Der Unfallchirurg
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Osteoporosis results in fragility fractures that are associated with a high morbidity and mortality as well as an increased risk for subsequent fragility fractures. Thus, the first fragility fracture should be the last. To achieve this goal patients need treatment of osteoporosis according to the prevailing clinical guidelines. ⋯ In Germany, FLS should be established nationwide and according to uniform standards. This would significantly improve the quality of clinical care of patients with manifest osteoporosis.
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After controversial discussions in the literature about therapy regimens for calcaneal fractures, a retrospective study of patients operatively treated in a maximum care trauma center was conducted. ⋯ In this patient collective nicotine abuse and a long interval between trauma and surgery were risk factors for development of wound infections. Other factors with an influence on the outcome were the postoperative development of arthritis and the type of health insurance; however, patient age had no impact on the outcome.
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Osteoporosis is a common disease that affects both women and men. Due to a reduced bone mineral density and increasing age, the risk for atraumatic fractures increases. These fractures cause pain due to the fracture itself and also have far-reaching sequelae in nearly all areas of life of patients. ⋯ The effects of osteoporosis and fractures are multifactorial and often severe for the patient. The measures for prevention of osteoporotic fractures should be consistently implemented in the daily clinical routine and the necessary diagnostics and treatment should be rapidly initiated.
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Fragility fractures are fractures in multimorbid, geriatric patients. Currently, their number is already high and is likely to increase in the future. ⋯ There is evidence that with optimal care the treatment of patients with fragility fractures can be significantly improved.
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Arthroplasty has become a very successful operation with excellent long-term results. A dedicated diagnostic set-up to exclude osteoporosis prior to a joint replacement and the use of drugs to improve the outcome of a joint replacement are currently not recommended. ⋯ The same is recommended for hip joint replacement, even if the cement-free acetabular component yields good results. Rapid loading and mobilization appear beneficial also with respect to the osteoporosis and its systemic treatment.