Zeitschrift für Orthopädie und ihre Grenzgebiete
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Z Orthop Ihre Grenzgeb · Jul 2003
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial Controlled Clinical Trial[Randomised trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain - range of motion analysis].
The aim of this study was to compare the effects of acupuncture on active motion of the cervical spine in patients with chronic neck pain with those of "sham" laser acupuncture and massage. ⋯ The results of the study indicate that acupuncture is superior to conventional massage for improving active range of motion in patients with chronic neck pain. Because of its positive effects, its acceptance among patients and the lack of severe side effects, acupuncture can be recommended for the treatment of chronic neck pain, although there was no significant difference in results between "sham" laser acupuncture and acupuncture.
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Z Orthop Ihre Grenzgeb · Jul 2003
Multicenter Study Comparative Study[Suggestions for implementation of DRG in the fields of Orthopaedics and Trauma Surgery for 2004].
The Implementation of a DRG-Variant in Germany - voluntarily since January 1 st, 2003 and obligatory from January 1 st, 2004 - has been leading to uncertainty, particularly in the hospitals, due to fears that currently practised German diagnostic and therapeutic measures will not be financed properly by a DRG-Variant. The G-DRG-Version 1.0 that was drawn up in connection with an executive order law is to a large degree identical to the Australian AR-DRG-Version 4.1. Adjustments to German requirements were made only marginally. Therefore it is necessary for every medical field to investigate by stock-taking to what extent currently practised German diagnostic and therapeutic measures are considered in the G-DRG-Version 1.0 and whether and where modifications and adaptations need to be made. In order to make qualified statements scientific evaluations of possible problems have to be made based German data. Therefore an evaluation was made of the mapping of the medical fields of orthopaedics and trauma surgery. The German Society of Trauma Surgery (DGU), the German Society of Orthopaedy and Orthopaedic Surgery (DGOOC) in cooperation with the DRG-Research-Group of the University Hospital Muenster, the German Hospital Federation (DKG) and the German Medical Association carried out a DRG evaluation project in order to investigate the medical and economical homogeneity of the case groups. ⋯ The results of the DRG-Evaluation Project demonstrate the problems of mapping the very heterogenous and complex medical performances of orthopaedy and trauma surgery to a flat rate financing system that is not adapted properly to German conditions. The G-DRG-Variant Version 1.0 does not offer the sufficient possibilities of differentiation that are needed to map the various orthopaedical and trauma surgical measures in Germany.
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Z Orthop Ihre Grenzgeb · Jul 2003
Comparative Study Clinical Trial Controlled Clinical Trial[Complications after harvesting of autologous bone from the ventral and dorsal iliac crest - a prospective, controlled study].
In a prospective, controlled study, donor site morbidity after bone graft harvesting from the anterior and posterior iliac crest was documented. ⋯ Bone graft harvesting from the posterior iliac crest should be preferred over harvesting from the anterior iliac crest beeause of the substantially reduced donor site morbidity. Harvesting from the ventral iliac crest should have a clear indication, synthetic bone substitutes should be taken into consideration.
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Z Orthop Ihre Grenzgeb · Jul 2003
Comparative Study[Evidence-based medicine in orthopaedics - a sensible or unnecessary addition to clinical routine? Part 2: the therapy tool].
In the second part of our project to implement evidence-based medicine into day-to-day clinical practice the module therapy is presented. ⋯ In conclusion we can show, that EBM can help to solve day-to-day clinical problems, because the structured analysis concerning valid answers to concrete clinical problems is possible.
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Z Orthop Ihre Grenzgeb · Jul 2003
Comparative Study[Evidence-based medicine in orthopedics - a sensible or unnecessary addition to clinical routine? Part 1: the diagnostics tool].
The methods of evidence based medicine (EBM) are recommended to solve problems in day-to-day routine. Aim of this article is to demonstrate the practicability of this procedure for the diagnostic module. ⋯ In conclusion we show that EBM can help to solve day-to-day clinical problems, because the structured analysis of concrete questions can lead to a validation of the literature.