Der Unfallchirurg
-
In departments of orthopedic and trauma surgery patients with proximal femoral fractures constitute the largest proportion of trauma patients. The length of stay (LOS) has economic consequences and prolonged LOS leads to a shortage in bed capacity. ⋯ Surgical treatment during on-call service periods, short preoperative waiting times and avoidance of surgical complications shortened LOS and thus had an impact on costs and bed capacity.
-
We report the case of a 24-year-old female after sustaining a shotgun wound in the left upper extremity and chest. Initial emergency diagnostics revealed numerous shotgun pellets scattered throughout the left-side soft tissue, chest and upper lung lobe with one pellet having migrated into the left ventricle of the heart. Due to the devastating injury pattern, gunshot wounds are interdisciplinarily challenging and should include extended initial diagnostics, such as contrast agent CT. The potential toxicity of elevated lead blood levels have to be taken into further account.
-
Due to an increase in sporting activities, the number of injuries of the immature knee is continuously increasing. These injuries necessitate a special approach regarding the particular anatomical situation with open growth plates. Three of the most commonly occurring injuries are rupture of the anterior cruciate ligament, patella dislocation and meniscus injuries. ⋯ Isolated injuries to the meniscus are rare and discoid meniscus is a special phenomenon occurring in infancy. Meniscus injuries should be treated with primary sutures rather than resection. A discoid meniscus should be resected with extreme caution and anatomically reconstructed.
-
Case Reports
[Fatal hyperpyrexia in an adolescent patient with severe burns after a traffic accident].
After a motorcycle accident a 16-year-old patient suffered severe burns to 40.5 % of the total body surface area (TBSA) of which 37 % were deep subdermal burns. After tangential and partly epifascial necrosectomy, Integra® was used as a temporary dermis replacement material for the lower extremities, combined with extensive negative pressure wound therapy (NPWT). In the further course of the treatment the patient developed uncontrollable hyperpyrexia with a fatal outcome. Possible influencing factors, such as the dermis replacement material combined with NPWT over large areas as well as the differential diagnoses propofol infusion syndrome, heatstroke and malignant hyperthermia are discussed.
-
Case Reports
[Sternal fracture in growing children : A rare and often overlooked fracture? Documentation of four cases.]
Sternal fractures in childhood are rare. The aim of the study was to investigate the accident mechanism, the detection of radiological and sonographical criteria and consideration of associated injuries. ⋯ Isolated sternal fractures in childhood are often due to typical age-related traumatic incidents. Ultrasonography is a useful diagnostic tool for fracture detection and radiography is the method of choice for visualization of the extent of the dislocation.