Der Unfallchirurg
-
Review Case Reports
[Fat embolism syndrome following lower limb fracture despite rapid external fixation. Two case reports and review of the literature].
Fat embolism syndrome (FES) is a rare complication occurring in 0.9-2.2% of patients following long bone fractures. Patients present with a classical triad of respiratory manifestations, cerebral effects and petechiae. ⋯ Nevertheless, two healthy young men suffered from FES after immediate (within 3 h after trauma) external fixation of lower leg fractures. This postoperative complication should always be considered even after conservative or minimally invasive therapy.
-
Comparative Study
[Best matching. Experimental comparison of different matching procedures for use in computer navigation].
Computer navigation systems are increasingly becoming an integral part of the surgical routine in orthopedic and trauma surgery due to improvements in intraoperative visualization procedures. The matching, i.e. data alignment between virtual and therapeutic objects, is however still a persisting problem. In recent years various matching procedures have been developed to attempt to solve the problem. In this study we compared three matching procedures using the VectorVision navigation system. ⋯ In our study pairpoint matching was the only procedure without misplacement and on average had the largest safety margin for drillings. Thus this method was the most precise procedure. The region matching procedure offers the advantage of the fastest matching with comparable precision.
-
Complex fractures are still a major clinical challenge. The treatment options of large bony defects either with autografts or allografts are limited in terms of material availability and tissue in-growth. Tissue engineering might offer a solution to this problem. ⋯ So far tissue engineering of bone is mainly confined to laboratory investigations whereas clinical applications are still in the beginning. This manuscript presents the most important scaffolds as well as growth factors and cell systems. Furthermore, it focuses on clinical studies for the treatment of large bony defects using tissue engineered cell-matrix constructs.
-
Controlled Clinical Trial
[Quality of prehospital and early clinical care of pediatric trauma patients of school age compared to an adult cohort. A matched-pair analysis of 624 patients from the DGU trauma registry].
Conflicting reports exist regarding the quality of prehospital treatment of pediatric trauma patients. The purpose of this investigation was to determine whether prehospital treatment and emergency management in pediatric trauma patients were similar to that in adult patients. All patients who had been prospectively documented in the registry of the German Trauma Society (DGU) between 2002 and 2005 were selected for this study. ⋯ There was no significant difference regarding prehospital intubation, reanimation, fluid management, chest drainage, ground and air transport to the hospital, time to arrival or interval in the emergency room. In contrast, significant differences (p<0.05) were observed in terms of the cause of trauma and pre-existing diseases. Pediatric trauma patients were not triaged or treated differently from adult trauma patients in respect to key issues of prehospital and early clinical trauma management.
-
Inadequate treatment of distal intra-articular fractures of the humerus results in painful restriction of movement or malarticulation. Especially in geriatric patients with osteoporosis, stable osteosynthesis can be difficult. Primary total endoprosthetic replacement of the cubital joint could offer an alternative. ⋯ In elderly patients primary endoprosthetic treatment of a distal intra-articular fracture of the humerus with a semi-constrained cemented prosthesis may offer an alternative to osteosynthesis thus enabling creation of a mobile, painless and stable cubital joint.