Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deutschen Plastischen Chirurgen
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Handchir Mikrochir Plast Chir · Feb 2014
Comparative Study[Radiological evaluation of k-wire osteosynthesis, in comparison to fixed-angle-plate osteosynthesis, in patients aged 80 years or more with distal radius fractures].
This study evaluates the short-term radiological outcome of K-wire osteosynthesis (KWO) in comparison to the fixed-angle-plate osteosynthesis (ORIF) on distal radius fractures in elderly patients (aged 80 years or more) with osteoporotic bones. ⋯ Although the importance of anatomic reconstruction of distal radius fractures is often debated in cases involving elderly patients, it is our considered opinion that, should an operative solution be chosen, one should consider the fixed-angle-plate osteosynthesis as the preferred operation method to prevent loss of reduction.
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Handchir Mikrochir Plast Chir · Feb 2014
[Impact of soft tissue injury on results after osteosynthesis of intraarticular fractures of the base of the middle phalanx of the finger].
The aim of this study was to investigate retrospectively if soft tissue injuries have an impact on the functional results of surgically treated intra-articular fractures of the base of the middle phalanx. ⋯ Soft tissue injuries have a negative impact on the functional results of surgical treated intra-articular fractures of the base of the middle phalanx. The influence on PIP-ROM might be less. Other factors might play a considerable role for PIP-ROM. With an adequate operative treatment most intra-articular middle phalanx fractures show good to excellent functional -results.
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Handchir Mikrochir Plast Chir · Feb 2014
Comparative StudyA comparison of outcomes after K-wire fixation of distal radius fractures with and without associated ulnar styloid fracture.
A prospective study was carried out to compare outcomes after K-wire fixation of distal radius fractures without and with associated ulnar styloid fracture, but without fixation of the styloid fracture. ⋯ An unrepaired ulnar styloid fracture does not affect the outcome of a distal radius fracture which is fixed by the "augmented" K-wire method.
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Handchir Mikrochir Plast Chir · Dec 2013
Review[Optimising care structures for severe hand trauma and replantation and chances of launching a national network].
Severe hand traumata have a significant impact on our health system and on insurance companies, respectively. It is estimated that 33% of all occupational injuries and 9% of all invalidity pensions are due to severe hand trauma. Unfortunately, these high numbers are not only due to the severity of the trauma but to organisational deficiencies. ⋯ This article comprises 2 parts. First, the state-of-the-art of acute severe hand trauma care is summarised and explained. Subsequently, the above-mentioned pilot project is described in every detail, including positive effects but also barriers that still have to be overcome.
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Handchir Mikrochir Plast Chir · Dec 2013
[Economic profit of different injuries in a centre for hand surgery - replantation vs. amputation].
The Institute for Reimbursements in Hospital (InEK) annually provides an updated DRG system to ensure the medical service providers with a cost-covering remunera-tion. However, the underlying cost data are often opaque and disclosure of the basis of calculation does not take place. On the basis of cost and revenue data from our clinic between 2010 and 2012, a profit statement for amputations and replantation of one or more fingers was employed and compared with the nationwide data of the calculation clinics. ⋯ In order not to create any monetary disincentives at the expense of quality of care of individual patients, a cost-covering patient care for all case groups mentioned above should be ensured. The general distrust in the InEK's data that results from such a discrepancy in the cost data can only be rebutted by increasing transparency and disclosure of the calculation basis.