Der Unfallchirurg
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Techniques for operative treatment of supra- and intercondylar fractures have changed in recent years. Some of these changes have come about in reduction techniques and implant selection. ⋯ These techniques result in better operative visualization and management of intraarticular comminution, safer fracture healing and better functional outcome. New strategies and techniques for the avoidance of axial malalignment, rotational deformities and leg length discrepancies are described.
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Severely injured patients, in particular, benefit from initiation of endotracheal intubation and controlled ventilation before hospital admission. The most frequent and most serious mishap of this emergency procedure is inadvertent esophageal tube placement. A reliable and simple determination of proper tube placement involves capnometry, the measurement of carbon dioxide concentration during the respiratory cycle. ⋯ We conclude that the STAT CAP reliably detects tracheal placement of endotracheal tube in non-arrested patients. In the arrested patient, interpretation of CO2 nonappearance requires caution. In addition to the traditional clinical signs, semi-quantitative capnometry is a meaningful supplement to verify tracheal tube placement in the prehospital management of trauma patients.