Der Unfallchirurg
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Significant injuries to the thorax comprise pneumothorax, rib fractures, lung contusion, cardiac contusion, aortic laceration, ruptured diaphragm, and the very rare injuries to the tracheo-bronchial tree and the esophagus. A surgeon dealing with chest trauma patients needs to be familiar with the indications for and execution of chest tube insertion for thoracic drainage, pericardial puncture, and thoracoscopy and thoracotomy. Interventional techniques are gaining increasing acceptance in the management of major vascular injuries. The vast majority of patients with chest injury do not need an operative intervention, but it is necessary to place a thoracic drain in 10-15% of cases or to perform in a much lower proportion a pericardial puncture or a thoracotomy.
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A retrospective epidemiological multifactorial study of pediatric burn patients admitted to the Burn Center Bochum in the period of 1992-2002 was performed. ⋯ The number of children with a background other than German was higher; moreover, a high number of injuries was not covered by health insurance. Having identified the high-risk group among the pediatric burn patients, we suggest that prevention programs should be directed towards these families in order to reduce further risk of pediatric burns.
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Exsanguination plays a key role in avoidable prehospital deaths. As some bleedings from deep stab wounds cannot be stopped with direct compression, the insertion of a Foley catheter can prevent ongoing bleedings. A case report of bleeding from a stab wound in the supraclavicular region is given. The simple measure of careful insertion and blocking of a Foley catheter proved to be a key resuscitative procedure which can be done under any suitable circumstances.
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Comparative Study
[What advantages does volar plate fixation have over K-wire fixation for distal radius extension fractures in the elderly?].
The purpose of this retrospective study was to compare the outcome of open reduction and internal fixation (ORIF) followed immediately by physiotherapy and of percutaneous K-wire-fixation and casting for unstable distal radius fractures in elderly patients, considering the results both in general, for all such fractures, and selectively for A3 and C2 fractures. ⋯ All the treatments compared are suitable for the treatment of A3 and C2 fractures. The important advantages of ORIF are the early functional physiotherapy without casting and without obligatory second surgery and the earlier return to "activities of daily living", which are all of decisive importance for older patients, who are the ones most frequently affected.