Der Unfallchirurg
-
The quality of the reconstruction, follow-up treatment and care determine the treatment outcome of complex hand injuries. The initial estimation and therapy are decisive. Optimal results necessitate a structured approach with strategic planning, including thorough débridement, precise analysis of the resulting defect and loss of function and if possible unilateral reconstruction and well-founded planning of secondary interventions. ⋯ Taking these fundamental strategic steps into consideration, the primary aims of reconstruction and preservation of function, rapid occupational and social reintegration and avoidance of delayed complications can best be realized. There is no standard approach for these extremely variable injuries. Decisive is that even in cases of apparently harmless injuries, the involvement of functional structures must be considered early in the initial stages.
-
As part of the expansion of the site-specific education profile of the medical curriculum MED@ULM of the University of Ulm, a new track "trauma care and trauma research" was established in the winter semester 2012/2013. The acceptance of the track was evaluated during the winter semester 2013/2014. ⋯ With the introduction of the new trauma track into the curriculum of the medical curriculum MED@ULM of the University of Ulm, a further possibility for medical students to focus on their own individual options was established. At least half of the track students wanted to be later active in the triad of patient care, teaching and research. Further investigations are necessary to determine whether the establishment of the trauma track has a positive influence on the number of new recruits in trauma surgery and anesthesiology.
-
Surgery of sepsis in trauma surgery and orthopedics is attracting increasingly more attention due to the rising presence of multidrug-resistant pathogens and the increasing number of operative interventions. Despite extensive experience over decades neither the symptoms nor the treatment strategies have been evaluated and it has become obvious that a scientific investigation of this complex topic is necessary for optimization of patient care under economically sound conditions. The aim of this article is to give a snapshot from German healthcare institutions for trauma surgery and orthopedics to answer some questions on this topic from the section for bone and soft tissue infections (SeKuWi) of the German Society for Orthopedics and Trauma (DGOU) in cooperation with the German Society for Hospital Hygiene (DGKH).
-
Case Reports
[Surgical treatment of a complex adolescent carpal fracture : A rare injury to the growing skeleton].
We report the case of a 15-year-old boy with combined fractures of the scaphoid, capitate, and hamate that represents a rare variation of the well-known Fenton's syndrome. Fixation was performed for the unstable fractures of the scaphoid and capitate with the use of cannulated Herbert screws and K‑wires respectively. ⋯ After 6 months, CT confirmed complete consolidation of the two surgically treated carpal fractures and the conservatively treated fracture of the hamate. Regarding function, the patient is able to incorporate the hand into his school-related activities and has a good range of motion, with strong closure of the fist.
-
In approximately 4-13 % of cases plating of the humerus for stabilizing a shaft fracture is complicated by a secondary lesion of the radial nerve. In the majority of cases this is due to intraoperative traction on the nerve. ⋯ This article presents the case of a spontaneous regeneration of a radial nerve despite ongoing compression by the surgical implant after compression plating of a humeral shaft fracture. Recommendations are given to avoid such an iatrogenic lesion of the radial nerve, which most commonly is not spontaneously reversible.