Der Unfallchirurg
-
Fractures of the talus are uncommon, but they present difficult treatment challenges. The classifications of fractures are based on conventional X-rays, but the CT scan is necessary for treatment decisions. Open fractures, displaced fracture dislocations, or extrusion of the talus must be reduced and stabilized as an emergency procedure. ⋯ The outcome is related to the degree of fracture displacement and the soft tissue lesion but may be poor due to inadequate treatment. Talus malunion, nonunion, and secondary deformity should be corrected early with preservation of the joints whenever possible. Arthrodeses should be restricted to the affected joints.
-
Blindness can be the consequence of trauma, which until now had only been described in cases involving direct facial or cranial trauma. In our case a 53-year-old street worker became irreversibly blind after a thoracoabdominal compression trauma. The investigations performed were inconclusive regarding the cause of blindness. ⋯ Fat emboli syndrome or posterior ischemic optic neuropathy could be causes, but unrealistic for this case. It still comes into question why such a mechanism has not been seen in other blast injury cases. In the end, the additional factor that resulted here in complete irreversible blindness remains unclear.
-
It is still unknown exactly how many persons sustain a severe injury (ISS > or =16) in Germany each year. Considering the growing restrictions and the introduction of DRGs, it was necessary to acquire data about this rather resource-intensive aspect of trauma care. The aim of this study was therefore to assess the incidence of severe trauma within a defined population. ⋯ Extrapolated, up to 40,000 persons sustain a severe injury each year in Germany. For the first time, this study has provided data on the incidence of major trauma in Germany. Based on the acquired data and a previous cost analysis, hospital treatment costs for severely injured patients amount to up to 2 billion Euros per year in Germany.
-
Case Reports
[Fracture of the medial femoral condyle as a complication of retrograde femoral nail removal].
A 26-year-old female patient with a femoral shaft fracture underwent retrograde femoral nailing. Nail removal was performed 2 years later, after fracture healing. An intraoperative fracture of the medial condyle of the femur occurred. ⋯ After 6 weeks of fractional weight bearing, the patient proceeded up to full weight bearing without complication. The case demonstrates that the removal of retrograde femoral nails is not without complications. The decision to undertake implant removal should be made carefully.