Der Unfallchirurg
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American football is known for its high risk of injury, especially in the professional field. Although the number of players in the German football league (GFL) has risen in recent years, data concerning the injury rates of German amateur players in American football are scarce. ⋯ American football is a contact sport with high injury rates even in the German amateur field, especially during league games. Regarding body regions, shoulders and knees were predominantly affected while regarding the playing position, wide receivers and cornerbacks were particularly jeopardized. Therefore, a continuous close medical supervision during games and an intensive position-specific training seem to be necessary even in the amateur field in order to reduce the injury rate.
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Review Case Reports
[Proximal avulsion of the tendon of the rectus femoris muscle : Case description and literature review].
Injuries of the thigh muscles are among the most common sports injuries. In soccer they represent nearly 30% of all injuries. The rectus femoris muscle in particular is often exposed to injuries due to its anatomical features. ⋯ After persistent complaints over 2 months operative treatment was performed by anchor refixation of the tendon. During the follow-up at 6 weeks postoperatively, there was a very good functional result with good mobility and only slightly reduced strength with early full load and movement. The anamnesis revealed no deficits in the side to side comparison 1.5 years after the trauma.
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Emergency exit and escape routes in public buildings, such as schools, hospitals and administrative offices are controlled by legal rules and regulations. Thereby escape from the building is very well organized in cases of internal threats (e.g. fire, active shooter and hostage situations). Complex buildings with numerous rooms are a special challenge to emergency and law enforcement personnel. Without additional means of orientation a targeted localization of the incident is not possible in many cases. ⋯ For targeted localization of an internal incident there only seem to be three German systems worldwide that enable an intuitive and immediate orientation and guidance within buildings. An increasing threat of worldwide terrorism and the fact that hospitals are seen as crucial infrastructures for attacks by terrorists make the implementation of guidance and orientation systems in hospitals urgently necessary. This is the first review dealing with this topic.
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Shaft fractures of the tibia and fibula mainly affect younger patients and are therefore of great socioeconomic importance. Due to the high proportion of high-energy direct trauma mechanisms and the thin soft tissue covering layer of the ventromedian tibia, open factures occur in up to 39%. A structured diagnostic and therapeutic approach is essential for successful treatment. ⋯ Furthermore, the indications and the application of minimally invasive plate osteosynthesis (MIPO) and external fixators are described. Every trauma surgeon should be familiar with the etiology and the surgical treatment of compartment syndrome. A firm knowledge of the classifications of open and closed soft tissue injury is mandatory.
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Terrorist-related mass casualty incidents represent a medical and organizational challenge for all hospitals. The main reasons are the special patterns of injuries, the onset and development of the scenario, the lack of information at the beginning, the overall number of casualties and the number of uninjured but involved patients presenting at the hospital. Due to these circumstances and the high percentage of penetrating injuries with a permanent risk of uncontrollable bleeding and other life-threatening complications, a strategic and tactical initial surgical care is necessary. ⋯ It could be shown that standardized approaches and algorithm-based treatment could improve the outcome of trauma victims. Faced with the present day permanent risk of a possible terrorist-related MasCal situation, the question arises how and to what extent elements and principles of both course formats (TDSC® and ATLS®) could be used to improve and organize the initial care in a terrorist-linked MasCal incident. For the first time it is shown that the key elements of both courses (primary survey of the ATLS® and the TDSC® principles: categorization, prioritization, disposition and realization) could be established and integratively used to structure the initial intrahospital medical and surgical care.