Der Unfallchirurg
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The interdisciplinary care of severely injured patients is staff and resource intensive. Since the introduction of the G‑DRG system in Germany in 2003, most studies have identified a financial deficit in the care of severely injured patients. The aim of this study was to analyze the effects of the new aG-DRG system introduced in 2020 on cost recovery in the treatment of severely injured patients. For the first time, the costs for organization, certification and documentation as well as the costs for non-seriously injured shock room patients were included. ⋯ Polytrauma care under the aG-DRG 2020 is in deficit. Overall, in 2020 a deficit of 5858 € per severely injured patient resulted.
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Femoral head fractures a very rare emergency situation and occur in 4-17% of hip joint dislocations. Of femoral head dislocation fractures 3.7% occur in combination with acetabular fractures. Reduction of the dislocation should be immediately performed. ⋯ The follow-up treatment is carried out with 6 weeks of floor contact and pharmaceutical ossification prophylaxis. The danger of secondary femoral head necrosis needs to be considered at all times. In patients aged > 65 years a primary endoprosthetic joint replacement is indicated.