Der Unfallchirurg
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The future progressive aspiration of evidence-based medicine makes it necessary to carry out a comprehensive documentation of functional treatment after trauma surgery. Especially the subjective, patient-centered satisfaction with treatment results will be the focus of attention. ⋯ Additionally, modern technical options have the potential to evaluate specific joint function even better. Parameters, such as range of motion can soon be measured by the patient using the widely spread smartphone technology.
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The routine use of patient reported outcome measurements (PROMs) can support the orientation of healthcare systems towards the value and usefulness for patients. The collation of patient reported experience measurements (PREMs) is suitable for bringing transparency to the patient orientation of healthcare processes and the experience gained. ⋯ By means of newly developed patient surveys per medical service area, they will be used as additional sources for the legally binding quality assurance. Although this gives more weight to the evaluation of the quality of treatment by patients, special features must be taken into account in the development and implementation for orthopedics and trauma surgery in order to avoid misinterpretation of the results and subsequent misguidance in the healthcare system.
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Patient reported outcome measures (PROM) are considered a good method of measuring the results of treatment outcomes with the aim of improving the functional, cognitive and mental state of patients and the quality of life during and after treatment. The publication of these results serves the patient's interest in finding the best provider for a treatment. The existing interest of many service providers for the integration of electronic PROM into everyday clinical practice is often faced by barriers due to financial, personnel and technical factors. This must be eliminated in the interest of patient information in order to facilitate the rapid introduction of this patient-centered treatment outcome measurement into as many hospitals and specialist departments as possible.
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Geriatric trauma centers which are certified to the status of a Geriatic Trauma Center DGU® based on the criteria catalogue as outlined by the German Trauma Society (DGU), are required to participate in the Geriatric Trauma Register (ATR-DGU) for quality management and outcome analyses. The evaluation is pseudoanonymous and includes data on all treated hip fracture patients over 70 years old. This has been in regular use since 2016. This study analyzed the postoperative evaluation of gait, mortality, quality of life, hospital readmission and treatment of osteoporosis after 120 days. ⋯ Despite the clear advantages of interdisciplinary treatment, the results are still limited concerning mobilization and quality of life. Further analysis of causative and influencing factors is necessary.
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A 50-year-old male suffered a crash landing while paragliding and sustained a posterior dislocation of the hip with a Pipkin fracture type 4 (fracture of the posterior acetabular wall and Pipkin fracture type 2) and a lesion of the sciatic nerve. After primary treatment in an external hospital, the patient was transferred to this hospital 4 days following the trauma. ⋯ Following fixation of the Pipkin fragment an autologous bone graft harvested from the intertrochanteric region was used to fill the defect. Subsequently, a collagen matrix was applied onto the filled defect and a perineural adaptation of the sciatic nerve was performed.