Zeitschrift für Orthopädie und Unfallchirurgie
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For a very precise analysis of all injured bicyclists in Germany it would be important to have definitions for "severely injured", "seriously injured" and "critically injured". By this, e.g., two-thirds of surgically treated bicyclists who are not registered by the police could become available for a general analysis. Elderly bicyclists (> 60 years) are a minority (10 %) but represent a majority (50 %) of all fatalities. ⋯ Hanging lamps reduce with 35 % significantly bicycle accidents for children, traffic education for children and special trainings for elderly bicyclists are also recommended as prevention tools. As long as helmet use for bicyclists in Germany rates only 9 % on average and legislative orders for using a helmet will not be in force in the near future, coming up campaigns seem to be necessary to be promoted by the Deutscher Verkehrssicherheitsrat as, e.g., "Helmets are cool". Also, spots in TV should be broadcasted like "The 7th sense" or "Traffic compass", which were warning car drivers many years ago of moments of danger but now they could be used to warn bicyclists of life-threatening situations in traffic.
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Recognised methods for the treatment of spondylodiscitis in correspondence to the immobilisation are systemic antibiotic therapy. However, the available data for recommendations of specific antibiotic therapy are very heterogeneous. The aim of this study was to focus on the adjuvant antibiotic therapy in surgical treated cases of spondylodiscitis and to reach a guideline regarding its application in patients' spondylodiscitis. ⋯ In addition, suitable antibiotic therapy should be administered in correspondence to a culture and sensitivity testing and should be maintained for at least 12 weeks, even when a reduction of inflammatory markers by 50 % after 2 weeks has already been achieved. It is noteworthy to point out the high probability of coexistence of spondylodiscitis with diabetes mellitus, so that spondylodiscitis should always be considered in diabetic patients with back pain and increased levels of inflammatory markers. A significant reduction in the very long time until reaching a definitive diagnosis should be achieved.
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The German Cartilage Registry (KnorpelRegister DGOU) has been introduced in October 2013 and aims on the evaluation of patients who underwent cartilage repair for symptomatic cartilage defects. It represents a nation-wide cohort study which has been introduced by the working group "Tissue Regeneration" of the Germany Society of Orthopaedic Surgery and Traumatology and is technically based upon a web-based remote data entry (RDE) system. The present article describes first experiences with the registry including patient and treatment characteristics. ⋯ This analysis also provides new information on subgroups of patients that have not yet been recorded in the scientific literature. This will be part of the first analysis of clinical treatment data. An expansion of the KnorpelRegister DGOU to patients with cartilage defects of the ankle and hip joints is already decided upon and initialised.
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The treatment of multiple injured patients is a highly demanding process concerning the amount and speed of gathered information. Physicians have to evaluate the situation and begin a treatment immediately. There may be influencing variables in the pre-clinical treatment which are correlated to the specialisation of the first treating physician and influencing the outcome of the patient. The aim of this study was to examine the influence of the specialisation of the first treating physician on the pre-clinical treatment and the resulting outcome. ⋯ Multiply injured patients get a different treatment from the different specialised physicians in the pre-clinical phase. There were differences in the pre-clinical applied volume and haemoglobin value. Rescue time and intubation rate as well as outcome parameters were not statistically different. The case fatality rate in total was not significantly different between the 3 groups.