Zeitschrift für Orthopädie und Unfallchirurgie
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Only limited data are available concerning the effect of ventral thoracoscopic spondylodesis (VTS) on elderly patients and the medium-term outcome. ⋯ Also in older patients VTS seems to be an adequate treatment of traumatic burst fractures of the thoracolumbar spine. Perioperative pulmonary complications were easy to handle and had no effect on the clinical outcome. Postoperative radiographs showed only little loss of correction, in four cases iatrogenic damage of the cover-plate led to a distinct loss of correction. Careful and accurate preparation of the cover plates is therefore decisive.
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Clinical Trial
[Impact of surgical strategy on quality of life and radiological outcome in traumatic fractures of the thoracolumbar spine].
There are a variety of surgical strategies for the treatment of traumatic thoracolumbar vertebral fractures. There is still no proof for the superiority of any strategy concerning clinical or radiological outcomes. The aim of this study was the evaluation of residual complaints and correlation with radiological findings. ⋯ Overall outcomes of the four surgical strategies were comparable in our study concerning loss of correction and quality of life, respectively. The use of bone grafts, however, results in a high rate of non-fusion with a remarkable number of patients complaining about bone graft morbidity. Therefore we prefer the use of expandable titanium cages for anterior stabilisation if additional anterior stabilisation is necessary due to type of fracture or damage of adjacent discs. In any other cases, a limited approach by posterior instrumentation alone should be considered.
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The Young Forum of the German Society of Orthopedics and Traumatology is an interest group of young orthopedics and trauma surgeons in Germany. Besides dealing with topics of political interest, the group tries to arouse enthusiasm and interest for musculoskeletal surgery by means of new lectures and teaching methods. An example is the newly invented optional subject for students at the Medical School in Göttingen (Germany). ⋯ The course is divided in two main parts: a theoretical (16 hours) and a practical (10 hours) one. A good ratio of lectures, skills stations and workshops was on choice. This article explains the course in detail and shows a first evaluation result.
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Proximal femoral fractures are common in the elderly. Surgical and postoperative complications are of major importance in this population. Numerous factors affecting the treatment results could be identified so far. The effect of surgeons' experience in terms of educational status is not entirely clarified yet. The aim of the present study was to analyse the effect of surgeons' educational status on the outcome in proximal femoral fractures. Therefore treatment results were compared in terms of individual surgeons' experience. Furthermore, the surgical education concept of our department was evaluated. ⋯ Apart from cutting/suture time, surgeons' educational status had no statistically significant impact on the rate of complications, rate of blood transfusions, hospital mortality and in-hospital stay. It can be presumed that surgical education according to our educational concept has no negative effects on treatment quality of patients with proximal femoral fractures. Differences in cutting/suture time give a hint for the additional expense that is connected with surgical education.