Der Unfallchirurg
-
42 patients with complete acromioclavicular dislocation treated operatively and 38 patients managed non-operatively were examined retrospectively with a mean follow-up of 6.3 +/- 2.5 years. The dislocations in both groups included type III and type V injuries according to the Rockwood-classification. The operative technique was suturing of the tom ligaments and stabilization of the acromioclavicular joint using resorbable coracoclavicular PDS-banding. ⋯ Posttraumatic osteoarthritis developed mainly in those patients whose acromioclavicular joint healed in partial dislocation. Non-operative treatment was equal even in less severe dislocations in the subgroup of type Rockwood V injuries. The persisting deformity which must be expected in non-operative treatment did not affect the patient's outcome regarding pain, function and strength of the shoulder.
-
Clinical Trial
[Morbidity and mortality in para-articular femoral fractures in advanced age. Results of a prospective study].
This study was designed to determine risk factors and individual dispositions associated with morbidity and mortality in the operative treatment of hip fractures in elderly patients. ⋯ During the preoperative course high risk patients should be identified according to the data presented above in order to take all measures necessary in critical care during the perioperative period. Furthermore, the results underline the importance of an early operative treatment within a posttraumatic period of 12-24 hours. Concerning the method of fracture stabilization procedures allowing a primary full loading should be favoured with regard to early rehabilitation.
-
Dupuytren's disease is the "classical" hand illness of the north: it affects people of Celtic or Viking descent throughout the whole of northern Europe, whereas it is an unknown disease in the Mediterranean region. Dupuytren's contracture appears to be an extremity-related disease. Owing to the unclear etiology and a lack of up-to-date demographic data for northern Germany this study aims--together with the literature--to elucidate the role of associated illnesses in an attempt to discover pathogenic explanations. 566 patients suffering from Dupuytren's disease in the area around Hanover were analysed with respect to epidemiological features and their Tubiana contracture stage. 91.2% were of pure northern German stock, 12.5% had a family predisposition. ⋯ Drinkers, smokers and heavy manual workers present a more severe affliction, while diabetics suffer from a significantly less severe form. Although the ulnar type dominates, the radial type accounts for 14.4% of cases. 1.9 million Germans are chronically ill because of Dupuytren's disease. Despite a trauma history, Dupuytren's disease is not recognized as an occupational disease.
-
Review Comparative Study
[Multiple trauma with craniocerebral trauma. Early definitive surgical management of long bone fractures?].
Head injuries are found in 17.6% of all trauma in-patients and are the most common cause of death after injury (26.6%) in Germany. Main factors for the initial and follow up assessment are the Glasgow Coma Scale (GCS) and pupil reaction. These are of a very predictive value for the outcome and are essential for the emergency crew to choose the adequat trauma hospital. ⋯ Their difference determines the cerebral perfusion pressure which should be 60 mmHg at least. Intracranial pressure rates below 20 mmHg are favourable. Optimal management within the first days is essential for good outcome.
-
Comparative Study
[Predicting the outcome in severe injuries: an analysis of 2069 patients from the trauma register of the German Society of Traumatology (DGU)].
On hospital admission numerous variables are documented from multiple trauma patients. The value of these variables to predict outcome are discussed controversially. The aim was the ability to initially determine the probability of death of multiple trauma patients. Thus, a multivariate probability model was developed based on data obtained from the trauma registry of the Deutsche Gesellschaft für Unfallchirurgie (DGU). ⋯ These data show that the age, GCS, ISS, base excess and prothrombin time are potentially important predictors to initially identify multiple trauma patients with a high risk of lethality. With the base excess and prothrombin time value, as only variables of this multifactorial model that can be therapeutically influenced, it might be possible to better guide early and aggressive therapy.