Der Unfallchirurg
-
Open fractures are associated with a higher rate of infections and delayed fracture healing; therefore, in addition to fracture fixation, infection prevention and soft tissue management are also important. Administration of antibiotics should be carried out as early as possible and over 24-72 h depending on the injury. The initial debridement and assessment of the severity of injury determine the treatment strategy. ⋯ With substantial contamination, loss of bone or extensive soft tissue damage, temporary fixation and temporary wound closure are carried out. The definitive treatment with soft tissue coverage should be performed within 72 h in order to reduce the risk of fracture-related infections. For osseous segmental defects, different approaches are available to restore bone continuity, depending on the size and soft tissue situation.
-
Traumatic aortic injuries (TAI) are rare injuries in blunt thoracic trauma, which have a high morbidity and mortality. Rapid and accurate diagnosis as well as the correct choice of treatment are elementary for patient survival. ⋯ After rapid diagnosis and classification of TAI with CT, in most cases TEVAR has become the preferred treatment over open surgery.
-
Hemorrhage after trauma in the area of the upper abdominal organs and the kidneys can represent a life-threatening situation. The primary treatment options are conservative or surgical treatment. Only in exceptional cases can endovascular treatment with an angiographic depiction of the active bleeding and, if necessary, intervention by means of embolization be used as an alternative.
-
High primary stability of the pelvic girdle with full weight bearing. ⋯ The follow-up examination of a collective of 34 patients showed no implant loosening and a relatively low radiation exposure.
-
Approximately one third of all traumatic peripheral artery injuries affect the upper extremities, while two thirds involve the arteries of the lower extremities. Historically, these injuries were treated by open surgical repair. Nowadays, interventional treatment, such as embolization or stent grafting are increasingly used to treat peripheral artery injuries. ⋯ According to the promising clinical data, interventional treatment should be considered more often. Diagnostic algorithms need to be adapted accordingly.