Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
Historical Article[Why doesn't Aphrodite have a nose?].
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Olecranon and prepatellar bursitis have a prevalence of 3 in 1000 patients; the predominant etiology is a traumatic lesion with or without inoculation of infectious material, mainly during professional or leisure activities. Separation into septic and non-septic bursitis is possible in most cases according to clinical parameters and characteristics of the contents of the affected bursa. The therapy of acute and chronic bursitis is guided mainly by the nature of the aspirate retrieved from the bursa: a serous content justifies conservative treatment with compression, immobilization, antiphlogistic medication, and (in selected cases) the instillation of corticosteroids; a purulent aspirate necessitates bursotomy with incision and drainage, or bursectomy. Only in selected cases is a conservative trial with antibiotics, immobilization, and antiphlogistic medications justified.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
Review[Evaluation and quality management in multiple trauma care].
In total quality management of polytraumatised patients, it is necessary to use analysis of structure, process and outcome quality to search for problem areas and improvement possibilities. The structure includes the attributes of material and human resources. ⋯ To prove the outcome quality, an internal and external judgement is possible. Our own results show that quality assessment, concerning the process as well as the internal and external quality outcome, brings a significant improvement to the care of polytrauma patients.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
Review[Treatment of increased intracranial pressure in craniocerebral trauma].
The management of trauma patients with increased intracranial pressure is based on maintaining a normal "milieu interne", i.e. avoiding posttraumatic hypoxia and hypotension and applying specific treatment modalities, if indicated. If there are clinical signs of increased intracranial pressure or signs of cerebral edema in the CT scan, monitoring of intracranial pressure is indicated. ICP above 20 mmHg should be treated and the cerebral perfusion pressure should be maintained between 60 and 70 mmHg. Accepted treatment modalities of increased ICP are: 1) analgosedation, 2) head elevation, 3) hyperventilation, 4) osmotherapy, 5) barbiturate therapy, and 6) THAM (tris puffer).
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Distal tibial fracture--an indication for osteosynthesis with the unreamed intramedullary nail?].
In a prospective study, 50 fractures of the distal fifth of the tibia with additional involvement of the ankle joint in 18 patients were stabilized by unreamed nailing. In all, 90% of all fractures healed uneventfully without further surgical intervention after unreamed nailing, the highest ratio of complications (22%) being seen in all patients with distal fractures of the fibula without additional plating (of the fibula). Tibial fractures close to the ankle joint can be managed by unreamed nailing; distal fractures of the fibula should be additionally stabilized by fibular plating.