Der Unfallchirurg
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Fractures of the axis are among the most frequent spinal injuries. Posterior C1-C2 fixation according to Goel-Harms is an accepted alternative to the more traditional procedures: initial stability has been shown and there is a wide range of indications but there is a paucity of data on possible complications. Such knowledge, however, is essential in order to improve outcomes. ⋯ Preoperative ASA score was the only risk factor to significantly influence the number (p = 0.001) and severity (p = 0.002) of postoperative complications. Each increase of the preoperative ASA score increased the risk to get one more complication by a factor of 2.55 (odds ratio 2.55) and increased the risk to get a severe complication by a factor of 2.43 (odds ratio 2.43). Intraoperative blood loss, patient age and duration of surgery, however, were not identified as risk factors for complications.
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The level 3 guidelines on treatment of patients with severe/multiple injuries provide a defined framework for an appropriate treatment of these patients. It is presumed that prehospital diagnostic and therapeutic decisions are affected by the clinical expertise and the medical disciplines of the emergency physicians. ⋯ In this air rescue cohort differences in indications for invasive procedures were observed between the groups. This may be caused by their clinical background. Using the example of intubation, it has been shown that guideline recommendations were closely followed irrespective of the medical specialty of the emergency physician.
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To cope with the COVID-19 outbreak in Germany, the government imposed a lockdown, which led to restrictions and lifestyle changes for the population. ⋯ The lockdown and restrictions in personal life and daily routine had an impact on the frequency, etiology and management of trauma patients in Stuttgart.
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Free fascial flaps from the anterolateral thigh (ALT) were used to reconstruct soft tissue defects after trauma to the ankle. This modification was compared to the conventional fasciocutaneous method. ⋯ The modified method of a free fascial flap from the ALT can be useful in situations where a bulky flap makes it difficult to fit it into the defect.
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Traffic accidents and the traumatic injury consequences are frequent causes of mortality and irreversible damage in children and young adults. In motorcycle accidents the injury patterns differ depending on the age of the patient. ⋯ The study revealed age-specific differences with respect to injury patterns in patients involved in motorcycle accidents, either as drivers or co-drivers. Furthermore, the analysis of preclinical and in-hospital treatment elucidated the relevance of preventive and protective measures.