Der Unfallchirurg
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Prospective, multicenter study addressing late results after operative treatment of acute thoracolumbar spinal injuries. ⋯ All treatment methods under study were appropriate for achieving comparable clinical and functional outcome. The internal fixator is superior in restoration of the spinal alignment. Best radiological outcome is achieved by combined stabilization. Merely by direct reconstruction of the anterior column the postoperative re-kyphosing is prevented and a gain in segmental angle is achieved.
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The most commonly injected materials in high-pressure injection injury to the hand include paint, automotive grease, solvents and diesel oil. High-pressure injection injuries are a frequently mismanaged problem, as they are often not recognized and treated early, which may result in a compromised function of the hand or even the amputation of a digit. ⋯ We present one case of high-pressure injection injury to the hand with the surfacer Caparol Accord. This report describes the principles of treatment and gives an overview of the literature about tissue injuries caused by components of different substances encountered in high-pressure injection injuries.
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The abdominal compartment syndrome (ACS) causes dysfunctions of various organs through a progressive unphysiologic increase of the intraabdominal pressure. While the primary ACS is a result of the underlying disease/injury, secondary ACS is caused by surgical interventions. In the severely injured patient intra- and/or retroperitoneal bleeding, edema of viscera due to systemic ischemia reperfusion injury following hemorrhagic shock, abdominal/pelvic packing, and laparotomy closure under tension lead to ACS. ⋯ The abdomen is left open. In most patients staged laparotomy is necessary. The final closure of the abdominal wall is carried out after the edema have resolved between day 6 and 8 after primary laparotomy.
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The Hannover Fracture Scale (HFS) was first introduced in 1983. As the treatment of open fractures has improved over the years, mainly due to new implants, the prognosis of open fractures has also changed. Thus a reevaluation of this limb salvage score has become necessary. ⋯ In conclusion the HFS'98 has become a reliable extremity salvage score with a fairly high positive predictive value of 0.99, which is applicable for all open long bone fractures regardless of their location.
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Previous studies have shown that clinical criteria can be used for determining the need for radiographs after spraining injuries of an ankle. Following the criteria of the "Ottawa Ankle Rules" (OAR) fractures could be ruled out with a sensitivity of 100% and a specificity of 50% while reducing radiographs by 28%. The aim of this study was to assess the "OAR" when applied in a German emergency department. ⋯ Sensitivity using the "OAR" was 94% and specificity 17%. We found that 15% less radiographs can be ordered applying the "OAR". The "OAR" have the ability to rule out significant fractures at the ankle and midfoot.