Der Unfallchirurg
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Radiological diagnostics play a key role in the identification and assessment of pathological fractures. Conventional projection radiography is still the mainstay of imaging investigations. With knowledge of the patient history, the morphology and location of a fracture as well as concomitant findings, such as osteolysis or periosteal reactions can add valuable information on the origin of the fracture. ⋯ Computed tomography (CT) imaging provides valuable information on the morphological features of fractures and is useful for the planning of the surgical approach. Furthermore, it is the modality of choice for whole-body staging. In most cases of pathological fractures without a history of malignancy, a biopsy and histological work-up is recommended.
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Conventional chondrosarcoma is the second most common primary malignant bone tumor and usually occurs at older adult ages. It is rare in childhood and adolescence. ⋯ Based on the following case, potential radiological and histopathological differential diagnoses, such as chondroblastoma or chondroblastic osteosarcoma, are discussed against the background of current standards in orthopedic oncology.
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The study objective was to find out how cost-covering the treatment of patients with a potentially severe injury actually is in a Swiss trauma center and to what extent hospital profits/losses correlate with patient-related accident, treatment and outcome variables. ⋯ From a Swiss trauma center point of view only one third of emergencies are not loss-making, most of all privately insured patients or cases billable via a combined polytrauma and head trauma DRG.