Der Unfallchirurg
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Accidents with the risk of exposure to hazardous nuclear, biological, or chemical materials are rare. Most emergency rooms are not familiar with the management of contaminated patients after this kind of incident. There are also ambiguous cases concerning the contamination status of the patient. ⋯ The security arrangements should protect both (medical) personnel and third persons. Early medical treatment combined with decontamination should be the aim. Based on the case of a contaminated patient who was brought to our emergency department after an explosion of a fog grenade with red phosphorus, we discuss our management concept and the current literature.
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Case Reports
[Possibilities for the operative treatment of traumatic posterior shoulder dislocation].
Traumatic posterior locked shoulder dislocation is very rare. The dislocation is often combined with fractures of the humeral head or reversed Hill-Sachs deformities. This case report shows two different possibilities for treatment.
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Case Reports
[Accidental abdominal needlestick injury incurred while discarding a disposal container].
Needlestick injuries routinely occur in everyday clinical practice. Adequate instruction of employees in health care and correct prophylaxis against exposure could conspicuously reduce the incidence. Successful prevention of chronic infectious diseases comprises strict vaccination plans and substantial knowledge of post-exposure prophylaxis. The introduction of self-securing cannulas and injection instruments represents an important technological advance.
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The procedure of sacroplasty was introduced recently and involves the percutaneous application of cement to the sacral bone. Currently there are no standardized data available reflecting clinical results such as leakage rates or other complications. The aim of this study was to evaluate the feasibility and results of a balloon-assisted, CT-guided cement application in a controlled experimental approach. ⋯ The CT-guided technique presented in this study enables surgeons to perform sacroplasty with high precision and moderate radiation exposure. Further clinical studies are necessary to show if the balloon-assisted cement application can promote lower leakage rates than the conventional technique in patients with sacral fractures.
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Bacterial infections with local inflammation or hematogenous spreading may occur after joint punctures and intra- or periarticular injections. The risk of severe infections increases in patients with diseases accompanied by low immunity, e.g., gout, alcoholism, rheumatoid arthritis, and diabetes mellitus. Cases of septic omarthritis after intra-articular injection with fatal outcome after delayed onset of therapy are known. ⋯ Because the clinical picture was recognized early, we were able to prevent severe progression with organ failure. Another female patient developed a postinjection bacterial acromioclavicular arthritis followed by septic inflammatory response syndrome (SIRS) and eventually multiple organ failure (MOF). With inconspicuous clinical findings in the initial shoulder examination the bacterial arthritis was detected as the cause of sepsis only after intensive investigations.