Der Unfallchirurg
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Phlebothromboses represent alarming complications in accident victims since they can cause fatal pulmonary embolisms. More than half of those affected also develop post-thrombotic syndrome in the course of the illness. In addition to making clinical assessments, the traumatologist should also have fundamental knowledge about diagnostic methods and be familiar with interpreting internal findings. ⋯ It is not uncommon for post-thrombotic syndrome to be diagnosed for the first time during this process. An additional vascular appraisal is often required. An appreciation of social-medical and insurance-related aspects means a high degree of responsibility is placed on the expert.
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With increasing age, bone mass decreases and the structure of the cancellous bone in the vertebral body changes. Especially in osteoporotic patients, but also with metastases in the vertebral body, this leads to decreased strength and, thus, to an increased risk of vertebral fractures. It is expected that this problem will increase significantly because of demographic developments. To treat or to prevent such vertebral fractures, different augmentation techniques have been developed. They can mainly be divided into vertebroplasty or kyphoplasty procedures. ⋯ The efficacy of these new methods should be tested in appropriate experimental biomechanical studies before they are used in patients.
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The goal of the present study was to summarize current treatment for acute acromioclavicular (AC) joint dislocations. ⋯ Favored techniques have completely changed since 2001 when the majority of physicians preferred AC joint transfixation or coracoclavicular cerclages, both techniques that are hardly used today. The hook plate appears to have become "standard therapy". The arthroscopic TightRope® is the second most common despite being the newest technique.
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Coverage of extensive tissue defects is one of the tasks of plastic surgery. For the surgeon there are a series of possibilities differing in safety level and difficulty. With extensively exposed bones, however, there is mostly the indication for free tissue transfer. In the following case a possibility of wound closure of an extensive defect by one single free flap without preconditioning the tissue is demonstrated.
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The white paper on the medical care of the severely injured published in 2006 is a collection of proposals and recommendations concerning structure, organization and equipment for the medical care of severely injured patients. Since its publication 50 networks ( http://www.dgu-traumanetzwerk.de/index ) have been established as part of the trauma network. This and the trauma register have helped to continuously improve the medical care of severely injured patients since 1993 [26]. ⋯ A highly critical view is taken of the new surgical specialists with respect to interdisciplinary and comprehensive emergency medical treatment and casualty care. The survey also revealed the continual conflict between managing costs and maintaining quality and resources. It gives an overview of patient treatment in the transition from preclinical to clinical care and provides insights into the targets achieved, current problems and conflicts.