Der Orthopäde
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Peroneal tendon injuries are recognized with increasing frequency to be the cause of persistent lateral ankle symptoms. The lesions are frequently found in patients with concomitant anatomical or biomechanical abnormalities, such as chronic lateral instability or cavovarus deformity. The most common mechanism involves a sudden inversion injury or repetitive activities. ⋯ Many of these conditions respond to conservative therapy. However, when left untreated, the disorders can lead to persistent lateral ankle pain and substantial functional deficits. This is particularly true in patients with an underlying anatomical predisposition to lesions.
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We report on a case of toxic shock syndrome (TSS) in a 17-year-old healthy patient after surgery of the right knee joint following a traumatic patella luxation. Two days after the intervention the patient showed fever, diarrhea, cough, and a diffuse erythroderma without any signs of postsurgical wound infection. ⋯ As result of treatment, full recovery was achieved. TSS can occur in its full picture in a postoperative wound infection in a young healthy patient without showing local signs of infection at the operation site.
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The goal of the study was to evaluate the acceptance of a web-based picture archiving and communication system (PACS) by orthopedic surgeons 1 year after implementation. ⋯ There is an over all acceptance of PACS by physicians outside the radiology department. The availability of images was not only facilitated it was faster as well. However, the quality of monitors in the operating theater should be improved. To achieve sustained success of PACS consistent training on PACS and its features is necessary. Conventional radiograms were often missed at the ward rounds.
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There is clinical evidence that a standardized management of trauma patients in the emergency room improves outcome. ATLS is a training course that teaches a systematic approach to the trauma patient in the emergency room. The aims are a rapid and accurate assessment of the patient's physiologic status, treatment according to priorities, and making decisions on whether the local resources are sufficient for adequate definitive treatment of the patient or if transfer to a trauma center is necessary. ⋯ SOPs and training courses increase the process and result quality in the treatment of the trauma patient in the emergency room. These programs should be based on the special demands of the physiology of the trauma as well as the structural specifics of the hospital. ATLS does not equal an SOP but it qualifies as a standardized concept for management of trauma patients in the emergency room.