Der Unfallchirurg
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The therapy of the midshaft clavicle fracture, in particular dislocated midshaft fractures, remains controversial. Therefore the objective of this study was to obtain data about the current treatment for midshaft clavicle fractures. ⋯ This survey demonstrates a high rate (26%) of German trauma hospitals operating clavicular midshaft fractures. This result is consistent with recently published studies showing better results for operative treatment of dislocated midshaft clavicular fractures compared to conservative therapy.
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Few data on risks and injury patterns of road cycling events are available. The aim of our study was to evaluate all injured participants in the 2006 Hamburg "Cyclassics". ⋯ In conclusion, accidents were more likely to occur in inexperienced drivers, in the shortest distance, with straight conditions and in well-known dangerous areas.
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Comment Letter
[Diagnostic strategy in occult fractures of the sacrum].
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Acute carpal tunnel syndrome (ACTS) is rare and is mostly the result of fractures of the distal radius or the carpal bones. This paper gives the first report of an ACTS following contusion of the wrist as the result of an extensive haematoma of the flexor tendon sheath, which did not appear until 50 hours after the injury was sustained but then developed rapidly. ⋯ It is assumed that the haematoma arose from an aneurysm of such a small vessel. The treatment of choice in ACTS is emergency incision of the carpal tunnel.
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The primary goal of drilling procedures for the treatment of osteonecrotic lesions is revascularisation of the defect area. In the literature good results are reported for this technique in 70% of cases. Precise drilling of the necrosed area as part of a minimally invasive technique does, however, require unequivocal intraoperative identification of the region visually, either by arthroscopy or by fluoroscopy. ⋯ In future, we hope it will prove possible to transfer the image data back into the navigation system after they have been merged. At present this is only possible with CT and MRI images. A comparative clinical trial is needed to find to what extent the success rate is improved over that achieved with conventional techniques.