Wiener medizinische Wochenschrift
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Perforating injury allows the dispersion of environmental fungi and fungal spores together with miniscule foreign bodies into traumatized tissue where they can multiply and cause invasive infection. Acute invasive fungal infection after open fractures is uncommon. ⋯ Injury-related fungal infections of the immuncompromised host may lead to rapid invasion and generalization of the fungal infection. The following review will focus on the fungal infections after perforating injuries and open fractures including the invasive mycoses as a direct consequence of the trauma, post-traumatic fungal infections, tropical fungal infections (mycetoma), invasive fungal infections after near-drowning and nosocomial invasive fungal infections of the critically ill post-traumatic patient admitted to the intensive care unit.
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Wien Med Wochenschr · Jan 2007
[Surgical treatment of knee joint osteoarthritis in the middle-aged patient].
Several treatment options for the osteoarthritis of the knee in middle-aged patients to preserve the joint are available. Arthroscopic debridement is still a valuable treatment when detailed indications are considered. Microfracture procedure showed good and excellent results primarily at a follow-up of 2 years. ⋯ Up till now, there was no significant difference in outcomes comparing ACI and mosaicplasty or microfracture. Basic for successful surgical cartilage repair is a stable joint with a normal limb. An eventual additional osteotomy of the knee should be considered based on a standing, three-joint radiograph in every patient.
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The expectations of total joint replacement are constantly increasing: Freedom of pain and mobility used to be the primary goal, while nowadays it is longevity despite heavy loading and intense sporting activity. A preoperative sportive patient expects to be able to perform his favorite sporting activities like hiking, swimming and cycling, but also the more demanding skiing, tennis and jogging, for example, after surgery. The aim of this article is to illustrate what level of sporting activities can be performed by patients with total joint replacement. Are there differences between the pre- and postoperative levels? What are the risks for, and negative influences on, the prosthesis during intense sporting activity? What is the role of the physician? Finally, recommendations for sporting activities after total hip and knee replacement are given.