Der Unfallchirurg
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With the regulation of the Saxon State Government and the Saxon State Ministry for Social Affairs and Social Responsibility on the modification of the Infection Protection Act of March 2020 coming into force, a video-based outpatient consultation was implemented to maintain patient care. In order to allow communication with minimized contact, this was continued after the lockdown. ⋯ In 40% of the patients a definite decision could be made by the initial video-based consultation alone. On the other hand, 47% of the patients needed in-person follow-up for a clinical examination. Thus, video consultation is a very useful measure to manage patient volume and visibly support direct doctor-patient contact.
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Surgical stabilization of high-energy sacral avulsion fractures with spinopelvic dissociation places high demands on the surgeon. The goal is to achieve maximum stability while minimizing invasiveness. The present case of a dislocated U‑type fracture in a 25-year-old motocross rider exemplifies how a reduction with the targeted application of closed reduction techniques through hyperextension of the hip joints and lordosis in the lumbosacral hinge and through a standardized procedure in intraoperative fluoroscopic imaging, a minimally invasive stabilization by means of transsacral screw fixation and spinopelvic fixation of lumbar vertebra 5 to the ilium in the sense of a bilateral triangular stabilization is possible without compromising the achieved stability of the osteosynthesis. The limitations of the described approach are also pointed out.
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Measures such as restrictions on personal contact and going out were taken to reduce SARS-CoV‑2 infection numbers, ultimately resulting in the first lockdown. This was intended to create capacity in the healthcare system to manage the pandemic. ⋯ There was a 31% decrease in work and commuting accidents. This contributed to resource reallocation in the context of the pandemic. Nevertheless, almost constant numbers of severely injured patients and accidental deaths occurred, which shows the relevance of trauma surgery structures especially in times of crisis and makes it indispensable to include them in the calculation of intensive care resources.
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Successful treatment of complex regional pain syndrome (CRPS) depends mainly on an early diagnosis and an adequate treatment concept with active participation of the patient. ⋯ Good patient education regarding the clinical picture and course of the disease form the basis for the treatment of CRPS. The patient should always be considered holistically and treated correspondingly by a multiprofessional team. Active involvement of the patient in the treatment from the beginning is always essential.