Der Unfallchirurg
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Case Reports
[Atlanto-axial instability presenting a rare complication in fibrous dysplasia - a case report].
Fibrous dysplasia, in either monostotic or poliostotic form rarely involves the cervical spine. Most of these lesions remain asymptomatic and are incidental radiographic findings. ⋯ In addition, atlanto-axial instability causing clinical symptoms was detected. A dorsal stabilisation was performed using the DCS System.
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Review Case Reports
[Dorsal carpometacarpal dislocation of the fifth finger: discussion of diagnosis and therapy on two cases].
Dorsal dislocation of the fifth carpometacarpal joint after injury is rare. Only five cases are reported in the literature. We report on two cases of dorsal dislocation of the fifth carpometacarpal joint after injury and we give a review of related literature. ⋯ A reduction without following Kirschner wire fixation - even in those dislocations that were found to be stable after closed reduction - is not recommended because of the risk of persisting pain after heavy manual work. In our two cases an instability of the fifth carpometacarpal joint existed after closed reduction. After Kirschner wire fixation and cast immobilisation for 6 weeks both patients showed 3 months after operative therapy a full range of movement and a powerful grip without any pain in the fifth carpometacarpal joint.
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Multicenter Study Comparative Study
[The Trauma Registry of the German Society of Trauma Surgery as a basis for interclinical quality management. A multicenter study of the German Society of Trauma Surgery].
Based on the "Trauma Registry" of the German Society of Trauma Surgery, an interclinical quality management (QM) system was implemented. The principles of the QM system as well as the differences in the quality of outcome and treatment are presented. The analysis uses the data on 2,069 severely injured (ISS = 22 +/- 14) patients from 20 hospitals collected prospectively and anonymously between 2/93 and 12/97. ⋯ The hospitals participating in the Trauma Registry receive an annual analysis of their preclinical and acute clinical performance. Thus, every hospital can analyze and improve the quality of treatment based on reliable data that show which parts of the process have to be optimized. Furthermore, the data allow a comparison of the average and optimal results of the whole series.
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The case of a 25 year old male with a stab wound of common carotid artery and the internal jugular vein is reported. He was admitted in severe hemorrhagic shock and immediately treated successfully by arterial reconstruction by means of a venous patch. ⋯ A survey of the literature shows that the fast repair of the carotid artery is clearly to be given preference to ligature. First can be executed successfully in exceptional emergency cases also by non-carotid surgeons, if basic vascular-surgical techniques are controlled.