of many service providers for the integration of electronic PROM into everyday clinical practice is often faced by barriers due to financial, personnel and technical factors. This must be eliminated in the interest of patient information in order to facilitate the rapid introduction of this patient-centered treatment outcome measurement into as many hospitals and specialist departments as possible.
-
The development of the numbers of cases involved in accident insurance consultant procedures (DAV), injury type procedures (VAV) and severe injury type procedures (SAV) after the introduction of the new injury type catalogue from 1 July 2018 is presented. Furthermore, possible alterations to organizational aspects, such as operating room times and average duration of hospitalization are presented. A first critical assessment of the modifications in the new catalogue was carried out, particularly with reference to the newly introduced section on complications (section 11).