Zeitschrift für Orthopädie und Unfallchirurgie
-
Statistics of the arbitration office of the North German Medical Boards show that 30% of all panel proceedings confirm medical malpractices. In panel proceedings concerning the treatment of fractures in children, the percentage rose to 60% with significant differences in the individual fracture localisations. ⋯ From a traumatological point of view, the elbow region of a child constitutes a distinct problem zone due to the rarity and diversity of the fractures and dislocations in this area. Relevant experiences in diagnostics and therapy of injuries in this region cannot always be expected. Every doctor who happens to come across a case in which a child suffers from such injuries should be responsible for the timely referral to a treatment facility that has the relevant experience to treat such cases.
-
Clinical Trial
[Deep infection after treatment of proximal femur fractures--results and assessment of life quality].
Proximal femur fractures are the second most prevalent fractures in patients older than 65 years. Despite large improvements in implant design and surgical technique, complications in fracture healing are very common. Deep infection after osteosynthetic treatment is considered to be one of the major complications with a high rate of mortality. Little is known about the adequate treatment and results in patients with infection of proximal femur fractures. The aim of this study was to evaluate the different treatment options for eradication of infection as well as to analyse the clinical outcome and quality of life. ⋯ Deep infection after osteosynthetic treatment of proximal femur fractures is a severe complication. Radical surgical treatment and adequate local and systemic antibiotic application can help clear an infection. Quality of life is significantly reduced. Treatment should therefore be adapted to the individual patient's condition.
-
Low follow-up rates are a limitation of many long-term studies. Studies on patients after surgical treatment of adolescent idiopathic scoliosis (AIS) rarely have follow-up rates that reach 80% after 5 years or 70% after 10 years. While there is general consensus that a high patient drop-out rate will decrease the accuracy of a study, little is known about the characteristics of those patients who have dropped out. The purpose of the present study was to identify patients who were lost to follow-up after surgical correction of AIS and to compare their clinical characteristics to those of patients who were available for follow-up. ⋯ We found significant clinical differences for patients who are lost to follow-up when compared to patients who are available for follow-up. While we are aware of the difficulties in obtaining high follow-up rates for a clinical study, care should be taken in analysing studies with low follow-up rates because results may be skewed.