Der Unfallchirurg
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To date, little attention has been given to greater tuberosity fractures (GTFs) in the literature. Several mechanisms of injury are described, but few authors report that a GTF is accompanied by a high rate of often unrecognized associated injuries. ⋯ The reason for a GTF seems to be an anterior shoulder dislocation or partial dislocation. In multifragmentary GTF or GTF with dislocation surgery is necessary frequently; without dislocation surgery is necessary less frequently. Associated injuries should be searched for selectively. An arthroscopy could be performed for diagnosis and therapy. In a GTF that can be treated conservatively, an MRI should be performed.
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Trauma surgery is a discipline in which the training phase for specialization requires a technical and time-intensive learning curve, including the repetitive training of manual skills. This results in prolonged operation times and thus elevated costs. ⋯ Surgical training of residents costs hospitals the appropriate amounts of time and money and reduces the overall number of procedures performed, justifying special consideration of the financing of training hospitals.
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Review Practice Guideline
[Orthopedic surgery with limited resources after mass disasters and during armed conflicts : First international guidelines for the management of limb injuries and the experience of Doctors Without Borders].
Disasters and armed conflicts are often the unfortunate basis for aid projects run by Doctors Without Borders/Médecins Sans Frontières (MSF). The nature of war and disasters means that surgery is an integral part of this medical emergency aid. In these situations, resources are usually limited. ⋯ The Field Guide to Manage Limb Injury in Disaster and Conflict has been written to help new surgeons who may face the challenges of disaster and war surgery and to avoid unnecessary suffering for patients ( https://icrc.aoeducation.org ). Under the guidance of the International Committee of the Red Cross (ICRC), with participation of the World Health Organization (WHO), financed by the AO Foundation, and featuring the experiences of experts from different organizations (amongst them MSF), the book details techniques and guidelines for surgery in low resource settings. The following article provides a short summary of some of the surgical challenges when working with limited resources and reflects on a few specific recommendations for so-called war surgery.
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Comparative Study
[Simultaneous surgical treatment of the long head of the biceps tendon during operative treatment of proximal humeral fractures].
Pathologic conditions of the long biceps tendon can be found within treatment of proximal humeral fractures or as a source of pain after surgery. However, simultaneous surgical treatment at the index surgical intervention is so far not well established. The purpose of this study is to evaluate the results of a simultaneous biceps treatment during plate osteosynthesis of proximal humeral fractures. ⋯ The simultaneous surgical treatment of the LHB during plate osteosynthesis of proximal humeral fractures shows good clinical and cosmetic results. In a preselected patient population (cosmetic and functional demand) the kind of treatment (LHB tenotomy or LHB tenodesis) is indifferent.
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The small developing countries in the Pacific are grouped together as Small Island Development States (SIDS) because they face similar problems which they cannot cope with nationally. They are developing countries, so-called low and lower middle income countries (LMIC), are economically weak and the islands of the different nations are widely scattered. Approximately 80% of the 10 million inhabitants live in rural regions. ⋯ The AOAF is an independent organization with the only aim to enhance trauma surgery capacity in LMICs. The AOAF supports the PIOA program together with the Wyss Medical Foundation. Currently, 18 trainees from 8 Pacific SIDS are participating in the PIOA training program.