Der Unfallchirurg
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The combination of ipsilateral femoral neck and shaft fractures remains a treatment challenge in orthopedic surgery because both fracture types constitute separate entities and require specific treatment concepts. ⋯ Treatment of ipsilateral femoral neck and shaft fractures is still demanding, but diagnosis has improved with regular use of CT body scans in the management of multiply injured patients. Furthermore, possibilities for operative treatment have been advanced by the introduction of the long proximal femoral nail and the antegrade femoral nail, two implants supporting stabilization of these fracture entities.
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Anisocoria after blunt head trauma, associated with altered vigilance, is not unusually assumed to expanding intracranial mass lesion. Obvious signs of head-trauma and vomiting might strengthen this diagnosis. We report from an unconscious 15-year-old girl (Glasgow-Coma-Scale score 3) that showed these symptoms secondary after head-trauma due to alcohol intoxication but turned out to be misleading after cranial computed tomography (CT). ⋯ Prehospital discrimination of artificial eyes and natural eyes might be difficult in comatose emergency patients. Neurological examination should check corneal reflex and manual palpation of the bulbus. Independent from anisocoria, patients presenting GCS 3 and head injury need rapid admission to CT-diagnostic, neurosurgical treatment respectively.
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Isolated rupture of the short head of the biceps muscle is a rare injury and only very few cases have been published. This case study describes an isolated, complete, traumatic rupture through the short head of the biceps muscle in a 39-year-old healthy male who was involved in a car accident. We report on the diagnostic and therapeutic measures and compare the procedure with data from the literature.
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A 22-year-old woman suffered an anterolateral dislocation of the talus in a horse-riding accident. Immediately after admission, closed reduction was performed, and then a low knee cast was used for 12 weeks of immobilisation with partial weight bearing (10 kg). ⋯ There were no radiological signs of osteoarthritis or talus bone necrosis. Immediate closed reduction led to an excellent outcome.