Der Unfallchirurg
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This case report describes the osteosynthetic treatment and postoperative course of a fracture of the capitulum humeri and a concomitant fracture of the head of the radius with a follow-up over 3 months. Simultaneous fractures of the capitulum humeri and the head of the radius are rare injuries of the elbow. Due to the complex anatomical relationships this type of fracture poses a big challenge for treating traumatologists.
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The future of emergency departments in Germany is influenced by increasing numbers of patients, demographic changes, new therapeutic concepts, current legislation and expert opinions. There is a lack of reliable data concerning the quantity and the type of injuries and diseases presenting in emergency departments. ⋯ The present study analyzed the frequency of major diagnoses corresponding to the various medical disciplines including more than 500,000 patients. Of the emergency cases included, 43% were allocated to trauma surgery or orthopedics. These patients presented in the emergency departments around the clock and necessitate the permanent attendance of a trauma and emergency surgeon. Thereby, timely surgical care and decisions regarding indications for surgery and admission are ensured. Competence in trauma and emergency surgery is therefore essential for emergency departments.
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Abstract
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This overview article highlights the central role of health services research (HSR) for the further development of the healthcare system. As a young scientific discipline in Germany, HSR covers five important elements with different weighting in different definitions, which are elaborated in some detail in this article: patient orientation, results and outcome orientation at the patient and population levels, implementation perspectives and context relation, complex interventions and improvement, multidisciplinarity and multiprofessionalism. One of the fundamental pillars of HRS is related to the insufficient implementation of scientifically proven treatment methods and improvement strategies into routine patient care. ⋯ The scientific methods used in HSR clearly extend beyond the spectrum of (clinical) epidemiology. The methodological standards are developed as consensus memoranda of members of the German network of HSR, which serve as orientation points for qualitatively good HSR. Finally, various perspectives for the long-term safeguarding and improvement of the quality of HSR in Germany are proposed.
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The aim of the surgical treatment of intra-articular bicondylar tibial plateau fractures is the anatomical reconstruction and direct biomechanical optimal fixation of the fractured articular surface and the leg axis, taking the frequently associated soft tissue damage into account. ⋯ This is an established and safe delivery strategy for complex fracture patterns with dorsally running fractures. The risk of intraoperative malreduction is low. Postoperative reduction losses depend on fracture, operation and especially patient-specific characteristics.