Der Orthopäde
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Review
[Whiplash-associated disorders: a challenge for the expert in compensation claims and litigation].
In the literature, the association between chronic complaints of the cervical spine and sustained"whiplash trauma" is a matter of controversy. Whiplash trauma is identified as contusion, compression, and/or sprain without definite imaging proof of injury to the bone, disk, or ligaments. ⋯ The data from the literature dealing with this topic are contradictory and deficient. In this article, based on the present available data from the literature, we critically examine the causality between spinal whiplash trauma and possible permanent chronic complaints in order to support the process of decision making in cases of litigation and controversial compensation claims.
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Peroneal nerve palsy is a rare but distressing complication of total knee arthroplasty (TKA). After introducing a standardised intraoperative and postoperative epidural anaesthesia protocol under otherwise unchanged perioperative management, we noted a sudden cumulation of peroneal nerve palsies after TKA. ⋯ To prevent a peroneal lesion after TKA while using continuous epidural anaesthesia, we strongly recommend limiting the pneumatic tourniquet pressure to 320 mmHg while ensuring pressure-free positioning of the operated leg.
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Perioperative hemorrhage after total hip arthroplasty is a rare but life-threatening complication. The aim of the current retrospective analysis of five cases was to answer the question of whether bleeding can be controlled by angiography and catheter embolization. A retrospective analysis of five patients with perioperative bleeding complications after hip surgery was done. ⋯ One patient died from multiorgan failure after control of peracute hemorrhage. Subacute hemorrhage after hip surgery can be controlled by angiography. In peracute situations clamping of the external iliac artery is an alternative procedure.
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Chronic low back pain as a leading symptom of a somatoform pain disorder is a remnant diagnostic category for many physicians, general practitioners and orthopaedic surgeons. Patients with somatoform pain disorder (ICD-10: F45.4) are often not diagnosed until after several years and multiple diagnostic procedures, in some cases after iatrogenic impairment. A more precise knowledge of the disorder can prevent chronification. This article outlines the clinical features, diagnostic procedure and differential diagnosis in somatoform pain patients and presents current psychotherapeutic approaches.