Der Unfallchirurg
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Shaft fractures of the tibia and fibula mainly affect younger patients and are therefore of great socioeconomic importance. Due to the high proportion of high-energy direct trauma mechanisms and the thin soft tissue covering layer of the ventromedian tibia, open factures occur in up to 39%. A structured diagnostic and therapeutic approach is essential for successful treatment. ⋯ Furthermore, the indications and the application of minimally invasive plate osteosynthesis (MIPO) and external fixators are described. Every trauma surgeon should be familiar with the etiology and the surgical treatment of compartment syndrome. A firm knowledge of the classifications of open and closed soft tissue injury is mandatory.
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The global rise of conflicts and catastrophes causes new challenges for western healthcare systems. There are obvious parallels between civilian disaster medicine and military combat care. The integration of disaster and deployment medicine into the medical curriculum thus seems necessary. ⋯ The medical students questioned considered disaster and deployment medicine to be an integral part of the curriculum. Despite some statistical differences between the two groups, the survey showed that medical students possess a great interest in disaster medicine. Both groups were in favor of further integrating e‑learning tools. A regular inclusion of disaster and deployment medicine into the spectrum of medical student teaching is warranted.
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Case Reports
[Application of transarticular C1/2 screws connected with C1 lateral mass screws in a rod-screw system].
Fractures of the second cervical vertebra with involvement of the odontoid process can mostly be treated conservatively by immobilization. In the case of high-grade unstable fractures and pseudarthrosis dorsal C1/2 spondylodesis should be considered. ⋯ During a follow-up of 36 months there was no screw loosening or dislocation. The presented alternative technique of dorsal C1/2 spondylodesis is a safe and effective method for stabilizing the atlantoaxial movement segment in cases of posttraumatic instability.
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The main injury mechanism of rare pelvic girdle injuries in children is high-energy trauma with a high rate of accompanying injuries and a mortality up to 6%. Anatomical features often result in complex pelvic trauma. Emergency treatment is based on established standards in adults. ⋯ Most acetabular injuries can be treated conservatively. Considerable displacement or additional intra-articular injuries necessitate open reduction and internal fixation. Frequent follow-up examinations up to the end of the growth phase avoid posttraumatic acetabular dysplasia being overlooked.