Der Unfallchirurg
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Acetabular nonunions are rare, especially after operative treatment of an acetabular fracture. There are only single reports of the reconstruction and therapy of acetabular nonunion. Furthermore, there are fewer reports for treatment of acetabular nonunion with a long follow-up. We report a successful revision of an acetabular nonunion after transversal fracture and previous operative intervention, as well as the long-term follow-up after revision surgery.
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After examining the causes of an accident the medical expert working in the area of private health care insurance under the general accident insurance (AUB) sample conditions must ascertain incapacity within a period of time that has been contractually agreed between the parties involved. In addition, this must also state their position on the question as to whether there may exist any circumstances up to the latest possible point in time in insurance terms that would comprise an adequate prognosis of a future change in the long-term condition. This requires a high probability. ⋯ The prosthesis supplements that have been applied to date in the context of an assessment of prognosis have their justification. In applying them, however, it must be considered on one hand that this supplement is comprised of an equally weighted proportion for future risk and on the other hand a preventive portion. This increases in significance with different prostheses on one and the same limb.
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It is undisputed that the stability of fracture fixation influences the fracture healing process; however, up until now the mechanical conditions which guide bone healing were unknown and it was therefore not possible to optimize the design of fracture fixation devices. This article presents how the stability of fracture fixation, interfragmentary movement and interfragmentary tissue strain depend on each other and how the mechanical environment influences the cellular processes in the healing tissue. ⋯ This tissue differentiation hypothesis allows the prediction of bone healing by intramembranous and endochondral bone formation as a function of the local mechanical environment in the fracture healing zone. This allows the possibility for selection of a fracture fixation stability to achieve high-quality bone healing.