Der Unfallchirurg
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From the perspective of trauma and orthopedic surgery interdisciplinary reconstructive surgery of the extremities encompasses different indications ranging from IIIB/Copen fractures with major segmental loss of bone and soft tissue, to arterial vessel in-jury necessitating vascular repair and to biological, plastic reconstructions following resections of musculoskeletal tumors. The interdisciplinary treatment concept including trauma-orthopedic surgery combined with vascular, plastic and neuro- as well as microsurgery has significantly decreased amputation rates and functional deficits thereby improving quality of life and long-term oncological outcome The multisdisciplinary management of both complex trauma and malignant bone/ soft tissue sarcoma of the extremity is an integral task of the surgical trauma or tumor center. Close interdisciplinary communication and expierence are the precondition for performance of a priority-adapted therapeutic strategy, low complication rates and improvement of overall prognosis.
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Surgery on the meniscus of the knee joint is one of the most frequently performed operations. The arthroscopic technique currently represents the general treatment standard and except in a few cases has completely superseded the open approach. Arthroscopy facilitates precise diagnosis and classification of all forms of meniscus lesions. ⋯ Substitution of lost meniscus tissue is possible with allograft transplantation; good results are possible especially on the lateral meniscus. A novel alternative is arthroscopic implantation of a biodegradable collagen matrix, which replaces partial defects on the medial meniscus. Long-term results of this treatment form must be awaited.
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The aim of primary treatment for eyebrow injuries should be preservation of the original eyebrow under any circumstances. Debridement should be kept to a minimum even when the wound is severe. The treatment of total or partial loss of an eyebrow concerning the exact reconstruction of details and aesthetic aspects is a challenge for the surgeon. ⋯ We present a classification for eyebrow injuries, which considers type and size of defects. Based on this, different techniques and methods of reconstruction are recommended. Advantages and disadvantages are discussed and illustrated by several examples.