Der Unfallchirurg
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Vascularized pedicled bone grafts are known since the beginning of the last century. Microvascular bone grafts (free vascularized bone transfer) are known since the beginning of the seventies. ⋯ Because of those properties, it became possible to successfully treat a large segmental bone defect by only few operations. As the treatment of complicated combined soft tissue/bone defects led to high complication rate up to 40 to 60% the indications of this method were altered.
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Hyaline articular cartilage consists mainly of water, which is reversibly transferred to the joint space under compression to reduce friction between the cartilage surfaces. This water content is regulated by proteoglycanes, which are produced by chondrocytes. ⋯ Power training should lead to a submaximal loading of cartilage below the rupture limit as the capacity of cartilage tissue to adapt to higher loads is limited. When the cartilage tissue shows osteoarthritic changes the loading capacity of the cartilage matrix is significantly reduced, which should be taken into consideration during power training.
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Central emergency units were established for medical and economic reasons in many German hospitals. The huge number of patients requiring treatment more or less urgent led to an implementation of triage-systems, which are known from abroad. ⋯ Before implementing the above-mentioned systems to German emergency unit all of them need further development. Furthermore a scientific verification of the efficiency and the safety of triage-systems is necessary.
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Quality management and the early implementation of whole-body multi-slice spiral computed tomography (whole-body MSCT) are becoming increasingly important in the management of patients with multiple trauma. The aim of this study was to evaluate both components with respect to the time factor for treatment. ⋯ Quality management and the early implementation of whole-body MSCT can accelerate the treatment work flow. A rapid initial diagnosis represents an important component in the high quality of treatment of polytrauma patients.
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Should osteosynthesis infection occur after ankle fractures in patients with microangiopathy, the infection needs to be cured quickly and safely to protect implants, bone, and tendons. Vacuum therapy (TNP) provides a perfect treatment plan that keeps the inpatient time low whilst ensuring high patient comfort. ⋯ Vacuum therapy is a perfect strategy after surgical debridement and before secondary mesh grafting. It protects the stability of the bone and open-lying delicate structures in patients with infected osteosynthesis of the ankle and angiopathy and offers an easy, safe, and successful treatment path with a short inpatient time.