Der Unfallchirurg
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Clinical Trial
[Intramedullary nailing of proximal tibial fractures. Complications and risk factors].
We performed a consecutive study on patients with proximal tibial fractures without joint participation to determine the early clinical and radiological outcome. ⋯ Two primary and one secondary malalignment were observed Two of them were initially polytraumatised. Furthermore, two patients developed a delayed union, and one non-union occurred. Risk factors for limited bony consolidation were smoking and an open fracture. Screw or nail breakage did not occur, and no infection was observed.
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The prognosis of severely injured patients depends on a rapid diagnosis and early initiation of therapeutic procedures. ⋯ The duration of time intervals depends on injury severity, treatment after completion of emergency trauma care and the level of the trauma centre. Time management in emergency trauma care can potentially be optimized after completion of the last diagnostic procedure in the emergency room.
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During the last decade there have been significant changes in the perioperative management of total hip replacement patients. This process begins in the preoperative phase. Many patients are much better informed and standardized preoperative patient programs improve patient outcome and optimize the clinical pathways. ⋯ In a standard primary hip replacement pain-adapted full weight bearing is possible if there are no patient-specific problems. There has also been a shift in the postoperative capability of performing athletic or recreational activities. In general patients can perform those activities that were performed before the surgery, which also includes, for example downhill skiing.
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Fractures of the lateral clavicle end account for 12-15 percent of all clavicle fractures. In contrast to the clear treatment of midshaft fractures the therapy of the distal third is still open to controversy. The high non-union rate up to 40 percent that occurs with the lateral end fractures shows the special biomechanical mechanisms. ⋯ To make a clear decision about the therapy we need a treatment based classification such as the one by Jäger and Breitner, which distinguishes four different fracture types. The treatment options reach from conservative therapy up to numerous different operative techniques. The aim of this article is to demonstrate a simple and save way for the diagnosis and therapy of that special kind of fracture.