Der Unfallchirurg
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Fractures of the olecranon account for 7% of fractures in adult patients. Of all elbow fractures, 38% are isolated fractures of the olecranon. Falling on the 90 degrees flexed elbow is the most common cause of isolated olecranon fractures. ⋯ Tension band wiring and plate osteosynthesis are the most commonly used techniques. Operative therapy is the therapy of choice, since it permits early physical therapy. Some non-dislocated fractures and fractures in elderly and multimorbid patients are indications for conservative therapy.
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[Prehospital Trauma Life Support (PHTLS): An interdisciplinary training in preclinical trauma care].
There is clinical evidence that standardized management of trauma patients in the emergency department improves outcome. Standardized prehospital management has been established for stroke patients and those suffering acute coronary syndrome. Prehospital treatment of trauma patients differs quite significantly from one system to another. The data from the German Trauma Registry show that the average time from accident until arrival in the emergency department is 72 min. This needs improvement. ⋯ PHTLS teaches a standardized and established approach to the trauma patient in the emergency department. It has been established in 36 countries and the content is reviewed regularly to consider new scientific evidence. Healthcare personnel in Germany have the chance to participate in this international standard of care and to introduce their own experiences into the review process.
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Modern strategies for postoperative care of patients with hip fractures include early discharge from the acute care hospital to inpatient interdisciplinary rehabilitation facilities. Whether these programs are effective for the patients and improve their long-term outcomes or if they simply transfer costs, with a reduction of the inpatient days in the acute care hospital, is currently under discussion. ⋯ Postoperative inpatient rehabilitation programs enhance short-term activities of daily living. In particular, patients who lived at home before the trauma and were reintegrated back home benefited in perpetuity from geriatric rehabilitation. A policy for early discharge to geriatric rehabilitation is associated with extension of overall hospital stay. This association along with the related increased health care costs should be weighed against the sociofunctional effectiveness of these programs.
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The management of patients with sport-related injuries of the spine is a challenging issue with regard to the ability to resume former sport activities. The current study analyses the rate of resumption of sports participation after conservative and operative treatment. ⋯ The current management of injuries of the spine effectuates a high rate of resumption of sports activity following conservative or operative treatment.
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Epiphysiolysis of the dens axis at the infant age is a rare injury, which must be surely clarified at car accidents with frontal application of force at medium high speed. We report of a small patient sitting in a child seat, who suffered a epiphysiolysis of the dens axis, which was initially not diagnosed, due to a abrupt deceleration in the context of a car accident. The epiphysiolysis of the dens axis could be secured with the aid of conventional radiography, MRT and CT. The delayed conservative treatment due to the anamnesis was then complicationless.