Der Unfallchirurg
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In its digital agenda the German Federal Government pursues the ambitious objective to facilitate digital competence and perform research into digital learning and teaching processes. Considerable investments are to be concentrated into the future viability of education, academic research and digitalization. As far as academic teaching and further education are concerned, not only in the field of orthopedics and trauma surgery, three aspects can be identified: digital organization, digital competence and digital tools. ⋯ If orthopedic and trauma surgeons take an active role in the process of digitalization of teaching, they can take part in decisions, adequately prepare the colleagues of tomorrow, optimize patient care, encourage innovations and altogether improve the discipline even more.
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In addition to the advantages for patients and physicians, the progression of digitalization will also have economic implications for healthcare systems in toto worldwide. The integration of digital innovations enables healthcare institutions to transform their current activities and processes and to create a new form of patient care. ⋯ Economic redistribution due to digitalization of medicine will become increasingly apparent in the future. Ethical considerations as well as data protection will be important topics. At the same time investments and digital innovations must be sponsored by the government and industry. Scientific studies are necessary to secure the evidence of new methods for practice in orthopedics and trauma surgery.
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Separation of the pubic symphysis with corresponding diastasis can be stabilized by symphyseal plating. ⋯ These observations suggest that radiological signs of implant loosening are commonly observed but rarely the reason for revision surgery. Complete implant failures, however; occur mainly within the first postoperative weeks and require early revision. A timely clarification by additional X-ray imaging should be carried out if this is suspected.
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This article reports on the case of a rare combination injury of a C3 pelvic ring fracture (Malgaigne's fracture) and simultaneous unstable traumatic spondylolisthesis (Meyerding grade 2) of the lumbosacral spine. The patient had pronounced neurological deficits of the lower extremities and tearing of the thecal sac. The selected primary and secondary surgical treatment algorithm of the polytraumatized patient as well as the course are described and critically discussed on the basis of the sparsely available literature.