Der Unfallchirurg
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The indication for radiography should strictly follow the ALARA (as low as reasonably achievable) principle in pediatric and adolescent trauma patients. The effect of radiation on the growing sensitive tissue of these patients should not be disregarded. ⋯ Comparing the results of the survey with the consensus findings of the SKT recently published in this journal, persuasion is still needed to change the use of radiography in primary diagnosis.
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The indication for radiographic examinations in pediatric and adolescent trauma patients should follow ALARA (as low as reasonably achievable). Because of the effect of radiation on the growing sensitive tissues of these young patients, a strict indication should always be given for radiation use and during controls after fracture repair.
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Periprosthetic infections with problematic and multiresistant pathogens represent a great challenge for trauma surgeons, especially when repetitive surgical débridement combined with calculated i.v. antibiotic treatment does not lead to resolution of the infection. This can necessitate a deviation from state of the art treatment concepts, such as the additive implementation of a rifampicin-loaded polymethyl methacrylate (PMMA) spacers.
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Presentation of a 16-year-old male patient due to a cycling accident while mountain biking 14 days after primary treatment after open epiphyseal injury. Metaphyseal intraosseous stones within the anatomically reduced distal radius fracture were misinterpreted as an incidental osteoma.
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Due to the demographic trend and the rising number of implanted joint prostheses, the incidence of periprosthetic fractures is going to increase in the future. This article describes the case of an aged person with a very unusual combination of periprosthetic and interprosthetic fractures with an inlying cementless total hip replacement and total knee replacement. By complying with the treatment strategies recommended for the respective individual injuries and the use of a geriatric trauma algorithm, it is even possible to successfully treat such a case. In addition to the unusual injury constellation, especially the surgical and geriatric traumatological treatment strategy are presented.