Der Unfallchirurg
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Controlled Clinical Trial
[Postoperative implant-associated osteomyelitis of the shoulder : Hardware-retaining revision concept using temporary drainage.]
Posttraumatic and postoperative osteomyelitis (PPO) is a subgroup of bone infections with increasing importance. However, to date no standardized reoperation concept exists particularly for patients with PPO of the shoulder region. Therefore the purpose of this study was to evaluate a revision concept including débridement, irrigation, and insertion of temporary drainage with hardware retention until healing. ⋯ A cost-efficient, simple, and successful revision concept for patients with PPO of the shoulder region is described.
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The advantages that are inherent to the air ambulance service are shown in a reduction in mortality of critically ill or injured patients. The air ambulance service ensures quick and efficient medical care to a patient as well as the immediate transport of patients to a suitable hospital. In addition, primary air rescue has proved to be effective as a support for the standard ground-based ambulance services in some regions of Germany during the night. ⋯ Particular requirements should be imposed for air rescue operations at night: a strict indication system for alerting, 4-man helicopter crews solely during the night as well as pilots (and copilots) with the correct qualifications and experience in dealing with night vision devices on a regular basis. Moreover, the helicopters need to be suitable and approved for night flying including cabin upgrades and the appropriate medical technology equipment. To increase the benefits of air rescue for specific diseases and injuries, a nationwide review of the processes is needed to further develop the primary air rescue service.
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Popular trend sports are characterized by intensive and high speed performance. Due to the high energy mechanism in falls, typical injury distributions and patterns result. ⋯ In popular trend sports injuries of the extremities are common, especially of the carpal bones and ligaments. It is important to distinguish stable from destabilizing injuries in order to provide adequate therapeutic options.
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Case Reports
[Bilateral carotid artery dissection in a kite surfer by strangulation with the kite lines.]
While a kite surfer was preparing the kite it was caught by a gust of wind, which blew it 10 m into the air and the cords became entangled around the neck of the kite surfer causing strangulation. After admittance to hospital, the diagnostics revealed multiple injuries including a bilateral dissection of the internal carotid arteries, cerebral edema and multiple fractures. As kitesurfing is gaining popularity severe injuries are becoming more frequent. Safety precautions, such as preparing the kite with two persons, wearing safety equipment and using bars with a safety leash can prevent severe injuries.
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Apart from clean cut finger amputations, every kind of hand injury can be seen in mountain and winter sports but only skier's thumb and injuries of the pulley system in sport climbers are seen in a greater number of cases. Nevertheless, these two common injuries as well as the rare frostbite of the fingers are often underdiagnosed or overdiagnosed as well as undertreated or overtreated. ⋯ Most cases of skier's thumb as well as lesions of the pulley system can be treated non-operatively but precise diagnostics are needed.