Der Unfallchirurg
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Prolonged surgical site infections after spinal fusion surgery may lead to exposure of the implant due to the formation of extensive tissue defects and endanger the clinical outcome. ⋯ The keystone perforator flap offers a stable coverage for soft tissue defects and supports infection control after spinal fusion.
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The journal Der Unfallchirurg and the German Society for Trauma Surgery (DGU) are connected by a colorful story, which reaches a climax in a mutual anniversary year in 2022. Der Unfallchirurg, initially named the Monthly Journal for Trauma Medicine (Monatsschrift für Unfallheilkunde) had already endured 125 years as the specialist journal of the DGU in 2019; however, in 1944 in the 51st year the publication came to a halt due to the upheaval and serious consequences of the Second World War and only reappeared in 1949 with the 52nd year. In its 100-year history the DGU passed through 4 temporally definable phases with respect to content, politics and personnel, to which must be added its preliminary phase as the Division of Trauma Medicine (Abtheilung für Unfallheilkunde) within the Society of German Natural Scientists and Physicians (GDNÄ). In the synopsis on the history of the specialist journal, this article analyzes the more than 125-year development of the DGU.
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Infections of the hand and forearm are a frequently seen surgical emergency of the hand. Patients of all age groups are affected and underlying systemic diseases are risk factors. Posttraumatic causes are the leading cause of infections. ⋯ Follow-up treatment includes early functional exercise under the guidance of a hand therapist to minimize postinfectious restrictions in the range of motion and to enable occupational rehabilitation. In rare cases, fulminant necrotizing infections with resulting skin and soft tissue defects can occur. In these cases, secondary plastic reconstruction is usually required after cleansing of the infection.
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Due to its low invasive nature, arthroscopy nowadays represents the gold standard in the treatment of native joint empyema. This article gives a summary of the literature with expert recommendations, reviews and case reports on arthroscopic treatment of native joint empyema and the limitations. ⋯ In postoperative infections with enclosed foreign material, such as after cruciate ligament reconstruction, the foreign material can in most cases be left in and successful infection eradication can be carried out with several arthroscopic lavages and débridement. In cases of higher grade infections with destruction of the joint, arthroscopic treatment alone is normally insufficient.
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The triceps brachii muscle is the main extender of the elbow joint. Triceps tendon rupture or tearing presents a rare injury pattern in general. Distal tendon ruptures occur most commonly in the area of the insertion of the olecranon. ⋯ However, the most frequent trauma mechanism is a direct fall onto the extended forearm or a blow to the elbow. Beside clinical examination and sonography, magnetic resonance imaging is the diagnostic gold standard. The treatment of triceps tendon injuries includes conservative as well as operative approaches, whereby the indications for surgical treatment must be generously considered depending on the patient's age, functional demands of the patient, involvement of the dominant extremity as well as on the extent of the tendon rupture.