Der Unfallchirurg
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Possible use of 3D-printing technology in orthopedic surgery ranges from preoperative planning to dedicated counselling with patients by the use of individual 3D models, intraoperative surgery tools or implants and various other applications. This article describes a technique for the creation of intraoperative tools with which the process from computed tomography (CT) images to 3D-printed tools in trauma surgery can safely be administered. ⋯ The standard triangulation file created in this way (file ending: .stl) must subsequently be post-processed. By the use of the digital casts from bone and fractures in computer-aided design (CAD) programs implants and patient individual tools are created, which can range from ortheses to protheses to intraoperative saw guides.
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The use of 3D printing (synonyms "rapid prototyping" and "additive manufacturing") has played an increasing role in the industry for many years and finds more and more interest and application in musculoskeletal surgery, especially orthopedic trauma surgery. In this article the current literature is systematically reviewed, presented and evaluated in a condensed and comprehensive way according to anatomical (upper and lower extremities) and functional aspects. As many of the publications analyzed were feasibility studies, the degree of evidence is low and methodological weaknesses are obvious and numerous; however, this pioneering work is extremely stimulating and important for further development because the technical, medical and economic potential of this technology is huge and interesting for all those involved in the treatment of musculoskeletal problems.
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Burns and thermal injuries from other causes often affect exposed body regions such as the hands. Besides aesthetic aspects, deep dermal burns of the skin are often critical from a functional point of view, especially for important subcutaneous structures. This article reports the course of two patients who received enzymatic debridement with bromelain-based salve as a treatment for deep grade burns of the hands.
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Metatarsal and toe fractures are the most frequent injuries of the foot skeleton. Nondislocated fractures can be conservatively treated with good success. Long-term relief and immobilization including the ankle joint are unnecessary. ⋯ The correct classification is necessary in order to initiate an adequate treatment. In general, intra-articular layer formation, inclination >10° and shortening between 3 mm and 5 mm, taking the position of the head of the metatarsal bone into consideration, are recommended as indications for surgery. Operative treatment of toe fractures is only rarely necessary.
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Decentralized trauma care in the Wald and Weinviertel region in the north of lower Austria comprises five hospitals for primary care including one regional trauma center. Due to the geographical position and adverse weather conditions a web-based teleradiology system was established to ensure the best possible treatment and joint access to the results of radiological investigations. ⋯ Especially in rural areas with decentralized trauma care, the joint use of teleradiological resources can lead to a better treatment quality.