Der Unfallchirurg
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Malnutrition in geriatric trauma patients is associated with an increased risk of complications and mortality and is therefore a key risk factor. The assessment of the affected patients plays an important role in improving the outcome of this growing patient group. ⋯ The establishment of suitable and time-effective screening instruments and their implementation are still a challenge.
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Review
[The diagnosis and management of medial tibial stress syndrome : An evidence update-German version].
Medial tibial stress syndrome is a common overuse injury in jumping and running athletes. It is defined as exercise-induced pain along the distal posteromedial border of the tibia and the presence of recognisable pain on palpation over a length of 5 or more centimetres. This overview article provides an evidence update on the diagnosis and management of athletes with medial tibial stress syndrome.
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This article presents the case of a 53-year-old male patient born in Sri Lanka, who presented to the outpatient unit with the suspicion of empyema of the knee joint. Within the framework of knee arthroscopy, the diagnosis of ochronosis was made and later confirmed by histopathological biopsy. The alkaptonuria is caused by a homogentisate 1,2-dioxygenase deficiency and leads to an accumulation of homogentisic acid, a degradation product of tyrosine. This leads to the characteristic appearance of ochronosis with bluish-black deposits in the tissue (e.g. in connective tissue, sclera and ear cartilage) and a black coloration of the urine.
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The 3D image enhancer-adjusted percutaneous triangular stabilization of geriatric pelvic ring fractures avoids implant-associated perioperative complications. Displaced fractures of the posterior pelvic ring require stable instrumentation to enable solid bony fusion in a balanced alignment and to control the risk of neurological and vascular damage. This is mandatory in high-energy injuries in young patients and especially in low-energy injuries of geriatric patients. ⋯ After percutaneous insertion of the guide wires into the L4 vertebral body, the iliac bone and transiliosacrally under 2D X‑ray control, the correct wire position is verified by the 3D scan. Then, screws are inserted and the instrumentation is completed in a standard fashion. Using this technique implant-associated perioperative complications, such as nerve and vascular damage due to screw misplacement can be reduced.